Just Say “No”: Can Dentists Refuse Care on the Basis of Finances? A Survey Using an Ethical Vignette in an Iranian Dental School
Abstract Background: Many dental procedures seem to be too expensive for many people. Responding to the requests of patients for fee reduction could be considered a common ethical issue of dental practice. The aim of this study was to evaluate dental students and tutors’ ethical attitude towards fee reduction at dental offices. Method: Our study was a questionnaire-based survey, which examined the ethical attitudes of students and tutors of an Iranian Dental School. The questionnaire included a vignette about an ethical dilemma at a dental office. Different ethical approaches, i.e. duty-based, virtue-oriented and consequentialist arguments, for or against fee reduction at dental office were suggested. Respondents were asked to rank those ethical options. Data was entered and analyzed in SPSS 16.0. 121 dental students and 36 faculty members (dental specialists) participated in this study. Result: Our findings revealed that the majority of dental students and tutors (68%) are in favor of making a reduction when facing an imagined request at dental office, using either virtue-oriented (54%) or consequentialist (14%) arguments. The difference between rankings of four options was statistically significant, while no statistically significant difference exists neither between male and female respondents, nor students and tutors. Conclusion: This case study provides a basis for fruitful discussions in ethics courses for dental students. Our study suggests that financial issues should be considered as a part of ethical training in the dental students’ curriculum.