| Summary: | Increasing numbers of institutionalized elders have very poor oral health. It has been
suggested that ethical problems may influence dentists who attempt to provide oral care for these
people, but little attention has been given to formal research in this area. A qualitative interview
method was used to investigate the views and experiences of dentists working with institutionalized
elders. Particular attention was given to the ethical difficulties encountered and how the dentists
resolved them. Ten dentists experienced in long-term care were interviewed individually using openended
questions. Verbatim transcripts were prepared from these interviews, and the dentists were
interviewed again to validate a summary of their comments. An extensive thematic analysis
identified that the dentists struggled primarily with practical rather than ethical problems. The ethical
problems focused on the difficulty of identifying the wishes of patients or predicting the outcome of
treatment. The participants reported few difficulties making clinical decisions in this setting, and it
appeared that each participant had a consistent approach to resolving clinical problems. However,
analysis revealed that the ethical perspectives of the dentists varied substantially. Variation was
notable particularly in their preference for idealistic or realistic treatment and in their preference for
autonomy or beneficence. The participants appeared to believe that the professional training of
dentists promotes idealism and autonomy and that this may hinder decisions in a long-term care
setting. Overall, this suggests that dentists might be better able to care for institutionalized elders if
exposed to broader undergraduate instruction and experience in geriatric care. === Dentistry, Faculty of === Graduate
|
|---|
