Ethical aspects of dental care for demented patients. Methodological considerations.
Management of demented patients who forcefully refuse dental treatment may cause ethical dilemmas and arouse feelings of frustration and anxiety in the dentist. The aim of this study is to develop and evaluate an appropriate method for analysing ethical problems in dentistry for demented patients. A taperecorded transcribed semistructured interview was performed with four experienced and competent hospital dentists. A phenomenological-hermeneutic method was used in the analysis of the narratives and the structured parts of the interviews compared with the interpretation of the narratives to focus on each interview as a whole. The dentists' professional task in dentistry for severely demented patients are both treating and caring. They have to make the treatment decision and also perform the treatment task. This may contribute to the results of this study that hospital dentists' concept in conflict situations are very vague. The results and tendencies of this study disclose a need for further knowledge about the handling of ethical conflicts in dental management of severely demented patients. With some modifications the narrative method and the analysis model used in this study are suitable in further studies.
Nordenram
G
G
Department of Geriatric Dentistry, School of Dentistry, Karolinska Institute, Huddinge, Sweden.
Norberg
A
A
Bischofberger
E
E
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease; D026686:Beneficence; D003661:Decision Support Techniques; D003730:Dental Care for Persons with Disabilities / Q000523:psychology*; D004990:Ethics, Dental; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D026706:Paternalism; D026684:Personal Autonomy; D016312:Treatment Refusal