Diploma of the Faculty of Dental Surgery (MFDS) Professionalism, Ethics, Law and Practice Governance Syllabus

Professionalism, Ethics, Law and Practice Governance syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Professionalism, Ethics, Law and Practice Governance in Diploma of the Faculty of Dental Surgery (MFDS), not a summary of it.

1. 1

   Professionalism and Ethics

   5 topics

   • GDC Standards for the Dental Team
     • Putting patients' interests first and honesty
   • Ethical principles in clinical practice
     • Autonomy, beneficence, non-maleficence and justice
   • Confidentiality and data protection
     • GDPR and Caldicott principles
   • Maintaining professional boundaries and conduct
   • Probity in dental research and practice
2. 2

   Consent, Law and Medico-legal Issues

   5 topics

   • Valid consent and Montgomery ruling
   • Record keeping and documentation
   • Complaints handling and duty of candour
   • Negligence, liability and indemnity
   • Capacity and consent in children (Gillick competence)
3. 3

   Clinical Governance and Quality Improvement

   5 topics

   • Audit and the audit cycle
     • Setting standards and re-audit
   • Significant event analysis
     • Learning from incidents and near misses
   • Risk management and patient safety
   • Clinical effectiveness and CPD
     • Enhanced CPD and reflective practice
   • Raising concerns and whistleblowing
4. 4

   Infection Prevention and Practice Safety

   5 topics

   • Decontamination and sterilisation
     • HTM 01-05 requirements
   • Standard infection control precautions
     • PPE, hand hygiene and sharps management
   • Cross-infection control and waste management
   • Radiation protection and IRMER
     • Justification, optimisation and dose limitation
   • Health and safety legislation in the dental workplace
5. 5

   Teaching, Leadership and Personal Development

   5 topics

   • Principles of teaching and learning
   • Giving and receiving feedback
   • Leadership and teamworking in dentistry
   • Career development and portfolio building
     • Workplace-based assessments and ePortfolio
   • Self-care, resilience and wellbeing

Professionalism, Ethics, Law and Practice Governance flashcards for Diploma of the Faculty of Dental Surgery (MFDS)

22 of 81 cards from the Professionalism, Ethics, Law and Practice Governance deck — real questions with worked answers.

1. What are the four sections (domains) into which the GDC's 'Standards for the Dental Team' nine principles are grouped, and how many principles are there in total?

   There are nine principles. They map to four GDC priorities: put patients' interests first; communicate effectively; provide good quality care based on current evidence; and maintain trust. The nine principles cover: (1) put patients' interests first, (2) communicate effectively, (3) obtain valid consent, (4) maintain and protect patients' information, (5) have a clear and effective complaints procedure, (6) work with colleagues in a way that serves patients' interests, (7) maintain, develop and work within your professional knowledge and skills, (8) raise concerns if patients are at risk, (9) make sure your personal behaviour maintains patients' confidence in you and the profession.

2. List the four classical principles of biomedical ethics (Beauchamp and Childress) used in clinical dental practice.

   Autonomy (respecting the patient's right to self-determination), Beneficence (acting in the patient's best interest), Non-maleficence (do no harm / 'primum non nocere'), and Justice (fairness in distribution of resources and treatment).

3. Define the ethical principle of 'autonomy' and give one practical way it is respected in dentistry.

   Autonomy is respect for a patient's right to make their own informed decisions about their care, free from coercion. It is respected practically by obtaining valid informed consent and offering all reasonable treatment options including the option of no treatment.

4. What is the legal basis for confidentiality of patient information in the UK, and name one statutory framework governing it.

   Confidentiality arises from common law (the duty of confidence), professional GDC standards, and statute. The key statutory frameworks are the UK GDPR and the Data Protection Act 2018, supplemented by the common law duty of confidentiality and the Caldicott principles.

5. State the lawful bases under UK GDPR most commonly relied upon for processing patient health (special category) data in dentistry.

   For personal data: typically 'legitimate interests' or 'legal obligation' or 'public task'. For special category (health) data an additional Article 9 condition is needed, most commonly 'provision of health or social care or treatment' (Article 9(2)(h)). Explicit consent is another Article 9 basis but is not usually relied upon for direct care.

6. List four of the Caldicott principles governing the use of confidential patient information.

   Examples include: (1) justify the purpose for using confidential information; (2) use it only when absolutely necessary; (3) use the minimum necessary; (4) access on a strict need-to-know basis; (5) everyone must be aware of their responsibilities; (6) comply with the law; (7) the duty to share information for individual care is as important as the duty to protect confidentiality; (8) inform patients about how their data is used.

7. Give three circumstances in which a dentist may lawfully disclose confidential patient information without consent.

   When required by law/statute (e.g. notifiable diseases), by order of a court, or in the public interest (e.g. to prevent serious harm to the patient or others, such as risk to life). Disclosure to other health professionals involved in the patient's direct care is also permitted on a need-to-know basis.

8. What is meant by maintaining 'professional boundaries' with patients, and give an example of a boundary violation.

   Professional boundaries are the limits that protect the professional, trust-based relationship between clinician and patient. A violation includes pursuing a personal or sexual relationship with a current patient, accepting inappropriate gifts, or treating close family/friends where objectivity is compromised.

9. Define 'probity' as it applies to dental research and practice.

   Probity means honesty, integrity and truthfulness in all professional dealings. In practice it includes accurate record keeping, honest billing and claims (e.g. to the NHS), truthful advertising, declaring conflicts of interest, and not falsifying research data.

10. Name two forms of research misconduct that breach probity.

    Fabrication (inventing data), falsification (manipulating or altering data/results), and plagiarism (using others' work without attribution). Failure to obtain ethical approval or proper consent for research is also misconduct.

11. What are the three core elements required for consent to be legally valid?

    Consent must be: (1) given voluntarily (without coercion or undue influence); (2) given by a person with capacity to consent; and (3) informed (the patient understands the nature, purpose, material risks, benefits and reasonable alternatives of the proposed treatment).

12. Summarise the significance of the Montgomery v Lanarkshire Health Board (2015) ruling for consent.

    Montgomery established that doctors/dentists must disclose all 'material risks'. A risk is material if a reasonable person in the patient's position would attach significance to it, or if the clinician is or should be aware that this particular patient would attach significance to it. It shifted the test of disclosure from the doctor-centred Bolam standard to a patient-centred standard.

13. Before Montgomery, what legal test (case) was used to judge the adequacy of information disclosure for consent, and why was it superseded?

    The Bolam test (Bolam v Friern, 1957) judged disclosure by what a responsible body of medical opinion would do (doctor-centred). It was superseded for consent because Montgomery requires a patient-centred standard based on what risks the individual patient would consider material.

14. List four pieces of information that should be documented in a dental record to demonstrate valid consent was obtained.

    The diagnosis and proposed treatment; the risks, benefits and prognosis discussed; the alternatives discussed (including no treatment); confirmation the patient had opportunity to ask questions; costs; and that the patient agreed. Ideally the specific material risks and any patient concerns are noted.

15. State four features of good clinical dental record keeping.

    Records should be: contemporaneous (made at the time), accurate and legible, complete (history, examination, diagnosis, treatment plan, consent, treatment provided, advice given), dated and signed/attributable, and free from unjustified alteration. Any amendment should be dated and the original remain visible.

16. Why is contemporaneous documentation legally important in dentistry?

    Because records made at the time of the event are far more credible as evidence in complaints, GDC fitness-to-practise cases and litigation. The legal adage applies: 'if it wasn't written down, it didn't happen.' Retrospective or altered notes carry little evidential weight and raise probity concerns.

17. What is the statutory 'duty of candour', and when is it triggered?

    The duty of candour is the legal and professional obligation to be open and honest with patients when something goes wrong with their care that causes (or could cause) harm. The statutory duty (CQC regulation 20) is triggered by a 'notifiable safety incident' causing moderate harm, severe harm, prolonged psychological harm or death. The professional duty (GDC) applies to all degrees of harm.

18. List the key steps required when fulfilling the duty of candour after a patient safety incident.

    (1) Tell the patient (or representative) that the incident has happened; (2) apologise; (3) offer an appropriate remedy or support; (4) explain fully the short- and long-term effects; and (5) follow up in writing. An apology is not an admission of legal liability.

19. Outline the recommended stages of handling a patient complaint in a dental practice.

    Acknowledge the complaint promptly (within ~3 working days), investigate it thoroughly and fairly, respond within the agreed timescale explaining findings and any action taken, apologise where appropriate, and inform the complainant of further options (e.g. ombudsman, Dental Complaints Service for private care, or NHS England for NHS care).

20. What are the three elements a claimant must prove to succeed in a clinical negligence claim?

    (1) A duty of care was owed to the patient; (2) there was a breach of that duty (the standard of care fell below that of a reasonably competent practitioner — the Bolam/Bolitho test); and (3) the breach caused the harm (causation) and resulted in foreseeable damage/loss.

21. Explain the 'Bolam' and 'Bolitho' tests in the context of negligence.

    Bolam (1957): a clinician is not negligent if their actions are supported by a responsible body of skilled professional opinion. Bolitho (1997) qualified this: the body of opinion must also be capable of withstanding logical analysis (it must be reasonable/logical), so courts can reject a practice that is illogical.

22. Distinguish between the roles of dental indemnity and the purpose of indemnity cover.

    Indemnity (via a defence organisation or insurance) provides professional protection and financial cover for claims of clinical negligence, plus support for GDC investigations and complaints. Holding adequate and appropriate indemnity is a legal requirement (Health Care and Associated Professions Order / GDC registration condition) for all practising dentists.

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