MJDF Law Ethics and Professionalism — Questions and Answers
Question 1: According to the GDC's Standards for the Dental Team, what are the nine principles that dental professionals must uphold?
- There are only three principles: do no harm, maintain confidentiality, and keep records
- The nine principles include: put patients' interests first, communicate effectively, obtain valid consent, maintain and protect patients' information, have a clear and effective complaints procedure, work with colleagues in a way that is in patients' best interests, maintain and develop your knowledge and skills, raise concerns if patients are at risk, and make sure your personal behaviour maintains patients' confidence in you and the dental profession (Correct answer)
- The GDC has no published standards for dental professionals
- There is only one principle: always follow the dentist's instructions
Correct answer: The nine principles include: put patients' interests first, communicate effectively, obtain valid consent, maintain and protect patients' information, have a clear and effective complaints procedure, work with colleagues in a way that is in patients' best interests, maintain and develop your knowledge and skills, raise concerns if patients are at risk, and make sure your personal behaviour maintains patients' confidence in you and the dental profession
The GDC's 'Standards for the Dental Team' (2013, updated) sets out nine principles that all registrants must follow. These principles are the basis of fitness to practise proceedings and guide ethical decision-making. They apply equally to all dental professionals (dentists, dental nurses, hygienists, therapists, technicians, orthodontic therapists, and clinical dental technicians). Breach of these standards may result in fitness to practise action including conditions, suspension, or erasure from the register.
Question 2: What constitutes 'valid consent' for dental treatment under UK law, and what are the requirements?
- A signed consent form is all that is required
- Valid consent requires that the patient has capacity to make the decision, has been given sufficient information about the treatment (including risks, benefits, alternatives, and the option of no treatment), is acting voluntarily without coercion, and the consent is given before treatment begins; consent is a process, not just a form (Correct answer)
- Consent is only needed for surgical procedures under general anaesthesia
- Verbal consent is never acceptable — written consent is always required
Correct answer: Valid consent requires that the patient has capacity to make the decision, has been given sufficient information about the treatment (including risks, benefits, alternatives, and the option of no treatment), is acting voluntarily without coercion, and the consent is given before treatment begins; consent is a process, not just a form
Valid consent under UK law (reinforced by Montgomery v Lanarkshire 2015) requires three elements: capacity (the patient can understand, retain, weigh up, and communicate their decision — assessed under the Mental Capacity Act 2005), information (the patient must be told about material risks — those that a reasonable person in the patient's position would consider significant, benefits, alternatives, and consequences of no treatment), and voluntariness (the decision is made freely without undue influence). Consent is an ongoing process, not a one-off event. A signed form is evidence of consent but is not consent itself. Verbal consent is valid for routine procedures but should be documented in clinical notes.
Question 3: Under the Mental Capacity Act 2005, what principles govern the treatment of a patient who lacks capacity to consent to dental treatment?
- If a patient lacks capacity, the dentist can do whatever they consider appropriate without restriction
- The Act establishes five principles: presume capacity, support decision-making, respect unwise decisions, act in the patient's best interests, and use the least restrictive option; treatment must be in the patient's best interests, considering their past and present wishes, beliefs, values, and the views of those close to them (Correct answer)
- Patients who lack capacity cannot receive any dental treatment
- A family member can always consent on behalf of an adult patient who lacks capacity
Correct answer: The Act establishes five principles: presume capacity, support decision-making, respect unwise decisions, act in the patient's best interests, and use the least restrictive option; treatment must be in the patient's best interests, considering their past and present wishes, beliefs, values, and the views of those close to them
The Mental Capacity Act 2005 (England and Wales) provides the framework: (1) A person is presumed to have capacity unless established otherwise; (2) All practicable steps must be taken to help them make their own decision; (3) An unwise decision does not mean a person lacks capacity; (4) Decisions made on behalf of a person who lacks capacity must be in their best interests; (5) The least restrictive option must be chosen. Best interests assessment considers the patient's past wishes, beliefs, values, and the views of carers, family, and any lasting power of attorney or court-appointed deputy. Note: in the UK, no other adult can give or withhold consent on behalf of an adult patient — the clinician decides in the patient's best interests.
Question 4: What are the dental professional's obligations regarding patient confidentiality under the Data Protection Act 2018 (UK GDPR)?
- Patient information can be shared freely with anyone who asks
- Patient information must be processed lawfully, kept secure, shared only with consent or when legally required (e.g., safeguarding, court order, public interest), kept for no longer than necessary, and patients have rights to access, correct, and request deletion of their data; the dental practice must have a data protection policy, appoint a data controller, and report breaches to the ICO within 72 hours (Correct answer)
- Confidentiality obligations end when the patient leaves the practice
- Digital records are exempt from data protection regulations
Correct answer: Patient information must be processed lawfully, kept secure, shared only with consent or when legally required (e.g., safeguarding, court order, public interest), kept for no longer than necessary, and patients have rights to access, correct, and request deletion of their data; the dental practice must have a data protection policy, appoint a data controller, and report breaches to the ICO within 72 hours
Under the Data Protection Act 2018 (incorporating UK GDPR), dental practices must process patient data lawfully, fairly, and transparently. The six lawful bases for processing include consent and legitimate interests. Health data is a 'special category' requiring additional safeguards. Confidentiality may be breached without consent only when: legally required (court order, notifiable diseases), necessary for safeguarding (child protection, vulnerable adults), in the public interest (serious crime, fitness to drive), or required by regulators (GDC, CQC). Patients have rights under GDPR including access to records (Subject Access Request), correction, and portability. Data breaches must be reported to the Information Commissioner's Office (ICO) within 72 hours if they pose a risk to individuals.
Question 5: What is the Gillick competency test and how does it apply to dental treatment of children under 16?
- Children under 16 can never consent to or refuse dental treatment
- Gillick competency (from Gillick v West Norfolk 1986) allows children under 16 to consent to treatment if they demonstrate sufficient maturity and understanding to fully comprehend what is proposed; however, a Gillick-competent child's refusal of treatment can be overridden by a parent or the court if treatment is in the child's best interests (Correct answer)
- Gillick competency only applies to contraceptive advice, not dental treatment
- All children over 12 are automatically Gillick competent
Correct answer: Gillick competency (from Gillick v West Norfolk 1986) allows children under 16 to consent to treatment if they demonstrate sufficient maturity and understanding to fully comprehend what is proposed; however, a Gillick-competent child's refusal of treatment can be overridden by a parent or the court if treatment is in the child's best interests
Gillick competency (established in Gillick v West Norfolk and Wisbech AHA [1986]) recognises that children under 16 can consent to treatment if they have sufficient understanding and intelligence to fully comprehend the proposed treatment, its risks, and alternatives. The assessment is treatment-specific (a child may be competent for one procedure but not another). Important asymmetry: a Gillick-competent child can consent to treatment but their refusal can be overridden by a parent or the court acting in the child's best interests. For children aged 16-17, the Family Law Reform Act 1969 gives statutory right to consent (same as adults), but refusal can still be overridden. At 18, full adult autonomy applies.
Question 6: What are the GDC's requirements for continuing professional development (CPD) under the Enhanced CPD scheme (from 2018)?
- No CPD is required after initial qualification
- All GDC registrants must complete a minimum of 100 hours (dentists) or 50 hours (dental care professionals) of verifiable CPD over each 5-year cycle, including mandatory topics (medical emergencies, disinfection and decontamination, radiography and radiation protection, safeguarding, and complaints handling), with a personal development plan and reflection documented (Correct answer)
- CPD is voluntary and has no mandatory topics
- Only 10 hours of CPD per year is required with no specific topic requirements
Correct answer: All GDC registrants must complete a minimum of 100 hours (dentists) or 50 hours (dental care professionals) of verifiable CPD over each 5-year cycle, including mandatory topics (medical emergencies, disinfection and decontamination, radiography and radiation protection, safeguarding, and complaints handling), with a personal development plan and reflection documented
The Enhanced CPD scheme (introduced 1 January 2018) requires: Dentists — minimum 100 hours per 5-year cycle (at least 10 hours per year); DCPs — minimum 50 hours per 5-year cycle (at least 10 hours per year). Mandatory topics (recommended hours vary) include: medical emergencies (10 hours), disinfection and decontamination (5 hours), radiography and radiation protection (5 hours), safeguarding children and vulnerable adults (updated regularly), and complaints handling (as appropriate). Requirements include: a personal development plan (PDP), documented reflection on CPD activities, and a CPD log maintained on the GDC's online system. Non-compliance may result in removal from the register.
MJDF Law Ethics and Professionalism
According to the GDC's Standards for the Dental Team, what are the nine principles that dental professionals must uphold?