MJDF Part 1 - Membership of Joint Dental Faculties Law, Ethics, and Professionalism Questions and Answers — Questions and Answers
Question 1: A 15-year-old patient attends your practice requesting tooth whitening. You assess them and determine they have the maturity and intelligence to fully understand the procedure, risks, and alternatives. However, their parents have explicitly forbidden the treatment. According to UK law and professional guidance, what is the most appropriate action?
- Refuse to provide the treatment as the patient is under 16 and lacks parental consent.
- Proceed with the treatment as the patient is 'Gillick competent' and their consent is valid. (Correct answer)
- Only proceed if you obtain a court order to override the parents' refusal.
- Advise the patient to wait until they are 16, when their consent automatically becomes valid.
Correct answer: Proceed with the treatment as the patient is 'Gillick competent' and their consent is valid.
In the UK, a child under 16 can consent to their own medical or dental treatment if they are deemed to have sufficient understanding and intelligence to comprehend the proposed treatment. This is known as being 'Gillick competent'. If a practitioner assesses a child as Gillick competent, that child's consent is valid and cannot be overruled by their parents. While encouraging discussion with parents is good practice, the competent child's decision is paramount. Waiting until 16 is incorrect advice, as Gillick competence can apply before this age.
Question 2: Which of the following is a core principle of the Mental Capacity Act 2005?
- A person must be assumed to have capacity unless it is established that they lack capacity. (Correct answer)
- An unwise or eccentric decision is, in itself, proof of a lack of capacity.
- Decisions for a person lacking capacity should prioritise the views of their next of kin.
- Capacity is a global assessment and once lost, it is lost for all decisions.
Correct answer: A person must be assumed to have capacity unless it is established that they lack capacity.
The Mental Capacity Act 2005 is built on five core principles. The first principle is that a person must be assumed to have capacity unless it is proven otherwise. Another key principle states that a person is not to be treated as unable to make a decision merely because they make an unwise one. Decisions must be made in the person's 'best interests', which involves considering their known wishes and consulting family, but the family's view is not the overriding factor. Capacity is also decision-specific and time-specific, not a global state.
Question 3: A dental nurse is concerned that a dentist in the practice consistently fails to obtain valid consent before starting complex procedures. According to the General Dental Council (GDC) 'Standards for the Dental Team', what is the nurse's primary professional duty?
- To discuss the matter only with other nurses to gather more evidence.
- To ignore the issue to avoid conflict and protect professional loyalties.
- To raise the concern, following local procedures first, as patients may be at risk. (Correct answer)
- To report the dentist directly to the GDC without any internal discussion.
Correct answer: To raise the concern, following local procedures first, as patients may be at risk.
GDC Standard 8, 'Raise concerns if patients are at risk', places a professional duty on all registrants to act when they believe patient safety is compromised. This duty overrides any personal or professional loyalties. The guidance advises raising concerns locally in the first instance (e.g., with the practice owner or manager). Reporting directly to the GDC is appropriate if local procedures fail or the concern is exceptionally severe. Ignoring the issue or only discussing it informally without taking action would be a breach of this professional duty.
Question 4: A patient makes a formal complaint in writing about the outcome of their NHS-funded crown preparation. According to the NHS complaints procedure in England, what is the recommended first step for the practice?
- Immediately refer the patient to the General Dental Council (GDC).
- Advise the patient that they must contact a solicitor to proceed.
- Acknowledge the complaint and handle it via the in-house local resolution process. (Correct answer)
- Forward the complaint directly to the Parliamentary and Health Service Ombudsman (PHSO).
Correct answer: Acknowledge the complaint and handle it via the in-house local resolution process.
Both NHS and private dental practices in the UK must have a formal complaints procedure. The first stage of the NHS complaints procedure is 'local resolution', where the practice that provided the care investigates and responds to the complaint directly. The practice should acknowledge the complaint and follow its procedure to resolve the issue. The GDC deals with fitness to practise concerns, not dispute resolution or refunds. The PHSO is the final stage and can only be approached after local resolution has been completed.
Question 5: Under the General Dental Council (GDC) requirements, what is the primary purpose of a dental professional holding appropriate professional indemnity?
- To protect the dentist from any investigation by the GDC.
- To ensure the professional can pay their GDC registration fees.
- To provide legal representation for the dentist in employment disputes.
- To ensure a patient who has suffered harm can receive appropriate compensation. (Correct answer)
Correct answer: To ensure a patient who has suffered harm can receive appropriate compensation.
The GDC legally requires all registered dental professionals to have appropriate indemnity or insurance cover. The primary purpose of this requirement, as stated in GDC guidance, is to ensure that a patient who suffers harm during the course of treatment has a mechanism to seek and receive any compensation they may be entitled to. While indemnity arrangements often provide legal support for GDC investigations or other issues, their fundamental purpose from the regulator's perspective is patient compensation.
Question 6: A dentist is creating a new website for their private practice. According to the GDC's 'Standards for the Dental Team' and guidance on ethical advertising, which of the following is permissible?
- Claiming to be a 'specialist' in a field without being on the relevant GDC specialist list.
- Using a patient's identifiable 'before and after' photograph without their explicit written consent.
- Making a claim that the practice's services are superior to those of a neighbouring practice.
- Providing a clear and accurate price list for common treatments offered at the practice. (Correct answer)
Correct answer: Providing a clear and accurate price list for common treatments offered at the practice.
GDC guidance on ethical advertising requires that all information produced is accurate and not misleading. Providing a clear and accurate price list is encouraged to ensure transparency for patients. Using a protected title like 'specialist' is illegal unless the individual is on the GDC's specialist list. Claiming superiority over colleagues is unprofessional and misleading. Using patient photographs requires explicit, valid consent for that specific purpose, and the patient must be fully informed about where and how their image will be used.
MJDF Part 1 - Membership of Joint Dental Faculties Law, Ethics, and Professionalism Questions and Answers
A 15-year-old patient attends your practice requesting tooth whitening.
You assess them and determine they have the maturity and intelligence to fully understand the procedure, risks, and alternatives.
However, their parents have explicitly forbidden the treatment.
According to UK law and professional guidance, what is the most appropriate action?