8. Unethical Acts: A Dental Surgeon shall not aid or abet or commit any of the following acts which shall be construed as unethical. For the purpose of this regulations a dental surgeon refers to all registered practitioners whether they are in individual private practice, attached to hospitals, teaching hospitals or employed by others whether they are corporate or otherwise:
8.1 Advertisement: The global position on the issue of Ethics of Advertisement by Dental/Medical professionals has drastically changed over the last few decades. A Dentist or a group of Dentists may advertise provided that they maintain decorum, keeping in mind the high moral obligations and the value that society places on the important nature of their work and the moral character and integrity expected of them. Dental Surgeons are expected to exhibit integrity, honesty, fidelity and selfless service. Monetary commitments can only be secondary to the welfare of his patients. Under these circumstances it is unethical:
(8.1.1) To indulge in demeaning solicitation and false promises through advertisements or direct marketing of individuals, clinics or hospitals in contravention of the National Advertising Council or any other body regulating advertising in the country;
(8.1.2) To advertise, whether directly or indirectly or being associated or employed with any organisation or company including corporate bodies that indulges in such activities in a manner which gives unfair professional advantage by cold targeting vulnerable groups and conducting camps and other promotional activity in schools, colleges, old age homes and distributing handbills, claim vouchers and other business promotional activities. Registered charitable organisations including registered body of Dental or Medical persons which provide fully free dental care and treatment out of altruism are however exempted;
(8.1.3) To be associated with or employed by those who procure or sanction such false and misleading advertisements or publication through press reports that promise inducements, rebates and false benefits;
(8.1.4) To employ any agent or canvasser for the purpose of obtaining patients in a manner that is commercial; or being associated with or employed by those who procure or sanction of such employment;
(8.1.5) To use or exhibit any disproportionately large sign, other than a sign which in its character, position, size and wording is merely such as may reasonably be required to indicate to persons seeking the exact location of, and entrance to, the premises at which the dental practice is carried on, and nowhere else;
(8.1.6) To allow the Dental Surgeon's name to be used to designate commercial articles such as toothpaste, toothbrush, tooth powder, mouthwashes liquid cleaners, or the like except if such articles are fabricated in the dental clinic e.g. dentures, crowns, bridges, etc.;
(8.1.7) To permit publication of the Dental Surgeon's opinion on any procedure, equipment, in the general or lay papers or lay journals except when validated or supported by evidence based studies;
(8.1.8) To indulge in surrogate advertisements in the garb of educating the public through TV programs, magazines or periodicals. Any public information disseminated to the public in good faith and intention should not carry addresses telephone numbers, e-mail addresses, etc., of the Dental Surgeon or the clinic employing him to attract patients to their establishment;
(8.1.9) To advertise in the electronic media, such as in television programs, that display names, addresses and telephone number of dentists as on-screen scrollers , or, of the clinics employing such dentists, etc.
8.2 Soliciting: Soliciting of patients, directly or indirectly, by a Dental Surgeon, by a group of Dental Surgeons or by institutions or organisations is unethical except when permitted under the provisions mentioned later (vide 8.2.1 to 8.2.10 of this document, Revised Dentists Code of Ethics Regulations, 2012). A Dental Surgeon shall not make use of himself (or his name) as subject of any form or manner of advertising or publicity through any mode either alone or in conjunction with others which is of such a character as to invite attention to him or to his professional position, skill, qualification, achievements, attainments, specialties, appointments, associations, affiliations or honors and/or of such character as would ordinarily result in his self-aggrandisement.
A Dental Surgeon shall not give to any person, whether for compensation or otherwise, any approval, recommendation, endorsement, certificate, report or statement with respect of any drug, medicine, nostrum remedy, surgical, or therapeutic article, apparatus or appliance or any commercial product or article with respect of any property, quality or use thereof or any test, demonstration or trial thereof, for use in connection with his name, signature, or photograph in any form or manner of advertising through any mode nor shall he boast of cases, operations, cures or remedies or permit the publication of report thereof through any mode. A Dental Surgeon is however permitted as an ethically acceptable practice to make a formal announcement in press regarding the following:
(8.2.1) On starting practice.
(8.2.2) On change of type of practice.
(8.2.3) On changing address.
(8.2.4) On temporary absence from duty for a prolonged period of time.
(8.2.5) On resumption of practice after a break a prolonged period.
(8.2.6) On succeeding to another practice.
(8.2.7) About the availability of new equipment or services without boastful claims of being the best or first especially if such services are already available in other facilities.
(8.2.8) Through insertion in telephone directories, yellow pages or on the internet is permissible and will only serve as public information. However any claim to superiority or special skills over others will be construed as unethical practice.
(8.2.9) Through maintenance of websites about dentists or dental clinics where all information is factual will not be construed as unethical practice. Websites can also carry details of treatment facilities available and the fees for the same. This will in fact help patients to make informed choices through a transparent system. However websites should not make claims or statements that are not factual and therefore misleading to the public.
8.3 Publicity and Signage:
(8.3.1) Printing of self-photograph, or any such material of publicity in the letter head or on sign board of the consulting room or any such clinical establishment shall be regarded as acts of self-advertisement and unethical conduct on the part of the physician. However, printing of sketches, diagrams, picture of human system shall not be treated as unethical;
(8.3.2) Using or exhibition of any sign, other than a sign which in its character, position, size and wording is merely such as may reasonably be required to indicate to persons seeking the exact location of, and entrance to, the premises at which the dental practice is carried on is considered unethical. These include:
(8.3.2.1) Use of sign-board with the use of such words which trivialise the dignity of the profession or notices in regard to practice on premises other than those in which a practice is actually carried on, or show cases, or flickering light signs and the use of any sign showing any matter other than his name and qualifications as defined under clause (j) of Section 2 of the Act;
(8.3.2.2) Affixing a sign-board on a chemist's shop or in places where the dentist does not reside or work.
(8.3.3) A Dental Surgeon shall not claim to be a specialist either through displayed signs on the name board and/or the office stationary (visiting cards, letterheads, etc.,) unless he has a special qualification (which is recognised by the Council) in that Specialty. A Dental Surgeon can however practice all branches of Dentistry provided he shows adequate qualification, competence and bona fide training in the concerned branch or branches.
8.4 Patent and Copyrights: A Dental Surgeon may patent surgical instruments, appliances and medicine or copyright applications, methods and procedures. However, it shall be unethical if the benefits of such patents or copyrights are not made available in situations where the interest of large population is involved.
8.5 Running an Open Shop (Dispensing of Drugs and Appliances by Physicians): A Dental Surgeon should not run an open shop for sale of medicine for dispensing prescriptions prescribed by doctors other than him or for sale of dental medical or surgical appliances. It is not unethical for a Dental Surgeon to prescribe, supply or sell drugs, remedies or dental appliances in his clinic as long as there is no exploitation of the patients. Drugs prescribed by a Dental Surgeon or brought from the market for a patient should explicitly state the proprietary formulae as well as generic name of the drug.
8.6 Rebates and Commission:
(8.6.1) A Dental Surgeon shall not give, solicit, or receive nor shall he offer to give solicit or receive, any gift, gratuity, commission or bonus in consideration of or return for the referring, recommending or procuring of any patient for dental, medical, surgical or other treatment. A Dental Surgeon shall not directly or indirectly, participate in or be a party to act of division, transference, assignment, subordination, rebating, splitting or refunding of any fee for medical, surgical or other treatment.
(8.6.2) Provisions of Section 8.6.1 (of this document, Revised Dentists Code of Ethics Regulations, 2012) shall apply with equal force to the referring, recommending or procuring by a physician or any person, specimen or material for diagnostic purposes or other study/work. Nothing in this section, however, shall prohibit payment of salaries by a qualified physician to other duly qualified person rendering medical care under his supervision.
8.7 Secret Remedies: The prescribing or dispensing by a physician of secret remedial agents of which he does not know the composition, or the manufacture or promotion of their use is unethical and as such prohibited. All the drugs prescribed by a Dental Surgeon should always carry a proprietary formula and clear name.
8.8 Human Rights: The physician shall not aid or abet torture nor shall he be a party to either infliction of mental or physical trauma or concealment of torture inflicted by some other person or agency in clear violation of human rights.
8.9 Unethical Practices: The following shall also be the unethical practices for a Dentist:
(8.9.1) A Dental Surgeon shall not employ a Dentist/Dental Surgeon in the professional practice or any other professional assistant (not being a registered dental hygienist or a registered dental mechanic) whose name is not registered in the State Dentists Register, to practice Dentistry as defined in clause (d) of Section 2 of the Act. He may however retain the services of a medical practitioner or anaesthetist as necessary.
(8.9.2) Signing under his name and authority any certificate which is untrue, misleading or improper, or giving false certificates or testimonials directly or indirectly to any person or persons.
(8.9.3) Use of abbreviations after the Dental Surgeon's name except those indicating dental qualifications as earned by him during his academic career in dentistry and which conform to the definition of recognised dental qualification as defined in clause (j) of Section 2 of the Act, or any other academic qualifications from a recognised university obtained through a convocation indicating exemplary achievement. Any degree conferred on an honorary basis should be suffixed with the words Honoris Causa . Such unacceptable abbreviations include, but not necessarily restricted to the following which are not academic qualifications:
(8.9.3.1) R.D.P. for Registered Dental Practitioner;
(8.9.3.2) M.I.D.A. for Member, Indian Dental Association;
(8.9.3.3) F.I.C.D. for Fellow of International College of Dentists;
(8.9.3.4) M.I.C.D. for Master of International College of Dentists;
(8.9.3.5) F.A.C.D. for Fellow or American College of Dentists;
(8.9.3.6) M.R.S.H. for Member of Royal Society of Hygiene;
(8.9.3.7) F.A.G.E. for Fellow of Academy of General Education, etc.;
(8.9.4) Submission of false information in declaration form at the time of assessment of Dental College.
(8.9.5) Serving as (Duplicate faculty) i.e. working simultaneously in two/more Dental Colleges.
(8.9.6) Conviction for any crime by any court will constitute unethical act.
2[(8.9.7) Not enriching his/her professional knowledge by participating in professional meetings as part of Continuing Dental Education programs.]
8.10 Naming and Styling of Dental Establishments: A Dental Surgeon or a group of Dentists/Dental Surgeons shall refer to their establishment as a dental clinic. It may however be referred to as a dental hospital if the practice involves surgical treatment of oral and dental diseases under local or general anaesthesia and if the patients need to be maintained as an in-patient for part of a day or for several days for post-operative care provided the hospital fulfils the statutory requirements for such hospitals or establishments in the respective States.
8.11 Contravention of Statutory Provisions: A Dental Surgeon shall not contravene any of the acts referred to in Article 3.9 of this document, Revised Dentists Code of Ethics Regulations, 2014, and named in Annexure 3 of the same document and the rules made thereunder as amended from time to time, involving an abuse of privileges conferred thereunder upon a dentist, whether such contravention has been the subject of criminal proceedings or not.
8.12 Signing of Certificates: A Registered Dental Surgeon is bound by law to give, or may from time to time be called upon or requested to give certain certificates, notification, reports and other documents of similar character signed by them in their professional capacity for subsequent use in the courts, or elsewhere for administrative purposes, etc. Such documents, among others, include the ones given at Appendix 4 of this document, Revised Dentists Code of Ethics Regulations, 2014. A Dental Surgeon shall not sign under his name and authority any certificate which is untrue, misleading or improper, or give false certificates or testimonials directly or indirectly to any person or persons. He shall however deem it his duty to sign all necessary certificates relating to health of the patients.
8.13 Doctor-Patient Sexual Misconduct: A Dental Surgeon shall not be involved in immorality involving abuse of professional relationship and involve in sexual misconduct with a patient by misusing fiduciary relationship.
8.14 Abiding by all Laws of the Land: A Dental Surgeon shall not aid or abet in any violation of the laws of the land or be involved in any matter that is against public policy. He shall not be convicted by a court of law for offences involving moral turpitude/criminal acts.
8.15 Relationship with Pharmaceutical Companies and Medical and Dental Industry:
8.15.1 Gifts, Travel, Hospitality, Monetary Grants: A Dental Surgeon shall not receive any gift from any pharmaceutical or allied health care industry and their sales people or representatives. A Dental Surgeon shall not accept any travel facility inside the country or outside, including rail, air, ship, cruise tickets, paid vacations, etc. from any pharmaceutical or allied healthcare industry or their representatives for self and family members for vacation or for attending conferences, seminars, workshops, CDE/CME program, etc., as a delegate. A Dental Surgeon shall not receive any cash or monetary grants from any pharmaceutical and allied healthcare industry for individual purpose in individual capacity under any pretext. Funding for medical research, study, etc. can only be received through approved institutions and Professional Organisations by modalities laid down by law/rules/guidelines adopted by such approved institutions, in a transparent manner. It shall always be fully disclosed.
8.15.2 Dental/Medical Research: A Dental Surgeon may carry out, participate in, and work in research projects funded by pharmaceutical and allied healthcare industries. A Dental Surgeon is obliged to know that the fulfillment of the following items [8.15.2.1 to 8.15.2.7 of this document, Revised Dentists Code of Ethics Regulations, 2012] will be an imperative for undertaking any research assignment/project funded by industry for being proper and ethical. Thus, in accepting such a position a Dental Surgeon shall:
(8.15.2.1) Ensure that the particular research proposal(s) has the due permission from the competent concerned authorities.
(8.15.2.2) Ensure that such a research project(s) has the clearance of national/state/institutional ethics committees/bodies.
(8.15.2.3) Ensure that it fulfils all the legal requirements prescribed for medical research.
(8.15.2.4) Ensure that the source and amount of funding is publicly disclosed at the beginning itself.
(8.15.2.5) Ensure that proper care and facilities are provided to human volunteers, if they are necessary for the research project.
(8.15.2.6) Ensure that undue animal experimentations are not done and when these are necessary they are done in a scientific and a humane way.
(8.15.2.7) Ensure that while accepting such an assignment a Dental Surgeon shall have the freedom to publish the results of the research in the greater interest of the society by inserting such a clause in the MOU (Memorandum of Understanding) or any other document/agreement for any such assignment.
8.15.3 Maintaining Professional Autonomy: In dealing with pharmaceutical and allied healthcare industry, a Dental Surgeon shall always ensure that there shall never be any compromise either with his/her own professional autonomy and/or with the autonomy and freedom of the medical institution.
8.15.4 Affiliation: A Dental Surgeon may work for pharmaceutical and allied healthcare industries in advisory capacities, as consultants, as researchers, as treating doctors or in any other professional capacity. In doing so, a medical practitioner shall always:
(8.15.4.1) Ensure that his professional integrity and freedom are maintained.
(8.15.4.2) Ensure that patients' interest is not compromised in any way.
(8.15.4.3) Ensure that such affiliations are within the law.
(8.15.4.4) Ensure that such affiliations/employments are fully transparent and disclosed.
8.15.5 Endorsement: A Dental Surgeon shall not endorse any drug or product of the industry publically. Any study conducted on the efficacy or otherwise of such products shall be presented to and/or through appropriate scientific bodies or published in appropriate scientific journals in a proper way.
Chapter 7