My current career goal is to teach, research, and practice dentistry in an academic environment, and I strongly believe that an education in bioethics will complement my passion for pursuing dental healthcare. In middle school, our family searched for an orthodontist to correct my hyperoccluded right lower canine. To my dismay, every orthodontist I met with gave me a different treatment plan. The very first orthodontist told me to start braces right away. Another orthodontist, however, did not recommend braces because only one tooth was out of place and the cost would be the same as a full treatment.
One dentist even recommended maxillofacial surgery in conjunction with orthodontics to make the correction more “permanent.” Bombarded with such differing medical opinions of varying invasiveness and prices, our family decided to hold off on the treatment entirely. I just couldn’t understand why such wide degree of variance existed in treatment options. I had believed that medical treatment options were based on peer-reviewed evidence and optimized for each condition, so I was curious to learn more about the evidences underlying the treatments that the dentists offered me.
One of the pillars of medical ethics is patient autonomy. In order for a patient to fully exercise his or her autonomy, the provider must explain in fullest details what each option entails. However, the execution of that fundamental principle is often hindered by the fact that patients themselves are often not healthcare professionals who bear knowledge on the subject of their chief complaints and relevant treatment options. So the fate of a patient is often left at the mercy of the provider’s decision. I still wonder about which one of the dentists that I consulted gave us options that prioritized our physical, emotional, and financial situation before their profit margins.
Although I was frustrated with the state of dental healthcare system at the time, my desire to improve the experiences for others in my shoes after me started not only to kindle my interest in dentistry, but also to encourage thinking about medical ethics in the context of patient care. I had never considered a formal training in bioethics, but that began to change when my grandfather passed away last summer from cancer.
One may be surprised to hear that he never even knew he had cancer. Our family decided to never tell him out of fear that the news will only amount to faster degeneration of his health. The decision was based on lengthy discussions involving many of our extended family members, who all agreed to omit the truth in order to preserve his sense of hope and spirit. At the time, everyone agreed that our action was justified given the circumstance. However, as I pondered further about the implications of our white lie after his passing, I couldn’t help but to wonder what my grandfather would have thought about our decision. Would he have deemed our action ethical?
Many people justify white lies on the grounds of their good intentions, but there is no absolute standard for determining what is actually “good.” Thinking back, I wish that I had a better grasp of the principles of medical ethics at the time so that our family could’ve engaged in a more in-depth and objective discussion about the ethicality of withholding information from my grandfather.
Overall, my childhood experience as a confused and scared dental patient and my lingering thoughts on the ethical dilemma surrounding my grandfather’s passing made me think more seriously about the importance of bioethical competency in the context of my dental medicine education. Bioethics will be an essential component of my career because at the foundation of medicine lies principles based on ethics, which serves as the backbone of clinical decisions. I hope to not only represent women in the field of academic dental medicine, but also engage in researches that could bring about more cost-effective and accessible solutions to improving dental health.