The Dentist-Patient Relationship: Re-modelling Autonomy for Dentistry

Previous work in the field of the clinician-patient relationship has relied on a generalized understanding of the ethical structure of the clinical relationship. This thesis seeks to rebut that presumption, by claiming that differing clinical relationships raise diverse ethical issues that call for specific ethical solutions. By looking closely at the primary dental care relationship this thesis will propose three specific instances where the dental-patient relationship faces unique challenges. The thesis will also go on to establish the claim that the current reliance on a rational notion of autonomy; one that is firmly attached to the consent process, is unable to theoretically address and adequately support the issues raised in relation to the dentist-patient relationship.

This work considers, through philosophical enquiry, a number of theoretical alternatives and examines in detail the extent to which an alternative way of understanding the dentist-patient relationship might be more effective in addressing the matters of ethical concern raised and, as a consequence, be more ethically robust.

The thesis concludes that a separation between our understanding of promoting and protecting autonomy enables us to re-visit and develop a more appropriate model of autonomy for the dentist-patient relationship that relies on a moderated, negative libertarian view. This transforms and simplifies obligations to the patient by providing an account that operates as a constraint in the clinical setting with our wish to promote autonomy being understood as the action of restoring health itself.