Editorial

Brief discourse on the right to health protection and ethical implications of the Dentist's professional practice

María Cristina Sifuentes Valenzuela*

* Academic General Secretary, National School of Dentistry, National University of Mexico (UNAM).

Correspondence

The World Health Organization (WHO) and the Pan American Health Organization (PHO) are institutions which constantly endeavor to further policies geared to reaching health for the world population. The aforementioned institutions have stressed the existing needs to promote actions which will promote the idea that health is a universal right. In Mexico, this social commitment is reflected in Article IV of the Political Constitution of the Mexican United States.¹ That article established the universal right to health protection. This right is not only limited to service rendering, it also encompasses the right to medical attention delivered in a professional and ethically responsible manner, within the framework of respect and dignity.

The General Health Law² endorses this need in all the paragraphs of Article II, where boundaries are determined from a holistic viewpoint, clearly stressing the relevance on human life quality as well as the importance of promoting responsible and supportive attitudes in the population in order to attain success in comprehensive health policies.

In this sense, it could be thought that guaranteeing the rights to health protection consolidates our social justice system, and supports bases which will deliver access to health services and protection through the ethical intervention of professionals and supporting staff. Nevertheless, security of comprehensive and qualified coverage is still an unreached goal. Among other factors, this is due to the operative inabilities of the health sector, the diversity of circumstances of peoples' birth, growth, life, reproduction, work, ageing and dying.³ This is especially true when considering the characteristics prevailing in the dental professional practice where mutilating procedures are still conducted which are geared to the disease and not to the prevention and promotion of oral health. Promoted by this right, these are clearly limitations to responsibilities already acquired.

The Bioethics Code of the Mexican Dental Association (MDA) includes bioethics as a part of the Philosophy which encompasses morals and obligations of the human being, in this instance considered as supra-social. Likewise, this same Code defines Professional Ethics as systematic ordination of principles, norms and rules established by a group of professionals, which is aimed at regulating and directing the moral behavior of its members.⁴ Meanwhile, Augusto Hortal⁴ considers that professional ethics is centered upon the ideal of general welfare, and has individual conscience as last resort.⁵ Based upon the aforementioned and within the scope of Dentistry, we can define it as the good we daily achieve as professionals in agreement with the aims of our profession, that is to say: to preserve and restore oral and dental health in the population supported by existing knowledge and available techniques at a given historical time.

The general good achieved when a particular profession is properly exercised constitutes the best criterion to decide who is a good professional when considering his technical skills and his exercise of ethics.⁵ In this regard, professional ethics is constituted by professional actions we carry out in order to comprehensively rehabilitate the patient, providing him with knowledge and fostering personal actions so he can preserve his health, independently from the social stratum he might belong to. In this context, welfare implicitly carries recognition of the human being who places trust in our profession to achieve optimal oral and dental health. This is an aspect our profession should per se always represent. We consider that educational institutions should stress this aspect as a fundamental aspect of the professional profile. We must stress the point that the patient is not merely an object or recipient (beneficiary) of these services, indeed the patient is a subject endowed with rights, to whom respect and consideration are owed. This implies involving him in decisions on the proposed intervention and all previous information required, that the professional must provide as an essential determinant for the protection of health, individual rights and principle of autonomy.

On this particular subject, we feel indispensable that those who participate in the training of future professionals should be cognizant with the aims of the educational projects offered by the institutions we work for, since no Professional Ethics can be conceived if we do not know the final aim of the profession. We can guarantee competent training in the techniques, excellent rehabilitators, knowledge of cutting edge materials, training and updating, but, if we don't clearly comprehend the benefits promoted by the profession (oral health and morbidity decrease among others), or do not know the socioeconomic determinants as well as individual requirements, Professional Ethics might very probably be misinterpreted and guided conducts might end up being very distant from the dictates of professional ethics.

Therefore, professional practices include a sense of social responsibility adhering to ethical and legal principles of the profession, under the precept that health is one of the fundamental values of the individual and the community, and situating oral and dental health problems within the framework of the country's health problems with a clear understanding of its social importance.

Health protection is a circumstance which must rule all professional actions. Therefore, health professionals bear the responsibility of caring, ensuring and promoting in all interventions the constitutional right to health protection, whose ultimate aim is to provide quality of life, regardless of the subject's profile.

Conflict is a constant factor of social life, where requirements and expectations are shared. The manner in which these conflicts manifest and are regulated can be very diverse. In this situation, dentists must always act adhering to the law and within the framework of bioethical principles, so that quality and warmth might prevail in all actions linked to professional exercise. The aforementioned skills show the need to promote inter-institutions intervention strategies where involved sectors perform adjustments in their programs or projects, and these might contribute to the quality of their processes. This is especially true for Higher Education Institutions, since their graduates must exert undertakings of professional practice geared to the good of the general population.

The fact or recognizing all those different, new and complex circumstances which explain and maintain the risk of oral and dental health expresses the need to permanently update and upgrade dental studies programs and plans under a multi-disciplinary and holistic perspective. These plans might provide the professional with greater space as a health promoter, as a fundamental activity inherent to his social responsibility, where attention given to adoption of attitudes acquires significant relevance. This might be the only way to envisage a different world and thus open new hope paths to achieve a basic human right... That is to say, health protection.

REFERENCES

1. Constitución Política de los Estados Unidos Mexicanos. Capítulo 1. De las garantías individuales. Artículo cuarto.         [ Links ]

2. Ley General de Salud. Artículo 2° [acceso 5 de marzo de 2014]. Disponible en: http://www.diputados.gob.mx/LeyesBiblio/pdf/142.pdf.         [ Links ]

3. Chan M. Regreso a Alma-Ata. 2008 [acceso 10 de abril de 2011]. Disponible en: http://who.int/topics/priimary_healt_care/es.         [ Links ]

4. Hortal A. Ética general de las profesiones. Bilbao: Desclée de Brouwer; 2002: pp. 35-51.         [ Links ]