Some cases have sought patient abandonment as a cause of action because the dentist failed to complete treatment or the dentist was not available to follow up treatment without valid legal reasons. To avoid such a complaint, the dentist must complete the services that were agreed to and be available for patients after hours or make arrangement for coverage when away from the office [1–3].

Having the duty to complete the agreed-upon services or the duty not to withhold agreed-upon treatment does not mean you must provide treatment for free when the patient has not upheld his or her agreed-upon payment. Hence there is a difference between abandonment and severing the doctor–patient relationship. Abandonment is a disregard of the patient’s well-being and below the standard of care [4]. Ethically, it is a violation of the American Dental Association (ADA) Code of Ethics as to nonmalfeasance and beneficence. Without proper continuation of care or the proper follow-up to treatment, harm may come to the patient, and the patient’s well-being will be jeopardized. There are basically four situations in which abandonment may arise:

1. Refusal to see a patient without a valid legal reason

2. Failure to provide proper follow-up care to rendered treatment

3. Failure to provide proper emergency care, including after-hours care

4. Failure to provide coverage for patient care when away from the office for extended time, such as during a vacation.

Merely referring the patient to the nearest hospital may fulfill the legal duty to not abandon the patient in an after-hours situation. Ethically, however, it falls short of truly caring for your patient since many hospitals may not have any definitive dental care available. Nonmalfeasance dictates that the dentist should cause no harm to the patient. If you are not available to patients you have treated and the patient has further injury or harm due to your unavailability, malfeasance has occurred. Therefore, as discussed in Chapters 12 and 14, it is wise to telephone patients after invasive or involved treatment to prevent any claim of unavailability when a problem subsequent to treatment arises.

To avoid a finding of abandonment, the dentist should properly discontinue treatment and/or terminate the doctor–patient relationship. To properly discontinue treatment, the dentist must inform the patient that the treatment is being discontinued due to one of several reasons:

1. Not following home-care instructions such that treatment outcome is jeopard­ized [5]

2. Not showing up for appointments [6]

3. Not paying for services as agreed [7, 8]

4. Lying on his or her health history

5. Unacceptable or threatening behavior, including a breakdown in the doctor–patient relationship

6. Limiting or closing a practice.

A discontinuation of treatment does not terminate the doctor–patient relationship. The patient must still be treated for emergencies a/>

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Jan 5, 2015 | Posted by in General Dentistry | Comments Off on 11 ABANDONMENT

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