Dentist’s Responsibility and Jurisprudence in Norway and Other Nordic Countries

Klaus Rötzscher (ed.)Forensic and Legal Dentistry201410.1007/978-3-319-01330-5_8

© Springer International Publishing Switzerland 2014

8. Dentist’s Responsibility and Jurisprudence in Norway and Other Nordic Countries

Tore Solheim 
(1)

Institute of Oral Biology, Pathology and Forensic Odontology, University Oslo, Oslo, Norway
 
 
Tore SolheimProf. (em) Dr. odont.
Abstract
The dentist’s professional responsibility can be divided into that according to either criminal law or civil law (jurisprudence). Criminal responsibility is regulated by laws whereby you risk punishment, either as a fine or by jail sentencing, if you break the law.

8.1 Introduction

The dentist’s professional responsibility can be divided into that according to either criminal law or civil law (jurisprudence). Criminal responsibility is regulated by laws whereby you risk punishment, either as a fine or by jail sentencing, if you break the law.
Civil responsibility is a responsibility towards other persons, bodies, or organizations. No criminal law is broken, but it may originate as a disagreement between the dentist and other parties, usually the patient, often involving economic aspects. It may also be an accident, and the victim, usually the patient, may demand economic compensation. Other cases may involve a missed diagnosis or a treatment that does not fulfill the patient’s wishes. The civil responsibility may also be directed towards the Dental Association where malpractice or ethical conduct may be the issue. Finally, it may be against colleagues or coworkers if disagreement arises.
In other Nordic countries, the dentists’ responsibilities are comparable to those in Norway; however, the exact laws and regulations may vary.

8.2 Criminal Law

Criminal law was intended to be a superheading, now as it is printed it may need a text. I suggest: “A number of laws may be broken whereby the dentist risk punishment. The most important is the Penal Code 2005 and the Health Personnel Law 1999. However, there are also other laws which will not be discussed here. These include laws on criminal proceedings, prescription of medicine, book keeping and taxation, working environment and working time, health and social preparedness in case of war and alternative treament of diseases.

8.3 Penal Code 2005

This law regulates the entire population of the country. Certain paragraphs, however, may be more relevant to dentists. The law states that assault is a criminal offence. If a patient has not consented to treatment, then the dentist is seen to have committed an assault. It is thus important that the patient is informed about treatment to be performed and gives his consent. He should also be given the opportunity to refuse a treatment at any time. This is further explained under special laws.
This law also confers the duty of confidentiality to employers in public services, including dentists. All health personnel, inclusive private practitioners, are governed by the Health Personnel Law which also requires the duty of confidentiality. However, the punishment of a breach of the law may for them be more severe according to the Penal Code, 6 months versus 3 months.
According to the Penal Code, misappropriation of funds is a criminal offence, and dentists found to be benefitting from illegal earnings may thus be punished according to the Penal code.
The Penal Code and also the Law on Child Protection state that a health worker is released from the duty of confidentiality in cases of suspected child abuse.

8.4 Health Personnel Law 1999

This law is directed towards all personnel providing health care. It is therefore rather general and not specific for dentists. From 1980 until 1999 there existed a law specific for dentists and physicians. The old law afforded a number of rights to the dentists, and in reality the monopoly held by dentists has disappeared with the new law. The new law only has duties the dentist and other health personnel must follow.
We, as dentists, have an ethical obligation to be responsible. Auxiliary personnel may be used if appropriate to the task in question. It is obligatory to provide emergency treatment. It is obligatory to abstain from alcohol and other narcotics during work. It is also forbidden to accept gifts given during the course of work. Advertisements should be responsible, reasonable, and sober. Attests and declarations should be objective.
When starting to practice it is necessary to file a report with the local community. It is also obligatory to have medical indemnity insurance.
It is a general rule that the personnel must maintain confidentiality regarding treatment and patient information. However, if the patient may give his consent the information may be passed on to others. After the death of the patient information may be given if valid reasons exist. Information may also be given to other healthcare professionals who are treating the patient, unless the patient objects. If an examination is performed in the capacity as an expert in a court, then it is acceptable to provide the court with information as long as the patient has been informed of the role of the dentist and the reason for the examination.
According to this law a record must be kept for each patient. The content of the record is subject to regulation (Regulation of Record Keeping 2000). It must be clear who has written the record. The patient may see his record and can ask to have it corrected if it is wrong. If the patient does not object the record may be transferred to another practitioner. Electronic records may be used, and the health authorities may have access to the records in case of dispute concerning authorization.
Authorization may be given not only to dentists but also to dental hygienists, dental health secretaries, and dental technicians. Authorization is normally lost when the dentist is 75 years of age. It may be temporarily or permanently lost if the dentist has a serious mental disease and physical disability, uses alcohol or narcotics, has been out of practice over a long period, or be guilty of malpractice or misconduct. The dentist may be given a warning. In case of violation of the law, the sentence may be a fine or up to 3 months prison sentence. A Committee for Health Personnel may examine the case if the dentist does not agree with the reaction from the health authorities.
In Sweden a patient security law affords specific rights to the authorized personnel. It is not specific to dentists; however, it is stated that following injection of local anesthesia, only authorized personnel may examine or give treatment to the patient.
In Iceland there is a special but relatively short law for dentists.
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Nov 26, 2015 | Posted by in General Dentistry | Comments Off on Dentist’s Responsibility and Jurisprudence in Norway and Other Nordic Countries
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