[Music] this video is sponsored by bootcamp.com check it out for iron bde prep and use coupon code mental dental for 10 off hey everyone dr ryan here and welcome back to our ethics series this video is dedicated to abuse and neglect now i know that topic is included as part of the ethical principle of beneficence but i wanted to dedicate this video just to abuse and neglect because it's so important dentists in fact are ethically obligated to keep current their knowledge of both identifying and reporting abuse and neglect so let's dive into this topic together first i want to define these terms abuse refers to willful infliction of pain injury or mental anguish basically any form of intentional harm whereas neglect refers to not receiving essential services from a caretaker parent or guardian essentially basically deprivation of essential needs either intentionally or unintentionally so with that out of the way there are four r's i want to make very clear for you and these will be the framework for the rest of this video and we want to be able to first recognize signs of abuse then we want to report the suspected abuse as soon as possible then we want to record what took place write down all of our notes before we forget anything so we have evidence to go back to later and then finally we can render any dental treatment that's needed or refer them to a specialist for care so that's the order from recognize to render for you to remember for the board exam so first recognize now dentists are at an advantage when it comes to identifying abuse especially in children since most of the characteristic signs can be visualized in the head and neck regions so some common signs of abuse include bruises burns bite marks fractured teeth community facial fracture red swollen eyes and then also having multiple untreated injuries other things to look for in children especially would be a child who is poorly dressed has a disheveled appearance appears hungry or thirsty frightened has social withdrawal and parents who are telling you different stories abuse is most common in children under the age of three next we have to report and this is really important there are some differences in reporting standards based on the state you're practicing in but there is one thing everyone agrees on in all 50 states dentists are mandated required to report suspected cases of child abuse not necessarily neglect not necessarily abusive adults but suspected cases of child abuse must be reported in all circumstances again this is really important because people get hung up on thinking well let's try to get the child alone and ask them what happened and get all the details to figure out if abuse really happened or not it isn't your role to investigate or decide whether a child has been abused concerns should be reported so that the experts can advise and take action if necessary so to make this as clear as possible for children if you suspect abuse at all you would ask your assistant to call the appropriate agency or do it yourself and report it immediately you do not wait until after the appointment we are morally ethically and legally obligated to report all suspected cases for adults ideally you would ask them alone first about your suspicions respecting their autonomy and then you would report following the principle of beneficence but that's not always possible but because they're an adult we should respect their right to self-determination and confidentiality and if they don't want you to report the suspected mistreatment we have to respect their wishes if you suspect child abuse you would call social services or child protective services and for adult abuse you would call the dhhs which is the department of health and human services or adult protective services for elderly and disabled individuals abuse is chronically underreported and i would suggest to report those cases immediately similar to the protocol we talked about for child abuse all right so as soon as you can after reporting you want to write down as much relevant information before you forget because it might be referenced to later as evidence if legal action is taken so some examples of things to write down beyond just the name of the patient you would want to include the date and time of disclosure a detailed description of all the injuries use of the patient's words you don't want to edit or make them sound more polite just word for word write down what the patient told you any concerns description of behaviors and you want to be as objective as possible in describing those behaviors and any details of any witnesses you would also want to record whether the disclosure was spontaneous or in response to a question that you asked the patient finally after you've recognized potential abuse reported it and recorded it then it's time to render any necessary treatment or refer if needed that's it for this video thank you so much for watching please like this video if you enjoyed it and subscribe to this channel for much more on dentistry if you'd like to support me please check out my patreon page and thank you to all of my patrons for their support you can unlock access to my video slides to take notes on and practice questions for the board exams so go check that out the link is in the description thanks again for watching everyone i'll see you in the next video [Music] [Music] you