St. André International Institute for Dental Ethics

Context

As a branch of health care, dentistry and oral health care more in general, is replete with ethical challenges. Dentists make many value-laden decisions on a daily basis while treating their patients. These range from recommendations about treatments for a child to assessments of the competency to consent of an elderly patient, and from investment choices regarding the purchase of expensive new technology to decisions whether to report the a fellow dentist suspected of a drug addiction to the Board of Dentistry. Similarly, these regulatory boards themselves, as well as dental schools, dental manufacturing companies, dental public health authorities, and professional organizations in oral health care all face ethically challenging situations that at times can be very complex.

Objective

As explicated in its Statutes, the St André International Center for Ethics and Integrity seeks “to organize international educational and scholarly activities in the area of ethics and thereby advance individual and institutional integrity.” The St André International Institute for Dental Ethics coordinates all of the Center’s activities in the area of dental ethics. It thereby seeks to assist practicing dentists, hygienists and other providers of oral health care, as well as institutions of higher education active, regulatory entities, research companies, and professional organizations in oral health care, to address ethically challenging issues with scholarly rigor and maximal transparency.

Activities

EDUCATION / PROFESSIONAL DEVELOPMENT. The Institute’s primary undertaking to realize the aforementioned objectives is by organizing educational activities. Those working in oral health care are invited and encouraged to enroll in one of the many intensive ethics seminars organized annually. While the subjects covered in these seminars may vary, they are always structured to maximize a joint exploration. We do this by:

  • bringing together a small group of interested individuals (max 25),
  • for an extended (4-9 days) period of intensive intellectual work together,
  • including individual reflection, sustained discussion, and international networking,
  • in an environment that fosters relaxation, collegiality and joie-de-vivre.

The seminars typically happen in the south of France. But the International Dental Ethics Institute can also develop educational programs in response to specific requests from other entities. And these can of course be organized in other places around the world as well.

RESEARCH. The Institute undertakes targeted research projects on specific themes in dental ethics. These projects either reflect the strategic research agenda of the Institute itself, or are undertaken in response to external entities requesting a critical examination of an urgent ethical challenge. In addition, the Institute cooperates with other entities around the world engaged in scholarly endeavors on topics in dental ethics.

Leadership Team

  • Wolter Brands, DDS, JD, PhD. Member of the Board of Directors of the St. André International Center for Ethics and Integrity (France). Practicing dentist in The Netherlands; Past-President of the Royal Dutch Dental Association.
  • Shafik Dharamsi, RDH, PhD. Member of the Board of Directors of the St. André International Center for Ethics and Integrity (France); Dean, School of Public Health, University of North Texas Health Science Center (Ft Worth, USA).
  • Linda S. Scheirton, RDH, PhD. Founding Member of the Board of Directors of the St. André International Center for Ethics and Integrity (France); Professor Emerita of health care ethics at Creighton University’s School of Pharmacy and Health Professions.
  • Jos V.M. Welie, MA, MMedS, JD, PhD, FACD. Founding President of the St. André International Center for Ethics and Integrity (France); co-founder of the International Dental Ethics and Law Society; Professor Emeritus of medical humanities at Creighton University’s School of Medicine (Omaha, USA).
  • W. Brands
  • S. Dharamsi
  • L Scheirton
  • J. Welie

Publications by Institute members

BOOKS

FDI World Dental Federation, Brands, W., Naidoo, S., Porter, S., Sereny, M., Van Dijk, W. & Welie, J.V.M. (Eds). Dental Ethics Manual (2nd edition). Available online.

Welie, Jos V.M. (Ed.): Justice in Oral Health Care. Ethical and Educational Perspectives. Milwaukee: Marquette University Press, 2006.

SELECTED CHAPTERS & ARTICLES AVAILABLE ON-LINE (OPEN ACCESS)

SELECTED CHAPTERS & ARTICLES WITHOUT OPEN ACCESS

  • Brands, W.G. (2006). The method of choice. British Dental Journal, 201, p.549.
  • Brands, W.G. (2006). The standard for the duty to inform patients about risks: from the responsible dentist to the reasonable patient. British Dental Journal, 201, 207-210. https://www.nature.com/articles/4813883
  • Brands, W.G., Brands, M.T. & Brands-Bottema, G.W. (2014). Limitated rights for minors in Dutch healthcare. Journal for Forensic Odontoloy and Stomatology JFOS, Vol.32, Sup.No.1 Pag 23-26.
  • Brands, W.G. & Welie, J.V.M. (2008). Dentists in Double Trouble: The (Un)Fairness of Punishing for the Same Mistake Twice. Journal of the American Dental Association, 139: 1249-1255 https://doi.org/10.14219/jada.archive.2008.0341
  • Brands, W.G., Bronkhorst, E.M. & Welie, J.V.M. (2010). The Chasm between Knowing and Choosing the Ethical Course of Action. A survey of dental students in The Netherlands. International Dental Journal 60,5: 321-8. On-line at http://www.idjonline.org/download.php?op=institution_view_article&article_id=460
  • Brands, W.G., Bronkhorst, E.M. & Welie, J.V.M. (2011). Professional Ethics and Cynicism in Dutch Dental Schools. European Journal of Dental Education, 15:1–5.
  • Broers, D.L.M., Brands, W.G., Jongh, A. de, Welie, J.V.M. (2010). Deciding About Patients’ Requests for Extraction: Ethical and Legal Guidelines, Journal of the American Dental Association, 141:195-203 https://doi.org/10.14219/jada.archive.2010.0139
  • Broers, D.L.M, Brands W.G., Welie, J.V.M. & de Jongh, A. (2010). Letter to the Editor (On extraction and the standard of care; a response to Dr. Ross). Journal of the American Dental Association 141 (2010) 503.
  • Broers, D.L.M., Dubois, L., Lange, J. de, Welie, J.V.M., Brands, W.G., Bruers, J.J.M., & Jongh, A. de (2022). Financial, psychological, or cultural reasons for extracting healthy or restorable teeth, Journal of the American Dental Association, 153,8: P761-768.E3 https://doi.org/10.1016/j.adaj.2022.01.008
  • Broers, D.L.M., Dubois, L., Lange, J. de, Welie, J.V.M., Brands, W.G., Bruers, J.J.M., & Jongh, A. de. (2023). How dentists and oral and maxillofacial surgeons deal with tooth extraction without a valid clinical indication Plos One, Published: January 17, 2023; https://doi.org/10.1371/journal.pone.0280288
  • Dharamsi, S. & MacEntee, M.I. (2002). Dentistry and distributive justice. Social Science & Medicine, 55(2):323-329.
  • Dharamsi, S. (2006). Building moral communities? First do no harm. Journal of Dental Education,70(11): 1235-1240.
  • Dharamsi, S. (2006). Social responsibility and oral health disparities: A constructivist approach. In: Welie J.V.M. (Ed.), Justice in Oral Health Care: Ethical and Educational Perspectives. Milwaukee, Wisconsin: Marquette University Press. p. 61-80.
  • Dharamsi, S., Pratt, D.D., & MacEntee, M.I. (2007). How dentists account for social responsibility: economic imperatives and professional obligations. Journal of Dental Education,71(12):1583-1592.
  • Dharamsi, S., Machado Ardenghi, D., Speers, R. & Welie, J.V.M. (2008) Conference Report – Human Rights and Oral Health Care: A Report of the 7th International Dental Ethics and Law Congress. Journal of the Canadian Dental Association 74,4 (2008) 337-340. On-line at http://www.cda-adc.ca/jcda/vol-74/issue-4/337.pdf
  • Dharamsi, S., Machado Ardenghi, D., Speers, R. & Welie, J.V.M. (2008) Rapport de conférence – Les droits de la personne et les soins buccodentaires : un rapport du 7e Congrès de l’IDEALS. [French translation of former listing] Journal de l’association dentaire canadienne 74,4 (2008) 337-340. On-line at http://www.cda-adc.ca/jadc/vol-74/issue-4/337.pdf
  • Dharamsi, S., Jivani, K., Dean, C., & Wyatt, C. (2009). Oral care for frail elders: Knowledge, attitudes and practices of long-term care staff. Journal of Dental Education,73(5):581-588.
  • Hasegawa, Thomas K & Welie, J.V.M. (1998). The Role of Codes of Ethics in Oral Health Care. Journal of the American College of Dentists, 65, 3: 12-14.
  • Hasegawa, T.K. & Welie, J.V.M. (2000). The Search for a Common Ethic: The Ethics Alliance of Oral Health Organizations. Journal of the American College of Dentists. 67,2: 21-22.
  • Levering, N.J. & Welie, J.VM. (2010). Ethical Reflections on Nitrous Oxide as a Dental Practice Routine. Journal of the American College of Dentists, 77,2: 40-47.
  • Levering, N.J. & Welie, J.V.M. (2011). Nitrous Oxide Usage in Children: Challenges When It Becomes Routine. World Dental Reporter May/June: 30-31.
  • Levering, N.J. & Welie J.V.M. (2011). The Emergence of a Routine. A Review of Nitrous Oxide Usage Trends. Journal of Dentistry for Children 78,1: 24-30.
  • McNally, M., Dharamsi, S., Bryant, R. & MacEntee, M.I. (2010). Ethical considerations for the oral healthcare of frail elders. In: MacEntee, Chalmers, Muller and Wyatt (Eds): Oral Healthcare and the Frail Elder: A Clinical Perspective. Wiley-Blackwell, p. 13-30.
  • Niederman, R., Richards, D., & Brands, W.G. (2012). The Daubert Standard of Care, Journal of the American Dental Association, 143(5): 434-437. https://doi.org/10.14219/jada.archive.2012.0190
  • Priebe, S., Aleksejuniene, J, Dharamsi, S., & Zed C. (2008). Oral cancer and cultural factors in Asia. Canadian Journal of Dental Hygiene, 42(6):291-295
  • Rule, J.T. & Welie, J.V.M. (2006). Justice, Moral Competencies, and the Role of Dental Schools. In: Welie, J.V.M. (Ed.): Justice in Oral Health Care. Ethical and Educational Perspectives. Milwaukee: Marquette University Press, 233-259.
  • Rule, J.T. & Welie, J.V.M. (2009). The Access To Care Dilemma: Symptom of a Systemic Condition. Dental Clinics of North America, 53,3: 421-433.
  • Scheirton, L.S., (1991). Tandarts besmet patiënten met AIDS [in Dutch; Dentist Infects Patients with AIDS]. Tijdschrift voor Geneeskunde en Ethiek 1, 2; 63-64.
  • Scheirton, L.S., Welie, J.V.M. & Harris, N.O. (1999). Ethics and Preventive Dentistry. In: N.O.Harris & F. Garcia-Godoy (Eds.): Primary Preventive Dentistry (5th edition). Stanford, CT: Appleton & Lang, Chapter 24, pp. 633-638.
  • Simpson, Melissa, Welie, J.V.M., & Westerman, G.H. (2001). The Troubled History of Dental Advertising. Part 3: Legal Limits. Nebraska Dental Association Newsletter 101, 1 (2001) 11-12.
  • Simpson, M., Welie, J.V.M. & Westerman, G.H. (2002). The Troubled History of Dental Advertising. Part 3: The Impact of Legal Regulations on the Debate in the United States. Bulletin of the International Dental Ethics and Law Society 2,1: 9-12 [modified reprint].
  • Sonneveld, R, Brands, W.G., Bronckhorst, E.M. & Truin, G.J. (2014). Organizational aspects of a general dental practice: views and expectations of patients and general dental practitioners
    Health Expect 2014; 17: 129-137
  • Sonneveld, R., Brands, W.G., Bronkhorst, E.M., Truin, G.J. & Welie, J.VM (2013). Patients’ priorities in assessing organisational aspects of a general dental practice. International Dental Journal, 63,1: 30-8.
  • Sonneveld, R., Brands, W.G., Bronkhorst, E.M., Welie, J.V.M. & Truin, G.J. (2013). Organizational aspects of dental practices: Do dental students think like patients or like dentists? European Journal of Dental Education, 17,1: e181-8.
  • Sonneveld, R.E., Wensing, M.J.P., Bronkhorst, E.M., Truin, G.J. & Brands, W.G. (2011). Are general dental practitioners aware of how patients view the organizational aspects of a general dental practice? BMC Health Services Research, 11:263
  • Speers, R.D., Brands, W.G., Nuzzolese, E., Smith, D., Swiss, P.B.F., van Woensel, M. & Welie, J.V.M. (2008). Dentists and Torture. The Developmental History of a New International Declaration. Journal of the American Dental Association 139,12: 1667-1673. DOI: https://doi.org/10.14219/jada.archive.2008.0109
  • Speers, R.D., Brands, W.G., Nuzzolese, E., Smith, D., Swiss, P.B.F., van Woensel, M. & Welie, J.V.M. (2009). “Passive Torture” and Dental Care for Prisoners. A Response to Dr. Dello Russo. Journal of the American Dental Association, 140, 4: 399-340.
  • Welie, J.V.M. (1998) May a Dentist Refuse to Treat an HIV-Positive Patient? An Ethical Commentary to the 1998 Decision of the United States Supreme Court in the Matter of Bragdon vs. Abbott. Medicine, Healthcare and Philosophy, 1,2: 163-169.
  • Welie, J.V.M. (1998). De tandarts, de gehandicapte, de rechter, en het kind. Een ethisch commentaar bij het recente vonnis van het Amerikaanse hoogste gerecht inzake weigering van behandeling van een HIV-seropositieve patiënt [in Dutch: The dentist, the disabled, the judge and the child. An ethical commentary to the recent verdict of the American Supreme Court concerning refusal of treatment of an HIV-seropositive patient]. Medisch Contact 53,43 (1998) 1370-1371.
  • Welie, J.V.M. (1999). “Doctor, I Really Need Whiter Teeth!” A Report on the Use of Deconstructed Cases in Dental Ethics Education. Medicine, Healthcare and Philosophy. 2, 2:195-203.
  • Welie, J.V.M. (1999). Do you have a healthy smile? Ugliness as a medical indication for dental and surgical treatment. Medicine, Healthcare and Philosophy. 2, 2: 169-180.
  • Welie, J.V.M. (2000). The Dentist as Healer and Friend. In: Thomasma, D.C. & Kissell, J.L. (Eds): The Health Care Professional as Friend and Healer. Georgetown, Georgetown University Press 2000, 35-48.
  • Welie, J.V.M. (2001). From the Diary of a Dental Ethicist: Bleaching strips. Bulletin of the International Dental Ethics and Law Society 1, 1: 16-17.
  • Welie, J.V.M. (2002). From the Diary of a Dental Ethicist: Students’ evaluations. Bulletin of the International Dental Ethics and Law Society 2, 1: 13-14.
  • Welie, J.V.M. (2002). From the Diary of a Dental Ethicist: The Letter. Bulletin of the International Dental Ethics and Law Society 2, 2: 19-20.
  • Welie, J.V.M. (2003). The Ethics of Roles. Journal of the American College of Dentists. 70: 45-48.
  • Welie, J.V.M. (2003). From the Diary of a Dental Ethicist: Maiden Name. Bulletin of the International Dental Ethics and Law Society 3, 1: 5-6.
  • Welie, J.V.M. (2004). Anaesthetizing a patient for the purpose of lip tattoos. Bulletin of the International Dental Ethics and Law Society 4, 2: 9-17.
  • Welie, J.V.M. (2004). From the Diary of a Dental Ethicist: The Amalgam Letter. Bulletin of the International Dental Ethics and Law Society 4, 2: 18-19.
  • Welie, J.V.M. (2004). From the Diary of a Dental Ethicist: The Pledge. Bulletin of the International Dental Ethics and Law Society 4, 1: 4-5.
  • Welie, J.V.M. (2004). “For Whom and For What?” Education and Research in the Medical and Dental Sciences. In: Welie, J.V.M. & Kissell, Judith L. (Eds.): Jesuit Health Sciences and the Promotion of Justice. An Invitation to a Discussion. Milwaukee: Marquette University Press, pp. 111-129.
  • Welie, J.V.M. (2006). Izazov profesionalizma. Rješavanje konflikta izme u individualnog interesa stomatologa i javnosti. [in Croatian: The Challenge of Professionalism. Resolving conflicts between the interests of individual dentists and those of the public] Hrvatski Stomatoloski Vjesnik, 13, 2: 33-36.
  • Welie, J.V.M. (2005). Dental Ethics as Punishment. Bulletin of the International Dental Ethics and Law Society 5.1: 15-17.
  • Welie, J.V.M.(2006). The Limits of Truthfulness. Ethical reflections on the provision of information in the dental care context. Bulletin of the International Dental Ethics and Law Society 6.1. On-line journal.
  • Welie, J.V.M. (2006). Profesija ili bizniz. Eti ki subok interesa kod prakticiranja estetske stomatologije. [in Croatian: Profession of Business? Ethical conflicts of interests in the practice of esthetic dentistry] Hrvatski Stomatoloski Vjesnik, 13, 4: 35-37.
  • Welie, J.V.M. (2006). Are Oral Health Disparities Merely Unfortunate or Also Unfair? An Introduction to the Book. In: Welie, J.V.M. (Ed.): Justice in oral Health Care. Ethical and Educational Perspectives. Milwaukee: Marquette University Press, 7-14.
  • Welie, J.V.M. (2006). The Preferential Option for the Poor. A Social Justice Perspective on Oral Health Care. In: Welie, J.V.M. (Ed.): Justice in Oral Health Care. Ethical and Educational Perspectives. Milwaukee: Marquette University Press, 127-144.
  • Welie, J.V.M. (2009). The Future of Dental Ethics. Reflections of a Past Secretary. Bulletin of the International Dental Ethics and Law Society. 9.1 On-line journal.
  • Welie J.V.M. (2012). Social Contract Theory as a Foundation of the Social Responsibilities of Health Professionals. Medicine, Healthcare and Philosophy 15,3: 347-55. doi: 10.1007/s11019-011-9355-7.
  • Welie, J.V.M. (2012). Dental Ethics. In: Chadwick, R. (Ed): Encyclopedia of Applied Ethics, Second Edition, volume 1. San Diego: Academic Press; pp. 762–770.
  • Welie, J.V.M. & Levering N.J. Dental Ethics Education at the Creighton University School of Dentistry. Bulletin of the International Dental Ethics and Law Society 9.2 (2009) 34-37. On-line journal.
  • Welie, J.V.M. & Rule, J.T. (2006). Overcoming Isolationism. Moral Competencies, Virtues and the Importance of Connectedness. In: Welie, J.V.M. (Ed.): Justice in Oral Health Care. Ethical and Educational Perspectives. Milwaukee: Marquette University Press, 97-125.
  • Welie, J.V.M., Simpson, M. & Westerman, G. H. (2000). The Troubled History of Dental Advertising. Part 1: Definitions and Statistics. Nebraska Dental Association Newsletter 100,10:10-11.
  • Welie, J.V.M., Simpson, M. & Westerman, G.H. (2000). The Troubled History of Dental Advertising. Part 2: Historical Notes. Nebraska Dental Association Newsletter 100, 11: 11-12.
  • Welie, J.V.M., Simpson, M. & Westerman, G.H. (2001). The Troubled History of Dental Advertising. Part 4: Ethical Reflections. Nebraska Dental Association Newsletter 101, 2: 12-13.
  • Welie, J.V.M., Simpson, M. & Westerman, G.H. (2001). The Troubled History of Dental Advertising. Part 1: Definitions and Statistics. Bulletin of the International Dental Ethics and Law Society 1, 1: 9-12 [modified reprint].
  • Welie, J.V.M., Simpson, Melissa & Westerman, Gary H: (2001). The Troubled History of Dental Advertising. Part 2: Historical Notes. Bulletin of the International Dental Ethics and Law Society 1, 2: 9-12 [reprint].
  • Welie, J.V.M., Simpson, M.& Westerman, G.H. (2002). The Troubled History of Dental Advertising. Part 4: Ethical Reflections. Bulletin of the International Dental Ethics and Law Society 2,2: 8-11 [modified reprint].
  • Witter, D.J., Kole, J.J. , Brands, W.G., MacEntee, M.I. & Creugers, N.H.J. (2020). Wish-fulfilling medicine and wish-fulfilling dentistry, Journal of Dentistry, 1-7 https

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