THE CONFLICT BETWEEN PATIENT AUTONOMY AND ORAL HEALTH IN DENTISTRY
Kovács Szilárd Dávid
Mental Health Sciences Division
Dr. Bódizs Róbert
SE Egészségügyi Menedzserképző Központ
2026-04-28 14:00:00
Magatartástudományok
Dr. Kovács József
Dr. Kovács József
Dr. Tari Gergely
Dr. Orsós Mercédesz
Dr. Pethesné Dávid Beáta
Dr. Török Szabolcs
Dr. Barabás Katalin
Bioethics is a discipline bridging biology and ethical philosophy, including medical ethics. Contemporary medical ethics most commonly relies on principlism, with patient autonomy receiving significantly increased attention in recent decades. However, this approach may eclipse real-life practices and prove inconsistent when solving ethical challenges. Therefore, a novel trend in bioethics is to uptake sociological and anthropological empirical data to shape existing theory. The topic of this thesis was dentistry, a field in medicine concerned with oral functions such as speaking, chewing, or conveying emotions. The research objective was to explore the ethical dilemma between patient autonomy and oral health in dentistry.
We explored relevant cases, judgements and principles in literature with a scoping review. This involved developing subcodes of these categories inductively, and synthesizing data via thematic analysis. Subsequently, we investigated patient and dentist narratives using semi-structured interviews. We developed a codebook with a guided-inductive approach and modelled the code co-occurrences with Epistemic Network Analysis.
The scoping review included articles predominantly published in dental journals. Most common cases were requests for tooth extraction and disease prevention. The majority of the sources took a paternalistic stance despite weighing patient autonomy, with notable exceptions linked to discussing disease prevention. In the interviews, dentist narratives were characterized by preferring interventions fulfilling both esthetic and medical needs, along with informing patients to empower autonomous decision-making. On the other hand, patients linked the sense of comfort to previous experience and to the state of their oral health. Furthermore, they often defined their oral health via esthetic appearance, while also acknowledging that esthetic standards vary for different individuals.
This thesis operationalized bioethical theory for explorative research. The scoping review revealed that the ideals in relevant literature contradict current practices, as patient wishes have been reported as a factor driving decision-making in dentistry. Furthermore, our results indicate that dentists applied similar concepts to those used in bioethics, while patients’ narratives were more subjective and grounded in personal perspectives. Thus, even though our project contributed to the understanding of the ethical dilemma by presenting various moral realities, a universally acceptable resolution of the ethical dilemma appears unlikely.
