"The obligations of the orthodontist as set forth in the American Association of Orthodontists Code of Ethics (1998) is ´to perform the highest quality orthodontic services within his power to perform ´while respecting the patient’s right to decide the treatment best fitting to personal needs. Disagreement may arise regarding what the patient wants and what the doctor thinks the patient ought to have. Though, patients have a right to self-government and ought to be responsible for what is or is not done to them in treatment.
A doctor who fails to reveal certain facts to the patient is acting paternalistically because the patient cannot decide on realistically if he is not fully informed.
Reciprocal understanding and consensus regarding treatment are not only highly enviable but also necessary in today’s controversial environment. Patient independence has become more than a moral set of guidelines. It is now a legal requirement and is the philosophical and ethical basis for the doctrine of informed consent. The attaining of informed consent and proper presentation of a treatment plan are necessary parts of risk management in orthodontic practice."
The Diagnostic and Treatment Planning Process
In diagnosis and treatment planning, the orthodontist must:
1) Recognize the various characteristics of malocclusion and dentofacial deformity;
2) Define the nature of the problem, including the etiology if possible;
3) Design a treatment strategy based on the specific needs and desires of the individual. As it was noted above; the natural tendency of the doctor to behave paternalistically toward the patient has changed. Since they are now warranted to involve patients in the decision-making process, orthodontists must as well.
4) Present the treatment strategy to the patient in such a way that the patient fully understands the ramifications of the decision."
Basic elements for "informed consent": diagnosis, treatment, fixed edgewise appliance. A doctor who fails to reveal information of Functional Anatomy, age adapted angulations and in this context of Fixed Functional Orthodontics / Bio-Functional Orthodontics, BFO, is acting paternalistically. In disclosing the theory of Functional Anatomy, the theory of official Anatomy, orthodontic diagnosis and treatments are in danger of becoming a general medical risk for malpractice.