Holden Alexander C L
Faculty of Medicine and Health, The University of Sydney School of Dentistry, 2-18 Chalmers Street, Surry Hills, NSW, 2010, Australia.
BMC Med Ethics. 2020 Jun 3;21(1):45. doi: 10.1186/s12910-020-00485-3.
What can the analysis of the evolution of a code of ethics tell us about the dental profession and the association that develops it? The establishment of codes of ethics are foundational events in the social history of a profession. Within these documents it is possible to find statements of values and culture that serve a variety of purposes. Codes of ethics in dentistry have not frequently presented as the subjects of analyses despite containing rich information about the priorities and anxieties within the profession's membership at the time that the code was written.
This essay uses critical discourse analysis to explore the 2012 and 2018 versions of the Code of Ethics produced by the New South Wales Branch of the Australian Dental Association. This method of discourse analysis examines contradictions between the discourses within the codes and how these relate to broader social realties that surround the dental profession in New South Wales. By analysing the 2012 and 2018 codes together, it is possible to understand how the dental profession views its commitments to society as established through the social contract. Through this assessment, it will be demonstrated that both codes suffer due to their failure to consider the public as a key stakeholder in the creation and curation of the Code of Ethics and how this this relates intimately with the social contract between the profession and the public.
Without the public being the central consideration, both codes amount to declarations of professional privilege and dominance. Although the more recent 2018 Code of Ethics demonstrates insight into the changes in public trust placed in the professions, this analysis shows that that the current code of ethics is still reluctant to recognise and engage with the public as an equal stakeholder in the planning and provision of oral health care and the development of the profession's values and cultural trajectory.
对道德准则演变的分析能让我们了解牙科行业以及制定该准则的协会的哪些方面？道德准则的制定是一个行业社会历史中的基础性事件。在这些文件中，可以找到服务于各种目的的价值观和文化陈述。尽管牙科道德准则包含了关于编写该准则时行业成员的优先事项和担忧的丰富信息，但它们并不常被作为分析对象。
本文运用批判性话语分析方法，探讨澳大利亚牙科协会新南威尔士分会制定的2012年和2018年版《道德准则》。这种话语分析方法考察了准则内话语之间的矛盾，以及这些矛盾与新南威尔士州牙科行业周围更广泛的社会现实之间的关系。通过对2012年和2018年版准则进行综合分析，能够理解牙科行业如何看待其通过社会契约对社会的承诺。通过这一评估将表明，这两个版本的准则都存在缺陷，因为它们没有将公众视为道德准则制定和管理过程中的关键利益相关者，以及这与该行业和公众之间的社会契约有多么密切的关系。
如果不将公众作为核心考量因素，这两个版本的准则都相当于职业特权和主导地位的声明。尽管最新的2018年《道德准则》显示出对公众对各行业信任变化的洞察，但本分析表明，当前的道德准则仍然不愿承认公众是口腔医疗保健规划与提供以及行业价值观和文化轨迹发展的平等利益相关者，也不愿与公众进行互动。
