Dean, Professor/Honorary Consultant in Paediatric Dentistry, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, S10 2TA, UK.
Evid Based Dent. 2021 Jan;22(2):84. doi: 10.1038/s41432-021-0180-4.
Aim To provide an international perspective on COVID-19 (SARS-CoV-2) safety measures and discuss the medico-legal perspective of providing dental care during the COVID-19 pandemic.Data sources This paper is a narrative review. The authors are drawn from academic dentistry and academic law.COVID-19 safety measures in dental clinics Dental care professionals are considered to be at high risk of exposure and subsequent transmission of COVID-19. Therefore, it is of great importance that dental professions put in place measures to prevent cross infection from the virus. These measures include screening patients and spacing of appointments to allow fallow time. Within the clinic, there is a requirement for adequate ventilation (perhaps aided by air cleaners and disinfection air fogging devices) together with cleaning and use of alcohol gels to ensure hands are clean. With regards to dental treatment, the measures expected are also itemised, such as the use of virucidal antiseptic mouthwash, use of personal protective equipment, rubber dam and moving to non-aerosol generating procedures wherever possible.COVID-19 safety measures and the law The point is made that the need for the implementation of these precautions is not only necessary for cross-infection prevention but also for the avoidance of legal issues. The paper discusses the liability of a dentist, both criminal and civil, should a person contract COVID-19 as a result of attending for dental treatment. Although opinion varies across legal jurisdictions, the general consensus is that a practitioner would only be liable if they had been negligent. This is not just the case when guidelines are available, whether legally enforced or not, as the practitioner is required to deliver care in an up-to-date and evidence-based manner. There is a need to document persuasions taken to protect the practitioner from litigation.Conclusion Dentists should follow the scientific evidence to reduce as much as possible the risk of them contracting or spreading COVID-19. In addition, to avoid criminal or civil legal consequences, all procedures to avoid cross infection should be documented, as in not doing so, the practitioner will not be able to prove they were carried out.
提供 COVID-19(SARS-CoV-2)安全措施的国际视角,并讨论在 COVID-19 大流行期间提供牙科护理的医学法律观点。
本文是一篇叙述性综述。作者来自学术牙科和学术法律领域。
牙科诊所的 COVID-19 安全措施:牙科保健专业人员被认为有很高的暴露和随后传播 COVID-19 的风险。因此,牙科专业人员采取措施防止病毒交叉感染非常重要。这些措施包括筛查患者和预约间隔,以留出空档时间。在诊所内,需要充足的通风(也许需要空气净化器和消毒空气雾化设备的帮助),同时还需要清洁和使用酒精凝胶以确保双手清洁。至于牙科治疗,也列出了预期的措施,例如使用杀病毒抗菌漱口水、使用个人防护设备、橡皮障,并尽可能转向非气溶胶产生的程序。
COVID-19 安全措施和法律:文中指出,实施这些预防措施的必要性不仅在于防止交叉感染,还在于避免法律问题。本文讨论了牙医的刑事责任和民事责任,如果一个人因接受牙科治疗而感染 COVID-19,牙医可能会承担责任。尽管法律管辖权的意见各不相同,但普遍共识是,只有在医生疏忽的情况下,医生才会承担责任。即使有指南可用,无论是法律强制执行的还是没有强制执行的,情况都是如此,因为医生需要以最新的、基于证据的方式提供护理。需要记录采取的措施以保护医生免受诉讼。
牙医应遵循科学证据,尽可能降低自己感染或传播 COVID-19 的风险。此外,为了避免刑事或民事法律后果,应记录所有避免交叉感染的程序,因为如果不这样做,医生将无法证明这些程序已经执行。