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The gentleman, with the help of his friends, takes responsibility for living at a high standard. Four historical examples are used to illustrate this point: Cicero, Castiglione, Lord Chesterfield, and Adam Smith. These lives span the period from the last half of the century before Christ to the last half of the eighteenth century. Gentlemen of that status are rare today, but the legacy of values, self-image, friendships, manners, and speech remain. These are especially a legacy of the professions.

The American College of Dentists is embarking on a multiyear project to improve ethics in dentistry. Early indications are that the focus will be on actual moral behavior rather than theory, that we will include organizations as ethical units, and that we will focus on building moral leadership. There is little evidence that the "telling individuals how to behave" approach to ethics is having the hoped-for effect. As a profession, dentistry is based on shared trust. The public level of trust in practitioners is acceptable, but could be improved, and will need to be strengthened to reduce the risk of increasing regulation. While feedback from the way dentists and patients view ethics is generally reassuring, dentists are often at odds with patients and their colleagues over how the profesion manages itself. Individuals are an inconsistent mix of good and bad behavior, and it may be more helpful to make small improvements in the habits of all dentists than to try to take a few certifiably dishonest ones off the street. A computer simulation model of dentistry as a moral community suggests that the profession will always have the proportion of bad actors it will tolerate, that moral leadership is a difficult posture to maintain, that massive interventions to correct imbalances through education or other means will be wasted unless the system as a whole is modified, and that most dentists see no compelling benefit in changing the ethical climate of the profession because they are doing just fine. Considering organiza-tions as loci of moral behavior reveals questionable practices that otherwise remain undetected, including moral distress, fragmentation, fictitious dentists, moral fading, decoupling, responsibility shifting, and moral priming. What is most needed is not phillosophy or principles, but moral leadership. [ABSTRACT FROM AUTHOR]

Moral choice is committing to act for what one believes is right and good. It is less about what we know than about defining who we are. Three cases typical of those used in the principles or dilemmas approach to teaching ethics are presented. But they are analyzed using an alternative approach based on seven moral choice heuristics-approaches proven to increase the likelihood of locating the best course of action. The approaches suggested for analyzing moral choice situations include: (a) identify the outcomes of available alternative courses of action; (b) rule out strategies that involve deception, coercion, reneging on promises, collusion, and contempt for others; Cc) be authentic (do not deceive yourself); (d) relate to others on a human basis; Ce) downplay rational justifications; (f) match the solution to the problem, not the other way around; (g) execute on the best solution, do not hold out for the perfect one; and (h) take action to improve the choice after it has been made. [ABSTRACT FROM AUTHOR]

One of the most extensively studied constructs in dental education is the four-component model of moral behavior proposed by James Rest and the set of instruments for measuring it developed by Rest, Muriel Bebeau, and others. Although significant associations have been identified between the four components Rest proposed (called here Moral Sensitivity, Moral Reasoning, Moral Integrity, and Moral Courage) and dental ethics courses and practitioners with disciplined licenses, there is no single instrument that measures all four components, and existing single component instruments require professional scoring. This article describes the development and validation of a short, self-scoring instrument, the Moral Skills Inventory, that measures all four components. Evidence of face validity, test/retest reliability, and concurrent convergent and divergent predictive validity are demonstrated in three populations: dental students, clinical dental faculty members, and regents and officers of the American College of Dentists. Significant issues remain in developing the Rest four-component model for use in dental education and practice. Specifically, further construct validation research is needed to understand the nature of the components. In particular, it remains undetermined whether moral constructs are characteristics of individuals that drive behavior in specific situations or whether particular patterns of moral behavior learned and used in response to individual circumstances are summarized by researchers and then imputed to practitioners. [ABSTRACT FROM AUTHOR]

Traditionally, ethics in the professions has focused on big problems that could be found on other peoples' back porches. Small, habitual, frequent, and personal lapses get little attention. In this essay, the literature on opportunism is applied to dentistry with a view toward bringing matters of "near ethics" within reach. Examples of small lapses are discussed under the headings of shirking, free riding, shrinkage, pressing, adverse selection, moral hazard, and risk shifting. The conditions that support opportunism include relationships with small numbers of transactions and uneven access to information. Practical limits on understanding all the consequences of agreements and the costs of supervising others and enforcing corrections of breaches are inescapable aspects of opportunism. Opportunism may not be accepted by all as the subject matter of ethical, but curbing it is a worthy goal and under- standing the causes and management of opportunism casts some light on the ethical enterprise. Four suggestions are offered for addressing issue of opportunism. [ABSTRACT FROM AUTHOR]

The field of dental ethics has matured to the point where it is worthwhile to summarize it. An overview is presented of the methods commonly used to present ethics in dental schools. The three most popular approaches to ethical theory are normative principles (good rules), virtue ethics (good people), and utilitarian views (good outcomes). Each of these approaches has advantages, and each is incomplete. The general problem of converting ethical knowledge to moral conduct will be presented in a subsequent essay. INSETS: NORMATIVE PRINCIPLES OF ETHICS.;EXAMPLE OF AN ETHICS TEACHING DILEMMA: HEINZ.. [ABSTRACT FROM AUTHOR]

This article explores the twin issues of whether organizations can act as ethical agents and what it means to exert moral influence over others. A discursive perspective is advanced that characterizes ethics as the action of communities based on promises. The received view of ethics as either the universal principles or individual responsibility is criticized as inadequate. Moral influence within community is considered under the various headings of democracy, office, brotherhood, agency, witness, and promise making. Moral influence among communities can include the damaging methods of "the superior position," coercion and misrepresentation, and appeal to third parties and the sound methods of rhetoric and promise making. [ABSTRACT FROM AUTHOR]

Progress addressing access to oral health is difficult to evaluate because it is unclear what access means. Ozar's proposal that access should be defined by dentists as true dental need is criticized. It is proposed that four different types of treatment are currently identifiable in dentistry: 1) traditional oral health care, 2) oral care that has minimal or no health component, 3) episodic care, and 4) oral health outcomes not resulting from dentist interventions such as fluoridation. Each of these models has a different definition of care and of access. The profession is becoming segmented--including growing disparities among dentists in earning potential--to the point where a single model may no longer be able to cover all needs for oral health. [ABSTRACT FROM AUTHOR]

There is a part of our mental functioning that makes decisions and executes them and another part that monitors and regulates the first part. When these operations are in balance, we may be said to exercise self-control. There is evidence that these functions operate in different parts of the brain. Self-control plays a vital role in performing complex tasks, habit formation, and ethics. Self-control also interacts with goal setting and achievement. There are predictable differences among individuals who seek success and those who avoid failure. [ABSTRACT FROM AUTHOR]

Persuasion is the art of giving others reasons to believe you. Classically, the three elements of rhetoric have been evidence or a strong case, connecting with and honoring the feelings of the audience, and character—the person and the message always come together as a package. Twenty types of common abuse and misuse of rhetoric are discussed. Rhetoric involves the ethical principle of allowing others to believe without forcing them to do so. It is essential to democratic societies.

The author reflects on aspirational codes and codes of permissible conduct and ethics. He states that aspirational codes and codes of permissible conduct can be based on ethical principles, although they need not be, because values, character and other touchstones are sometimes used. He mentions that the standard principles of beneficence, normaleficence, autonomy and justice are general terms for desirable kind of behavior, but by themselves, they are inclomplete.

The author reflects on the adoption of ethics among medical personnel for the preservation of trust among the public. He points that such criticism lessens the high standards of the profession from the presented discrepancy of the conducted patients' records keeping by ten students. Further, he reveals the must for the adoption of ethics to such profession to cope up with the prevailing issues on medical malpractice.

Examines the issue of distributive justice in dentistry in the United States. Branch of ethics on who the good things in society ought to be allocated; Argument that the existence of disparities in oral health care is stable, efficient and fundamentally fair, even by the standards of liberal social justice philosophers; Pareto optimality curve for dental care; John Rawls' fairness rule which states that any change must benefit the least advantaged members of society.