Fiduciary duty

Most dentists know that, like other health care practitioners, they owe a duty of care to meet the prevailing standards of practice in treating their patients and that they may be held civilly liable if they breach that duty.

What they may not know is that, even if there are no deficiencies in disclosing the risks of treatment or in the treatment itself, they may be exposed to a finding of liability if they fail to put their patients’ interests ahead of their own. Because of their special position in society, some professionals have a legal and ethical obligation, called a fiduciary duty, to act for the sole benefit of the people they serve.

While power imbalance is a feature of many fiduciary relationships, the key criterion is the discretion of one person to affect the interests of another. A fiduciary must meet the strictest standards of conduct, and may be held to account if his personal interests conflict with his duty or if he profits from his position without the beneficiary’s consent.

Dentists, physicians, lawyers and teachers have been found to be fiduciaries to their patients/clients/students. As emphasized in the RCDSO’s Code of Ethics, this means that “the paramount responsibility of a dentist is to the health and well-being of patients.” Therefore, while there is nothing illegal or unethical in earning a living or making a profit from the practice of dentistry, dentists must always ensure that their financial interests do not take precedence over doing what is best for their patients.