Exploring the gap between bioethics theory and clinical practice in dental faculties
Imagine a newly graduated dentist in Bogotá facing their first complex clinical case: an elderly patient with deteriorating oral health who cannot afford the ideal treatment plan. The technical aspects are straightforward—diagnosis, planning, procedures. But the ethical dimensions are profound: How does the dentist balance ideal care with financial constraints? Ensure truly informed consent across educational and cultural barriers? Navigate the power dynamics in the clinician-patient relationship? These questions lie at the heart of bioethics education, a field that occupies a curious, often contradictory position in dental faculties across Colombia's capital.
This gap has tangible consequences: studies show that dental professionals frequently demonstrate insufficient knowledge of fundamental ethical concepts like informed consent, regardless of their age, gender, or specialty .
The exploration of bioethics teaching in Bogotá's dentistry programs is more than an academic concern—it represents a critical examination of how we prepare healthcare providers to navigate the complex intersection of technology, humanity, rights, and responsibilities in modern dental care. As we delve into this silent curriculum, we uncover not just shortcomings but also promising pathways toward forming more reflective, responsible dental professionals.
Balancing ideal care with practical constraints
Disconnect between theory and clinical practice
Consequences for quality of care and trust
Bioethics, at its core, is the systematic study of ethical dimensions in healthcare, biological research, and life sciences. It goes beyond traditional medical ethics by addressing ethical questions arising from technological advances, changing patient expectations, and recognizing patient rights in increasingly complex healthcare systems. While ethics generally concerns moral principles and values, bioethics specifically focuses on their application to issues of life, health, and technological intervention in biological processes.
International competency frameworks for dentists now explicitly include ethical reasoning and moral accountability alongside clinical capabilities 3 .
Many Latin American programs have traditionally embedded ethical content within courses on Legal Dentistry rather than establishing standalone bioethics curricula 3 .
A comprehensive investigation into the state of bioethics education across Bogotá's dental faculties revealed striking patterns about how future dentists are prepared for ethical challenges. Researchers conducted a detailed analysis of academic plans across multiple universities and interviewed faculty members and students to understand both the formal curriculum and the lived experience of ethics education 1 .
Examination of formal curricula, syllabi, and course descriptions to identify stated learning objectives and content.
In-depth conversations with bioethics faculty members across institutions to understand teaching approaches.
Assessment of dental students at different training stages to capture perceived learning experiences.
Analysis of commonalities and differences between programs to identify patterns across institutions.
The investigation uncovered several concerning trends in how bioethics is taught across dental programs in Bogotá:
| Aspect | Current Approach | Implications |
|---|---|---|
| Conceptual Focus | Emphasis on legal professional regulations | Reduced to rule-following rather than ethical reasoning |
| Conceptual Clarity | Confusion between Ethics and Bioethics | Failure to address specific bioethical dilemmas in dentistry |
| Curricular Integration | Standalone courses rather than integrated approach | Difficulty applying ethical principles in clinical contexts |
| Teaching Methods | Theoretical transmission of norms | Limited development of moral reasoning skills |
To understand the practical implications of bioethics education, a revealing study was conducted with dentists at a dental university clinic in Valencia (similar studies are cited in Latin American literature). This research focused on a fundamental ethical concept: informed consent—the process by which patients voluntarily confirm their willingness to undergo a specific dental procedure after being informed of all relevant aspects .
62 dentists providing services at a university dental clinic
Structured online questionnaire assessing objective knowledge and self-perception of ethical training
Statistical examination of relationships between knowledge levels and demographic variables
out of 10 points
Average score among dentists surveyed
The findings revealed significant gaps in dentists' understanding of this fundamental ethical obligation:
| Assessment Area | Finding | Statistical Significance |
|---|---|---|
| Overall Knowledge Score | 4.27±0.55 (on a scale where 10 represents perfect knowledge) | N/A |
| Relationship to Age/Gender | No significant correlation | p > 0.05 |
| Relationship to Specialty | No significant difference between specialties | p > 0.05 |
| Self-Perceived Training | No relationship to demographic variables | p > 0.05 |
| Clinical Scenario Management | Significant relationship only with Orthodontics specialty | p < 0.05 |
Studying how ethics is taught and learned requires specialized methodological approaches quite different from those used in clinical dental research. The tools used in the Bogotá bioethics education study represent this unique methodological toolkit:
| Research Tool | Function | Application in the Bogotá Study |
|---|---|---|
| Curriculum Analysis | Examines official documents, syllabi, and course descriptions | Identified emphasis on legal norms over ethical reasoning 1 |
| Semi-Structured Interviews | Gathers in-depth perspectives from faculty and students | Revealed conceptual confusion between ethics and bioethics 1 |
| Clinical Vignettes | Presents realistic ethical dilemmas for response analysis | Assessed application of ethical knowledge to practice situations |
| Knowledge Assessments | Measures understanding of key ethical concepts | Identified gaps in informed consent knowledge |
| Comparative Framework | Enables cross-institutional analysis | Highlighted patterns across different dental programs 1 |
Real-world clinical dilemmas requiring ethical analysis
Ethicists, clinicians, and community representatives
Ethics content throughout dental training
Research identifies these approaches as particularly effective for ethics education 3
The examination of bioethics teaching in Bogotá's dental faculties reveals both challenges and opportunities for improving how we prepare future dentists. The research suggests several promising directions for enhancing ethics education:
Prioritize ethical reasoning over rule compliance to develop moral judgment capabilities.
Clearly differentiate between general ethics, deontology, and bioethics in curriculum design.
Enhance instructor preparation for effective ethics education across the curriculum.
Create explicit bridges between ethical principles and clinical applications.
This transformation requires recognizing that technical dental skill and ethical practice are not separate competencies but interdependent dimensions of professional excellence. The goal is not simply to train technically proficient dentists but to form professionals capable of navigating the complex ethical terrain of modern dental practice with wisdom, compassion, and moral courage.
As one study powerfully frames it, the essential task is "repensar la formación de los futuros odontólogos"—rethinking the education of future dentists through a bioethical lens that promotes more humane care and socially responsible practice 4 .