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South African Dental Journal

On-line version ISSN 0375-1562
Print version ISSN 0011-8516

S. Afr. dent. j. vol.74 n.6 Johannesburg Jul. 2019 



Ethics, values and practice



WG Evans





The Shorter Oxford English Dictionary carries four definitions of the concept of Value... firstly, that amount of some commodity which is considered to be the equivalent of something else. Secondly the material or monetary worth of a thing. Thirdly, the equivalent in material worth of a specified sum. And Fourthly... Ethics... that which is worthy of esteem for its own sake, having intrinsic worth.1

The concepts of Ethics and Value are in this way occasionally used as though they are interchangeable but a deeper insight may perceive that they are indeed different.

Surbhi, writing on the distinctions, records that Ethics is a set of rules that determine the behaviour of a person, whilst Values are those beliefs " for which a person has an enduring preference".2 Intriguingly, it may be helpful to consider that Ethics constrains, whilst Values motivate.

Accepting that concept implies that Ethics and Values exert rather different impulses on our lives. Surbhi lists what are considered to be the fundamental distinctions between the concepts.2

1. Ethics refers to the guidelines for conduct, that address questions of morality. Value provides the principles and ideals upon which judgement is made of what is more important.

2. Ethics is a system of moral principles, whilst Values stimulate thinking.

3. Ethics compel a person to follow a particular course of action, whilst Values affect the emotional state of mind, acting, as mentioned, as a motivator.

4. Ethics are consistent, affecting all equally. Values may differ between people... what is important for one may not be important for another.

5. Ethics guides decisions regarding what is morally correct or incorrect... but Values directs ambition... what we want to achieve.

6. Ethics determines right or wrong. Values define priorities in life.

These ethical principles reflect quite accurately the concepts which the profession espouses as determining whether we as practitioners conduct ourselves ethically.

Extending the principles to include the entire team in any dental practice opens wider considerations. For it is certain that an ethical practice can only be one in which the entire team is imbued with the sound ethical principles of the practitioner.

The Ethics Compliance Initiative recommends that when members of the team make a decision they should apply a set of Alters which may be summarised as the PLUS group:3

P = Policies

Is the decision in accord with the practice policies, procedures and guidelines?

L = Legal

Is the decision acceptable under the applicable laws and regulations?

U = Universal

Does the decision conform to universal principles which the practice has adopted?

S = Self

Does the decision satisfy personal definitions of right, good and fair?



There is much to be said in support of according the last point dominance in any hierarchy. Ethics is so deeply engrained in our persona that any decision should yield to introspective judgement. A pithy definition of Ethics may be... "that which you would do when no one is watching."

The question may then be raised again. what is the difference between Ethics and Values? So a pithy definition of Values may be "those beliefs that determine behaviour even when someone is watching".

Values set the tone of behaviour, reflecting what is important to the individual. Values may be at the personal or cultural level but importantly may be at the practice level.

Values contribute to the Ethical status of the practice. The application of Ethics in a practice may be helped if the team agree on a process in decision making. Every member of the team has to make decisions, every decision may impact on the practice.

The Ethics Compliance Initiative3 provides guidelines which may be useful...

First, define the problem. Paradoxically, this definition may be clarified by considering possible outcomes. If an outcome can be forecast the problem itself may be better understood.

Second.. seek help.. colleagues in the practice can advise and guide, based on experience and differing outlooks.

Thirdly, identify at least three and if possible Ave practical solutions to the problem. Try to avoid the two option situation which often implies opposing solutions.

Fourthly, evaluate the alternatives. With especial care to ensure recognition is given to what is factual.

Fifthly, make the decision! Apply the decision!

Finally... evaluate the outcome.

If a practice can develop core VALUES, these will be a guide for the team. Those VALUES will depend upon the ETHICS of each individual in the pursuit of moral excellence. The concepts are indeed intertwined but each retains separate influence.



1. The Shorter Oxford Dictionary 1970 Oxford University Press.         [ Links ]

2. Strategic leadership and decision making: Values and Ethics.         [ Links ]

3. Ethics Compliance Initiative.         [ Links ]

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