February 2005 ■ Journal of Dental Education 225 Why Our Ethics Curricula Do Work Larry E. Jenson, D.D.S., M.A. Abstract: The purpose of this article is to respond to Dr. Charles Bertolami’s article “Why Our Ethics Curricula Don’t Work” in the April 2004 issue of the Journal of Dental Education. This article analyzes the arguments put forth by Bertolami and challenges his assumptions and conclusions. Several examples are given of the ways in which our current ethics curricula do, in fact, work. Dr. Jenson is Associate Clinical Professor and Interim Chair, Division of Clinical General Dentistry, University of California, San Francisco, School of Dentistry. Direct correspondence and requests for reprints to him at University of California, San Francisco, School of Dentistry, 707 Parnassus Ave., Box 0758, San Francisco, CA 94143; 415-502-2289 phone; 415-476-0858 fax; jensonl@dentistry.ucsf.edu. Key words: ethics, dental curricula Submitted for publication 11/4/04; accepted 11/17/04 D r. Bertolami’s indictment of ethics curricula in U.S. dental schools 1 hinges on a curious argument that goes something like this: 1. Cheating would be rare if ethics courses worked. 2. Dental students cheat even after taking ethics courses. Therefore: 3. Ethics courses don’t work to change behavior. And 4. No one has ever done the right thing because of taking an ethics course. These are quite remarkable conclusions given the absence of any empirical research in his article, and although Bertolami acknowledges that he lacks the scientific goods, he nonetheless feels confident that his conclusions are “surely evident.” Well, let’s take a look. Cheating would be rare if ethics courses worked. First of all, cheating is only one of several bad behaviors discussed in a dental ethics course. I don’t have the numbers on this either, but based on my ex- perience as an ethics instructor and from reviewing dental ethics courses at other institutions, I can say that cheating is rarely an important topic in these courses because it is a rather obvious ethical trans- gression. Other, more important ethical issues that pertain to the patient care environment are addressed in these courses, such as keeping patient information confidential, fully informing patients of treatment risks and benefits, objectively criticizing the work of other dentists, declining to provide treatment when certain types of procedures are not warranted, and respecting the autonomous choice of patients. These issues and behaviors are far less obvious to novice dentists and thus are the focus for ethics courses in many dental schools. The fact that cheating behavior is more eas- ily discovered than the poor execution of these other behaviors does not necessarily make it a good barom- eter for pedagogical success. Secondly, Bertolami’s observations about the influence of ethics courses on cheating are very much like saying that traffic violations would be rare if ev- eryone had to pass a test to obtain a driver’s license. The fact is that everyone who has a license has indeed learned the rules of the road, at least enough to pass a written test, yet traffic violations are still quite com- mon. Now, no one would suggest that we abandon the driving test based on the prevalence of traffic viola- tions, yet this is exactly what Bertolami advocates. It should be obvious to anyone that, while knowing the rules of the road is not a sufficient condition for avoid- ing traffic violations, it certainly is a necessary one. One has to minimally know that a red light means “stop” to avoid committing the violation of not stop- ping at a red light. Whether one chooses to stop or not is quite another question (more on this later). It seems entirely reasonable that millions of traffic violations have been prevented simply by having motorists learn the rules of the road; the fact that some people con- tinue to make these violations out of either ignorance or willful neglect says nothing about the value of driv- ing tests. Dental students cheat even after taking ethics courses. No doubt this statement is true in part, but based on my personal experience, I am willing to bet that most instances of cheating in dental school occur in