I switched dentists recently and was very pleased with my new provider. On one occasion, he did a thorough exam and scheduled me for a procedure the following week. Arriving for the follow-up, I was told my procedure would be done by the dentist’s son, who had just completed his residency and joined the practice a few months ago. Is my dentist obligated to inform me before my appointment that a colleague will be performing services in his place? — Name Withheld
From the Ethicist:
When we make appointments to return to see professionals — and this is true about lawyers, accountants and hairstylists too — we generally expect that the appointment will be kept by the person we saw. That’s certainly the case when you make an appointment with a specific health care provider, particularly for significant procedures. What we agreed to wasn’t just the treatment itself; it was also our choice of the person to perform it.
In today’s dental practices, it’s common for teams to work collaboratively, with qualified assistants and associates handling various aspects of care. Sometimes a colleague may need to step in if the primary dentist is unavailable. This can be perfectly appropriate, provided you’re informed beforehand and the substitute provider has the right qualifications.
But when the switch happens without warning? You chose this particular dentist because you have confidence in his expertise and feel comfortable with him; finding someone else in his place (in this case, someone notably less experienced) must have felt like a violation of trust. This dental practice isn’t just responsible for the technical aspects of care — it ought to respect the relationship between patient and provider.
A Bonus Question
I used to work for a religious congregation, but though I left the job on not entirely good terms, I am still a member and key holder of the building it owns. Recently, while leaving the building, I nearly slipped in some water. I thought to let someone know, but I assumed that the water would be discovered during regular maintenance.
Later that day, I learned that a person intimately involved in my separation from the job slipped in the same area and broke her arm. No one knows I was there; insurance is covering everything. I feel terrible that this happened, and yet I don’t think anything would be helped by my coming forward. Am I obligated to do so? — Name Withheld
From the Ethicist:
It would clearly have been better had you alerted the people in charge of the facility when you saw the water; as a key holder, you should have been mindful about the safety of other members. At the same time, you had reason to suppose that the water would soon be found anyway, and not being an officer or employee of the organization, you didn’t have a duty to address the problem yourself. You may be feeling guilt that something bad happened to someone you have negative feelings about. Perhaps you even feel unconsciously that there’s a connection between those feelings and what happened. At this point, though, it’s water under the bridge.
Readers Respond
Last week’s question was from a woman who was in the market for a new appliance. She wrote: “My husband and I have decided to purchase a new induction range, to reduce both our fossil-fuel impact and our exposure to toxins. We currently have a beautiful 1940s-era Wedgewood gas range. Would it be unethical to sell or donate our Wedgewood to another user? I am concerned that we would be extending the continued personal risk and environmental impact of our gas range. My husband believes the next user will have decided to obtain a gas range, so the emissions and risk from ours would be displacing those of another, with no net impact. Can you assist us in sorting out the ethical choice?”
In his response, the Ethicist noted: “It seems a safe assumption that if you sell your Wedgewood you will, as your husband says, be selling to someone who’s in the market for a gas range. Your husband might also note that, because most of our electricity still comes from burning fossil fuels, the relative fossil-fuel consumption of different types of ranges will be affected by how your local electricity is generated. Induction ranges are impressively energy- efficient, but the power plants that juice them are typically far less so. On the other hand, there’s reason to hope that renewables will account for a growing share of our electricity. … Yet it’s hard to estimate the effects of a single uncoordinated act. … All told, my inclination would be to take the cooktop offline. There are a few people who just might be interested in the article as a collectible, for purely decorative purposes; sometimes these things are rented out to film and TV production designers. In those settings, a 1940s Wedgewood like yours can provide atmosphere — without affecting our own.” (Reread the full question and answer here.)
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I’m thankful for Dr. Appiah’s response and his suggestion to repurpose the old stove rather than add another noncompostable item to the landfill. Rather than taking her stove offline, another option for the letter writer is to use it as an outdoor stove under a covered area, which is what some friends have done with their lovely green Wedgewood. They turn the gas off at the connection when it’s not in use, and it’s a fun nostalgia piece in their outdoor entertaining area. — Chris
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I appreciate what the Ethicist is saying here, right up until the very end. I think if, after learning about its impact on his health, someone has made the decision to use a gas stove, who is the Ethicist to say it’s morally wrong to sell a stove to him? Is it morally wrong to sell someone a car that greatly increases their chances of dying in a crash (i.e. every car)? Is KFC breaking some moral law every time they sell a drumstick instead of a salad? What about cigarettes? Every purchase we make is a trade-off between certain costs and benefits, our health being just one variable in the equation. If some chef out there wants a beautiful 1940s gas range, it would be a real shame if the letter writer were to throw hers out in some paternalistic attempt to protect the health of someone she’s never met, especially considering how easy it is to mitigate said health impact with proper ventilation. — William
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Given the results of the recent election, the letter writer’s sensitivity, while noted, is unlikely to change the course of the planet. She should just put the stove in the basement while she ponders the future. A difference, to be a difference, must make a difference. — Hank
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We have an induction cooktop that replaced our electric range, which replaced the 1970s gas range that was in our 1940s-era home when we moved in 18 years ago. The letter writer could offer to donate her splendid gas range to the Henry Ford Museum, which maintains a large collection of Americana. — Tracy
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When it comes to the decision of whether it is better for the environment to replace an old energy hog — be it a building, a car or a gas range — with a new efficient model, the question mainly revolves around a comparison of the embodied energy in the new model versus the savings in energy it achieves over time. I can’t speak directly to gas stoves, but I can tell you that it is always preferable to retrofit an existing building over tearing down and building anew from the perspective of net energy use. In other words, the embodied energy required to produce the new building decisively exceeds the extra energy required to run the poorer performing retrofitted building over its useful life. By way of a case study, the United Nations might have considered scrapping its inefficient Secretariat tower some years ago to build a new energy-efficient tower, but the embodied energy in the new tower would have been far greater than the energy savings it presented over a 70-year useful life, and they wisely decided to remodel and upgrade. On the other hand, studies do indicate that you can get a worthwhile energy payback on an electric car if it is charged via solar cells. By extension, I am hesitant to tell the letter writer that dumping the old stove is best for the environment. — Tom
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