Ethics in optometry

The information in this article is based on the ethical and professional rules of the Health Professions Council of South Africa as promulgated in the Government Gazette R717/2006.

A practitioner should always respect a patient’s confidentiality, privacy, choices and dignity. It is vital that all information is stored in a patient record system which can either be digital or paper based, with both requiring a secure access mechanism. This is also in compliance with the Protection of Personal Information Act (PoPI).

An optometrist should always maintain the highest standards of personal conduct and integrity. It’s the optometrist’s duty to provide adequate eyecare information about the patient’s diagnosis. Patients should be provided with products they require and not be charged exorbitant prices for basic lenses and enhancements. One should not prejudge what the patient can or cannot afford.

Optometrist need to keep their professional skills and knowledge up to date. Education is key, one cannot cut corners during an eye test when explaining to a patient about their conditions. Technology such as digital acuity software can assist the optometrist by providing the latest information and methods. In so doing, the patient receives an overall better understanding in the examination room.

Maintaining proper communication with patients is vital. Customised recall system software tracks when patients need to return to the practice, this is usually bi-annually for spectacles and annually for contact lens wearers. This can be done in the form of an automated communication stating why they need to return to the practice and how they should go about it.

How do you ethically handle the following situations?

You are a junior Optometrist in the practice, and:

During a slitlamp evaluation, after doing Goldman tonometry with NaFl, you discover a corneal burn as a result of you not rinsing the Hydrogen peroxide off the tonometer tip. You know that when the effects of the Novesin wears off, your patient is going to experience rather unpleasant discomfort in that eye, and they are going to realise that something might have gone wrong during your examination.

How would you handle the situation?

a) Do you have an obligation to tell the patient the true cause of pain? b) Do you give the patient prophylactic drops to prevent infection and say nothing? c) If you feel the chance of serious damage to be low, do you tell the patient?

What would you do if the damage was such that you needed to refer this patient to an Ophthalmologist?

a) Should you contact the Ophthalmologist and tell him/her exactly what happened? b) Is it improper for the specialist to pass judgement regarding your mistake? c) Who would pay for the Ophthalmologist’s consultation, and possible treatment and follow up?

A student enters your practice with -2.00 right eye and +2.00, she has been wearing the spectacles constantly for 2 years. Corrected with -2.00 vx is 6/5 and no damage caused. What do you do?

a) Should you tell the patient? b) Should you call the previous optometrist to discuss it and get the Rx copy? c) Should you just leave it and say nothing, although there was a mistake there was no harm done?

Ethics involves examining a specific problem and values, facts, and logic to decide what the best course of action should be. Some ethical problems are straightforward, such as determining right from wrong. But others can also be more perplexing, such as deciding between two “rights”—two values that are in conflict with each other—or deciding between two different value systems, such as the patient versus the optometrist.

Latest Posts