Part One of the series (April SADJ) provided a comprehensive overview of Justice. 1 Part Two provides the application of these theories to oral health. In the first paper the evolution of Justice is traced back to Ancient Greece, through the testimony of Plato and Aristotle. 2,3 Their view of Justice was influenced by the occurrences in the Republic. The interaction and interpretation of politics, law, God and Man in this society shaped the ancient notion of Justice.

Malpractice complaints against oral health professionals (OHPs) are increasing globally, and include breach of confidentiality, failure to obtain valid informed consent, issuing fraudulent medical certificates, claiming for services not rendered and violating regulations governing the dental profession. South African dentists were most commonly charged with clinical complaints (59%) whilst 29% of dental cases and 46% of dental therapist cases were for fraud. To analyse the nature and outcome of malpractice by OHPs as reported by the Health Professions Council of South Africa (HPCSA) A cross sectional descriptive survey of the data between 2007-2016. 118 cases and 198 counts of dental malpractice were identified, predominantly by dentists (74.6 %), then specialists (17 %) and dental therapists (11%). Males recorded 77.1% of complaints, Gauteng practitioners, 53.4%, and 53.8% were OHPs who had worked for 10 years or more. Approximately a third (37%) of the OHPs had more than one count of malpractice. Mean ages for independent practice were calculated. Fraud, clinical misconduct and unprofessionalism constituted 66.7 %, 23.2 % and 10.1% of all counts of malpractice respectively, while there were significant differences between the involved dentists and dental therapists. Fraud remains the most serious and ever increasing form of malpractice among Oral Health professionals. Dental malpractice, HPCSA, misconduct, oral health professional. Malpractice claims against Oral Health Professionals (OHPs) are on the increase worldwide. 1-4 Malpractice encompasses breach of confidentiality, failure to obtain valid informed consent, issuing fraudulent medical certificates, claiming for services not rendered and violating regulations governing the dental profession. 5 The major cause of malpractice is a failure to adhere to norms and standards of the profession, and a failure to achieve the desired therapeutic goals that are commonly accepted and rendered by peer practitioners. 2 The literature records considerable variation in clinical malpractice claims lodged against OHPs. In the Netherlands, Turkey, Saudi Arabia, Spain and United States of America (USA), the clinical discipline most frequently implicated is oral surgery. 3,4,6-8 In contrast, in Kerman province in Iran, the highest number of clinical complaints are in endodontics, followed by prosthodontics, operative dentistry and oral surgery. 2 According to Postma, et al. 9 a similar distribution of implicated clinical disciplines was recorded in South Africa (SA). The study also showed that fraud was the leading form of malpractice laid against dental therapists (46%), and accounted for 29% of malpractice claims laid against dentists. 9 In most instances potential malpractice suits are settled between OHPs and the patients. In the absence of an amicable solution, patients normally report their complaints to the Health Professions Council of South Africa (HPCSA) or, rarely, lodge a civil malpractice suit. 10

Previous studies indicate that the delivery of the compulsory community service (CS) programme was far from the intended objectives. It is plausible that the intended vision of the programme for the young graduates to“…develop skills, acquire knowledge, behaviour patterns and critical thinking that would help in their professional development and future careers.” may not be realizable. This study evaluated the extent to which CS programme nenabled CS dentists to develop clinical skills. A national cross-sectional study was undertaken on CS dentists. Adapted visual analogue scale (VAS) assessed the frequency of work performed and levels of skills or competency acquired. A total of 217/235 dentists participated, (response rate of 92.34%). The clinical work undertaken and skills/competence acquired were positively correlated; [Mean (SD)= 1.10 (0.326), 1.10 (0.359); r =0.945, p=<0.000, n = 217] respectively. This finding validates the associated loss of skills and competence because of lack of clinical exposure during CS. Specialised dental procedures were never or rarely performed during CS (89.5%). Similarly the level of skills acquired during CS was minimal. CS in its present form disrupts continuing education and the development of learning and clinical skills. These cohorts of dentists have entered independent practice less prepared; may fail to provide quality care to the public. The CS programme is regressive, and requires urgent review and reform.

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The world is witnessing the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with countless serious and fatal cases of corona virus disease (COVID-19). The impact of this pandemic has been most devastating among the health professionals due to the nature of their work. The risk of COVID-19 is particularly greater among oral health professionals due to their proximity to the oral cavity and production of aerosols. This scenario then raises the question, is there a moral duty for dental professionals to care for patients when doing so exposes them to significant risks of COVID-19.