The Hippocratic Oath in daily practice: ethical challenges in modern oral and dental medicine in Cameroon

Abstract

Introduction: in the context of rapidly evolving oral health technologies and facing Cameroon's socioeconomic realities, the rigorous application of Hippocratic Oath ethical principles represents a crucial challenge for practitioners. This study evaluates adherence to ethical foundations and identifies barriers to their implementation in daily dental practice in Yaoundé and Douala.

Materials and methods: a mixed-methods cross-sectional study was conducted from January to April 2024 among 47 dentists from public and private sectors in Yaoundé and Douala. A semi-structured questionnaire explored adherence to four cardinal principles (beneficence, non-maleficence, autonomy, justice) and documented encountered difficulties. In-depth interviews enriched data collection. Statistical analysis (SPSS v26) and thematic analysis (NVivo 14) were employed.

Results: the 47 participants (mean age: 42.3 ± 8.7 years; experience: 14.2 years) showed variable adherence to ethical principles: beneficence (87.2%), non-maleficence (76.6%), autonomy (61.7%), and justice (53.2%). Primary barriers included economic constraints (89.4%), material insufficiency (80.9%), administrative pressures (68.1%), qualified personnel deficit (63.8%), and cultural divergences (57.4%). Qualitative analysis revealed three major tensions: profitability versus quality of care, training-field inadequacy, and influence of traditional beliefs.

Conclusion: Cameroon's complex socioeconomic context complicates the application of Hippocratic principles in dentistry. Contextualized strategies, including continuous ethics training and professional support structures, are essential to strengthen daily ethical practice