Governance review demonstrates a need to refine the comprehensive examination and treatment planning process for complex forensic odontology cases. This scenario is professionally challenging due to the inherent uncertainties in identifying remains, the potential for multiple individuals to be involved, and the critical need for accurate identification to provide closure to families and facilitate legal processes. Careful judgment is required to ensure that all available evidence is meticulously gathered, analyzed, and integrated into a robust treatment plan that maximizes the chances of a definitive identification while adhering to ethical and legal standards. The best professional practice involves a systematic, multi-disciplinary approach that prioritizes thorough documentation and collaborative analysis. This includes conducting a detailed ante-mortem data collection, a comprehensive post-mortem examination, and the meticulous comparison of both datasets. The treatment plan should outline a phased approach to identification, beginning with less invasive methods and progressing to more definitive techniques only as necessary, always with the goal of preserving evidence and respecting the deceased. This approach is correct because it aligns with established forensic science principles, ethical guidelines for handling human remains, and the legal requirements for identification in North America, ensuring that the process is scientifically sound, ethically defensible, and legally compliant. It prioritizes the integrity of the evidence and the dignity of the deceased. An approach that focuses solely on post-mortem examination without a robust ante-mortem data collection strategy is professionally unacceptable. This failure neglects a critical component of comparative identification, significantly reducing the likelihood of a successful outcome and potentially leading to misidentification. It violates the principle of thoroughness expected in forensic investigations and may contraindicate established best practices for identification. Another professionally unacceptable approach is to proceed with invasive identification techniques without first exhausting all non-invasive or less invasive options. This can lead to the irreversible destruction of valuable evidence, such as DNA or dental records, which could have been used for a more definitive identification. Ethically, this demonstrates a lack of respect for the deceased and their remains, and legally, it can compromise the admissibility of evidence. Finally, an approach that bypasses consultation with other relevant experts, such as medical examiners, law enforcement, or other forensic specialists, is also professionally deficient. Forensic odontology is often one piece of a larger investigative puzzle. Failing to integrate findings and collaborate with other disciplines can lead to incomplete analyses, missed connections, and ultimately, a less reliable identification. This violates the collaborative nature of forensic investigations and can hinder the overall justice process. Professionals should employ a decision-making framework that begins with a clear understanding of the case objectives and available resources. This involves systematically gathering all relevant ante-mortem and post-mortem data, performing a thorough and objective examination, and then developing a tiered treatment plan. This plan should be flexible, allowing for adjustments based on emerging findings, and should always prioritize ethical considerations, legal compliance, and scientific rigor. Regular consultation with colleagues and relevant stakeholders is crucial throughout the process.

Scenario Analysis: This scenario presents a professional challenge due to the inherent tension between the need for timely case resolution and the ethical obligation to maintain the integrity of forensic evidence. The pressure to expedite a case, especially when a preliminary identification has been made, can lead to shortcuts that compromise the rigor of the examination process. Forensic odontologists must exercise independent professional judgment, resisting external pressures that could lead to biased or incomplete analyses. The core challenge lies in balancing efficiency with the absolute requirement for meticulous scientific methodology and adherence to established protocols. Correct Approach Analysis: The best professional practice involves a comprehensive and systematic approach to the examination of dental evidence, irrespective of preliminary findings or external pressures. This includes a thorough review of all available antemortem and postmortem records, meticulous documentation of all findings, and the application of established comparative methodologies. The correct approach prioritizes scientific accuracy and objectivity, ensuring that any identification is based on a robust foundation of evidence. This aligns with the ethical principles of forensic science, which demand impartiality, accuracy, and the avoidance of premature conclusions. The commitment to a complete and unbiased examination is paramount to maintaining the credibility of the forensic process and ensuring justice. Incorrect Approaches Analysis: One incorrect approach involves relying solely on a limited set of dental characteristics for identification, particularly if these characteristics align with a preliminary suspect profile. This approach fails to acknowledge the possibility of coincidental similarities and neglects the importance of a comprehensive comparison of all available data. Ethically, this constitutes a failure to conduct a thorough and impartial examination, potentially leading to a wrongful identification. It violates the principle of scientific rigor by prioritizing a convenient outcome over a complete analysis. Another unacceptable approach is to overlook or downplay discrepancies between antemortem and postmortem records, especially if they are minor. While some variation can be expected, significant discrepancies should trigger further investigation and a re-evaluation of the identification hypothesis. Ignoring such discrepancies represents a failure to exercise due diligence and can lead to an erroneous conclusion. This approach compromises the integrity of the forensic process by allowing potential inaccuracies to persist. A further incorrect approach involves the premature release of findings or conclusions before a complete and thorough comparative analysis has been performed. This can occur under pressure to provide an early assessment. Such an action undermines the scientific process, as it presents an incomplete picture as definitive. Ethically, it is irresponsible and can have severe consequences for the individuals involved in the case, including potential miscarriages of justice. Professional Reasoning: Professionals facing such situations should employ a structured decision-making process. This begins with a clear understanding of the case objectives and the available evidence. It requires a commitment to established protocols and scientific methodology, prioritizing objectivity and impartiality. Professionals should be trained to recognize and resist external pressures that might compromise their scientific integrity. When faced with conflicting information or pressure to expedite, the decision-making process should involve a systematic review of all evidence, consultation with colleagues if necessary, and a clear articulation of the limitations and confidence levels associated with any findings. The ultimate goal is to ensure that conclusions are scientifically sound, ethically defensible, and contribute to the pursuit of justice.

The audit findings indicate a need to clarify the foundational principles and eligibility criteria for advanced practice certification in North American forensic odontology. This scenario is professionally challenging because misinterpreting or misapplying these core requirements can lead to unqualified individuals seeking advanced certification, potentially compromising the integrity of forensic dental evidence and expert testimony. Careful judgment is required to ensure that only those who meet the rigorous standards are recognized, thereby upholding public trust and the scientific validity of the discipline. The approach that represents best professional practice involves a thorough review of the established examination blueprint and the specific eligibility criteria as outlined by the certifying body. This includes verifying that all prerequisite education, supervised experience, and professional contributions align precisely with the stated requirements for advanced practice. Regulatory and ethical justification for this approach lies in adhering to the established standards of the profession, ensuring competence, and maintaining the credibility of forensic odontology as a specialized field. This meticulous verification process is paramount to upholding the integrity of the certification process and ensuring that advanced practitioners possess the requisite knowledge and skills. An approach that focuses solely on the number of years of general dental practice without confirming specific forensic odontology experience fails to meet the specialized requirements of advanced practice. This is ethically problematic as it bypasses the need for demonstrated expertise in the specific domain of forensic odontology, potentially leading to a certification that does not reflect true advanced competency. Another incorrect approach involves prioritizing the completion of a broad range of continuing education courses, even if they are not directly related to advanced forensic odontology principles or case management. This is a regulatory failure because the examination is designed to assess mastery of specific advanced competencies, not general dental knowledge. Without targeted education and experience in forensic odontology, such a broad approach does not guarantee the necessary specialized skills. Finally, an approach that relies on informal peer recommendations without objective verification of the candidate’s qualifications and experience is professionally unsound. This bypasses the structured assessment process designed to ensure competence and can lead to the certification of individuals who have not met the defined standards, thereby undermining the rigor of the advanced practice certification. Professionals should employ a decision-making framework that begins with a clear understanding of the certifying body’s published requirements. This involves actively seeking out and meticulously reviewing the examination blueprint, eligibility criteria, and any official guidance documents. When evaluating candidates or oneself for advanced certification, a systematic checklist approach, cross-referencing all submitted documentation against these established standards, is essential. Ethical considerations demand transparency and adherence to the defined process, ensuring that the pursuit of advanced practice is based on merit and demonstrable expertise, not on shortcuts or subjective interpretations.

This scenario presents a professional challenge due to the inherent risks associated with dental materials and infection control in forensic odontology. The forensic odontologist must balance the need for accurate identification with the ethical and regulatory obligations to preserve evidence integrity and prevent cross-contamination. The use of specific dental materials can impact post-mortem identification techniques, and improper infection control can compromise both the biological evidence and the safety of personnel. Careful judgment is required to select appropriate materials and protocols that meet forensic standards while adhering to best practices in healthcare. The best professional practice involves utilizing dental materials that are specifically designed for forensic applications or are known to be inert and non-interfering with standard post-mortem imaging and DNA analysis techniques. This approach prioritizes the preservation of evidence integrity and the reliability of forensic findings. Regulatory frameworks, such as those governing forensic science and healthcare, mandate that all procedures and materials used in evidence handling must not compromise the evidentiary value of the remains. Ethical guidelines for forensic practitioners also emphasize the importance of scientific rigor and the avoidance of any actions that could lead to misidentification or the degradation of critical biological information. The use of materials that are well-documented in forensic literature for their compatibility with post-mortem examination and identification methods is paramount. An incorrect approach would be to use standard dental restorative materials without considering their potential impact on forensic analysis. Some common dental materials may contain radiopaque components that could obscure details in X-rays, interfere with DNA extraction, or degrade over time in ways that are not predictable or documented for forensic purposes. This failure to consider the specific forensic context violates the principle of evidence preservation and could lead to compromised identification results, rendering the evidence unreliable in legal proceedings. Another incorrect approach would be to neglect proper sterilization and disinfection protocols for instruments and materials used during the examination. This oversight poses a significant risk of cross-contamination, not only compromising the integrity of the biological evidence from the deceased but also potentially introducing foreign DNA or pathogens. Such a failure directly contravenes established infection control guidelines mandated by public health authorities and professional bodies, which are critical for both personnel safety and the scientific validity of forensic investigations. A further incorrect approach would be to prioritize speed or convenience over established forensic protocols when selecting or applying dental materials. For instance, using a material that sets too quickly or is difficult to remove cleanly could inadvertently alter the dental anatomy or surrounding tissues, thereby hindering subsequent identification efforts. This disregard for meticulous procedure and the potential long-term implications for evidence analysis demonstrates a lack of professional diligence and adherence to the standards expected in forensic casework. Professionals should employ a decision-making framework that begins with a thorough understanding of the case requirements and the available forensic techniques. This involves consulting relevant forensic literature and guidelines regarding the use of dental materials in post-mortem examinations. A risk assessment should be conducted for any proposed material or procedure, considering its potential impact on all aspects of forensic analysis, including imaging, DNA profiling, and morphological examination. Prioritizing materials with a proven track record in forensic applications and adhering strictly to infection control protocols are essential steps in ensuring the integrity and reliability of forensic findings.

Scenario Analysis: This scenario presents a professional challenge due to the inherent subjectivity in interpreting dental evidence, particularly when dealing with fragmented or degraded remains. The forensic odontologist must navigate the potential for bias, the limitations of comparative analysis, and the critical need for scientific rigor when presenting findings that could have profound implications for identification and legal proceedings. The pressure to provide a definitive identification, coupled with the possibility of misidentification, necessitates a meticulous and ethically grounded approach. Correct Approach Analysis: The best professional practice involves a comprehensive comparative analysis of all available antemortem dental records against the postmortem findings. This approach prioritizes the systematic evaluation of all identifying features, including restorations, extractions, anomalies, and overall dental morphology, using established forensic odontology protocols. The justification for this approach lies in its adherence to scientific methodology, aiming for the highest degree of certainty through direct comparison. It aligns with ethical obligations to ensure accuracy and avoid premature conclusions, thereby upholding the integrity of the forensic process and respecting the deceased and their families. This method is supported by professional guidelines that emphasize thoroughness and the exclusion of alternative identifications. Incorrect Approaches Analysis: One incorrect approach relies solely on a single, striking dental characteristic, such as a unique restoration, without conducting a full comparative analysis. This is professionally unacceptable as it bypasses the critical step of ruling out other potential matches and can lead to a false positive identification if the characteristic is not truly unique or if other significant discrepancies exist. It violates the principle of comprehensive evidence evaluation. Another incorrect approach involves making a presumptive identification based on the absence of significant dental anomalies in the postmortem remains, assuming a lack of anomalies in the antemortem records. This is flawed because antemortem records may not be exhaustive, and the absence of documented anomalies does not guarantee their absence in life. It relies on assumptions rather than direct evidence, increasing the risk of misidentification. A further incorrect approach is to prioritize the speed of identification over the thoroughness of the comparative analysis, especially when under pressure from external parties. This haste can lead to overlooking crucial details or making unsubstantiated conclusions, which is a direct contravention of ethical duties to ensure accuracy and scientific validity in forensic casework. Professional Reasoning: Professionals should adopt a systematic, evidence-based decision-making process. This begins with a thorough review of all available antemortem and postmortem data. The core of the process is a rigorous comparative analysis, meticulously documenting similarities and differences. Any discrepancies must be thoroughly investigated and resolved. If a positive identification is proposed, it must be supported by a sufficient number of concordant features, with no unexplained significant discrepancies. The decision-making framework should always prioritize scientific accuracy, ethical conduct, and the avoidance of premature or unsubstantiated conclusions, even under pressure.

Scenario Analysis: This scenario is professionally challenging because it requires balancing the need for consistent and fair assessment of candidate competency with the practical realities of examination administration and resource allocation. Decisions regarding blueprint weighting, scoring, and retake policies directly impact the perceived validity and fairness of the examination, potentially affecting candidates’ careers and the public’s trust in the profession. Establishing clear, transparent, and justifiable policies is paramount to maintaining professional integrity. Correct Approach Analysis: The best professional practice involves a systematic and evidence-based approach to developing and revising the examination blueprint, scoring methodology, and retake policies. This includes regular review by subject matter experts, alignment with current professional practice standards and learning objectives, and consideration of candidate feedback and performance data. The weighting of blueprint sections should reflect the relative importance and frequency of topics in advanced practice forensic odontology. Scoring should be objective and reliable, with clear criteria for passing. Retake policies should be designed to allow for remediation and re-assessment while upholding the standards of the profession, typically involving a limited number of attempts and requiring evidence of further study or practice between attempts. This approach ensures that the examination accurately measures the required competencies and is administered fairly and consistently, aligning with the principles of professional assessment and ethical practice. Incorrect Approaches Analysis: One incorrect approach involves making arbitrary changes to blueprint weighting or scoring criteria based on administrative convenience or anecdotal feedback without rigorous review or expert consensus. This undermines the validity of the examination, as it may no longer accurately reflect the essential knowledge and skills required for advanced practice. It also fails to provide candidates with a clear and predictable assessment framework, leading to potential perceptions of unfairness. Another incorrect approach is to implement overly restrictive or punitive retake policies that do not allow for adequate remediation or learning opportunities. This can disproportionately disadvantage candidates who may have had extenuating circumstances or require different learning approaches, without necessarily improving their competency. Such policies can also discourage qualified individuals from pursuing certification. A third incorrect approach is to maintain outdated blueprint weighting or scoring methods that are not aligned with current advancements in forensic odontology or evolving professional practice. This can result in the examination becoming irrelevant and failing to assess the most critical skills and knowledge needed for contemporary practice, thereby compromising public safety and the profession’s standing. Professional Reasoning: Professionals should approach the development and revision of examination policies with a commitment to validity, reliability, fairness, and transparency. This involves establishing a standing committee of experienced forensic odontologists to oversee the examination process. This committee should regularly review the blueprint, scoring rubrics, and retake policies, using data from candidate performance, expert consensus, and current professional literature. Any proposed changes should be thoroughly vetted for their impact on the examination’s psychometric properties and alignment with professional standards. Communication of these policies to candidates should be clear, comprehensive, and accessible well in advance of the examination.

Scenario Analysis: This scenario presents a professional challenge due to the inherent conflict between a candidate’s desire for efficient preparation and the ethical imperative to maintain the integrity of the examination process. The pressure to perform well on an advanced certification exam, coupled with limited time, can lead candidates to seek shortcuts or engage in practices that, while seemingly beneficial for preparation, could compromise ethical standards or regulatory compliance. Careful judgment is required to balance personal ambition with professional responsibility. Correct Approach Analysis: The best professional practice involves a proactive and ethical approach to candidate preparation. This includes diligently reviewing the official examination blueprint, consulting recommended study materials provided by the certifying body, and engaging in structured self-study or study groups that adhere to ethical guidelines. This approach ensures that preparation is comprehensive, directly aligned with the examination’s scope, and avoids any potential ethical breaches. Specifically, adhering to the guidelines set forth by the American Board of Forensic Odontology (ABFO) regarding examination preparation is paramount. The ABFO emphasizes integrity and a thorough understanding of the subject matter, not the acquisition of proprietary or unauthorized materials. This method respects the examination’s purpose and upholds the professional standards expected of forensic odontologists. Incorrect Approaches Analysis: Seeking out and utilizing leaked or unauthorized examination questions from previous administrations is a significant ethical and regulatory failure. This practice undermines the validity of the examination, creates an unfair advantage, and violates the principles of academic and professional integrity. It directly contravenes the ABFO’s commitment to a fair and standardized assessment of knowledge and skills. Relying solely on informal online forums or social media groups for study materials without verifying their accuracy or origin poses a risk. While these platforms can offer peer support, they can also disseminate misinformation or outdated content. Without a critical evaluation of the sources and a grounding in official ABFO resources, candidates may develop a flawed understanding of the subject matter, leading to inadequate preparation and potentially incorrect application of knowledge in practice. This approach lacks the rigor and reliability expected for advanced certification. Purchasing study guides or question banks from third-party vendors that claim to contain “actual exam questions” or guarantee success is also problematic. Such vendors often operate in a gray area, and their materials may be derived from unethical sources or be inaccurate. This approach prioritizes perceived shortcuts over genuine learning and can lead to a superficial understanding of the material, failing to equip the candidate with the deep knowledge required for advanced practice. It also bypasses the structured and validated preparation resources recommended by the ABFO. Professional Reasoning: Professionals facing similar situations should employ a decision-making framework that prioritizes ethical conduct and adherence to established guidelines. This involves: 1) Understanding the examination’s purpose and the certifying body’s expectations. 2) Prioritizing official resources and recommended study materials. 3) Critically evaluating any supplementary resources for accuracy and ethical sourcing. 4) Recognizing that genuine mastery of the subject matter, achieved through diligent and ethical study, is the most reliable path to success and professional credibility.

This scenario presents a significant ethical and professional challenge due to the inherent conflict between a forensic odontologist’s duty to the deceased and the potential for familial distress, compounded by the need to maintain scientific integrity and adhere to established protocols. The deceased’s family is requesting a specific outcome that may not align with the objective findings, placing the forensic odontologist in a position where they must balance compassion with their professional obligations. Careful judgment is required to navigate these competing interests ethically and legally. The correct approach involves meticulously documenting all findings, adhering strictly to established forensic protocols for dental identification, and communicating the results clearly and objectively to the appropriate authorities, such as the medical examiner or law enforcement. This approach prioritizes scientific accuracy and the integrity of the identification process, which is paramount in forensic science. It acknowledges that the forensic odontologist’s role is to provide objective data, not to cater to familial desires that may contradict evidence. This aligns with the ethical principles of honesty, objectivity, and professional responsibility, as well as the legal requirements for accurate identification in death investigations. An incorrect approach would be to alter or selectively present dental findings to align with the family’s wishes. This constitutes scientific misconduct and a breach of professional ethics. It undermines the reliability of forensic evidence, potentially leading to misidentification or hindering justice. Such an action would violate the fundamental duty of objectivity and could have severe legal ramifications for the odontologist and the investigation. Another incorrect approach would be to refuse to perform the identification altogether due to the family’s emotional state or requests. While acknowledging the family’s distress is important, abandoning a professional duty based on emotional pressure is not ethically justifiable. The forensic odontologist has a responsibility to contribute to the identification process when called upon, and managing familial interactions is a part of that professional responsibility, often facilitated by liaisons. Finally, an incorrect approach would be to provide a definitive identification based solely on the family’s assertion without independent scientific verification. This bypasses the rigorous process of comparison with antemortem dental records and other identification methods, risking a false positive identification. It disregards the scientific methodology essential for reliable forensic conclusions and fails to uphold the standards of the profession. Professionals should approach such situations by first understanding their primary duty: to the scientific and legal process of identification. They should maintain a professional demeanor, communicate findings through official channels, and rely on established protocols. When faced with familial distress, it is appropriate to express empathy but to firmly reiterate the commitment to objective findings. If possible, a liaison (e.g., a detective, medical examiner investigator) should be involved to manage direct communication with the family, allowing the forensic odontologist to focus on the scientific aspects of the case. Documentation is key at every stage, ensuring a clear record of all observations and decisions.

This scenario presents a professional challenge due to the inherent conflict between the desire to provide a definitive forensic opinion and the limitations imposed by incomplete or degraded evidence. The forensic odontologist must navigate the ethical imperative to be truthful and accurate, avoiding speculation, while also fulfilling their duty to assist in investigations. The integrity of the scientific process and the potential impact of a premature or inaccurate conclusion on legal proceedings necessitate extreme caution and adherence to established protocols. The correct approach involves a thorough and objective assessment of the available evidence, acknowledging any limitations and clearly articulating what can and cannot be definitively concluded. This means focusing solely on the scientifically verifiable aspects of the craniofacial anatomy, oral histology, and oral pathology present in the remains. If the evidence is insufficient to establish a positive identification or to confirm specific pathological conditions with a high degree of certainty, the forensic odontologist must state this clearly and avoid making assumptions or extrapolations. This aligns with the ethical principles of scientific integrity, honesty, and the avoidance of misleading conclusions, which are paramount in forensic science. The professional duty is to present findings based on the evidence, not to create evidence or force a conclusion where none exists. An incorrect approach would be to attempt to force a conclusion or identification based on incomplete or ambiguous data. For instance, relying heavily on subjective interpretations of minor anatomical variations without corroborating evidence, or inferring the presence of specific pathologies without histological or clear macroscopic evidence, would be ethically and scientifically unsound. This could lead to misidentification, wrongful accusations, or the misdirection of investigative efforts, undermining the credibility of the forensic process and potentially causing significant harm. Another failure would be to withhold relevant, albeit limited, findings due to a desire for a more complete picture, as even partial information can be valuable to investigators when its limitations are clearly stated. Professionals should employ a systematic decision-making process that prioritizes evidence-based conclusions. This involves: 1) meticulously documenting all observations, no matter how minor; 2) critically evaluating the quality and completeness of the evidence; 3) consulting relevant scientific literature and established methodologies; 4) clearly distinguishing between direct evidence, inferences, and speculation; and 5) communicating findings with precision, explicitly stating any uncertainties or limitations. When faced with challenging cases, seeking consultation with peers or specialists can also be a crucial step in ensuring objectivity and rigor.

The evaluation methodology shows a forensic odontologist facing a complex ethical dilemma involving potential conflicts of interest and the integrity of their professional opinion. This scenario is professionally challenging because it requires the expert to navigate competing loyalties and maintain objectivity when their findings could have significant personal and professional repercussions. The pressure to conform to the expectations of a long-standing professional relationship must be balanced against the paramount duty to provide unbiased and accurate testimony, irrespective of the consequences. Careful judgment is required to uphold the highest ethical standards in forensic science. The best professional approach involves a clear and immediate disclosure of the potential conflict of interest to all parties involved, including the court, legal counsel for both sides, and the agency that retained the expert. This approach is correct because it adheres to fundamental ethical principles of transparency and impartiality, which are cornerstones of forensic practice. Specifically, it aligns with the ethical guidelines of professional organizations that mandate disclosure of any circumstances that could compromise or appear to compromise the expert’s objectivity. By proactively informing all stakeholders, the expert allows them to assess the situation and make informed decisions regarding the expert’s continued involvement or the weight given to their testimony. This upholds the integrity of the legal process and the expert’s professional reputation. An incorrect approach would be to proceed with the evaluation and testimony without disclosing the prior relationship and the potential for bias. This failure to disclose violates the ethical obligation of transparency and can lead to accusations of professional misconduct and bias, undermining the credibility of the expert and the evidence presented. The expert’s duty is to the truth and the court, not to a prior professional relationship that could influence their findings. Another incorrect approach would be to attempt to subtly downplay or omit any findings that might contradict the expectations of the agency that retained the expert, while still presenting a seemingly objective report. This constitutes a breach of professional integrity and a misrepresentation of the expert’s findings. Forensic experts are obligated to report all relevant findings accurately and completely, regardless of whether they align with pre-existing expectations or desired outcomes. Finally, an incorrect approach would be to withdraw from the case without providing a clear and ethical explanation to the court and legal counsel, especially if the withdrawal is perceived as an attempt to avoid scrutiny or difficult testimony. While withdrawal may sometimes be necessary, it must be done in a manner that respects the legal process and does not create further complications or suspicion. Professionals should employ a decision-making framework that prioritizes ethical obligations above all else. This involves a proactive assessment of potential conflicts of interest, a commitment to full and honest disclosure, and a willingness to adhere to professional codes of conduct even when it presents personal or professional challenges. When faced with a potential conflict, the professional should ask: “Does this situation create any appearance or reality of bias?” If the answer is yes, immediate disclosure and consultation with ethical guidelines are paramount.