Is there ever a situation where a dentist should refuse to treat a patient?

Whether you know the difference between legitimate limits and discrimination.

Written by Victoria Young, DDS · NYU College of Dentistry '24 · Penn Dental Medicine

The trap

Missing that the question is really testing discrimination law. Getting to HIV status and disability unprompted is what separates a strong answer here.

How to structure your answer

Yes, with clear categories → name legitimate reasons → name illegitimate ones firmly → the duty that survives refusal.

Legitimate: beyond your competence, abusive or threatening behavior, non-adherence making treatment unsafe
Illegitimate: race, religion, sexual orientation, disability, HIV status, ability to pay
Know that refusing on HIV status is illegal discrimination under the ADA
Emergency care and appropriate referral obligations remain either way

A weak answer

What most people say

Yes, in some situations. If a patient is threatening the staff or being abusive, I don't think you're obligated to keep treating them, and if something is outside your training you should refer instead of attempting it. Past that, I'd want to treat anyone who walks through the door. Personal feelings about a patient aren't a good reason to turn someone away.

Gets the easy categories and never reaches discrimination law or HIV status.

A stronger answer

What lands

Yes, in narrow cases. It's beyond my competence and belongs with a specialist, the person is threatening my staff, or they won't do the part of the treatment that makes it safe. What isn't a reason is who they are: race, religion, who they're married to, a disability, and specifically HIV status, which is discrimination under the ADA, not a clinical decision. I delivered meals for an HIV services group in college and one client had been turned away by two offices. And even when a refusal is legitimate, emergency care and a real referral don't go away.

Names the illegitimate reasons out loud, including HIV, and keeps the emergency duty.

This question looks like it's about difficult patients. It's about the ADA, and the second answer gets there unprompted.

These are illustrations, not scripts. An answer you memorize sounds memorized — the point is the shape and the specificity, in your own words and about your own life.

Reading it isn't the same as saying it.

Most people can explain a good answer and still fall apart saying one out loud. Admitted asks you all 100 questions in a faculty voice, records you, and scores your pace and filler words.

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