A dental hygienist saw a patient for a routine scaling in the office of a general dentist. She found a periodontal problem that had not been noted previously in the patient's chart. She explained to the patient the existence of an abnormality and that she would have to talk about it with the dentist.

She communicated to the dentist in private that the patient exhibits what she feels could be a moderately advanced stage of periodontal disease. The probing revealed numerous six$-$millimeter pockets, and the tissue was inflamed and enlarged. The dentist responded, Don't worry; it has been that way for a long time, and I think we can maintain her with cleaning periodically." The dentist tells this to the patient and them moves on to another patient.

The hygienist then tells the patient that she is not comfortable doing only a scaling, so maybe the patient should reschedule at another time with the other hygienist in the office. When the patient heard this, she asked what the hygienist would do if she were in this position. The hygienist replied, "I would see a periodontist."

Questions:

$1.$  Identify and explain the legal issues involved in this case? 

$2.$  Identify ALL the normative ethical principles and values involved in this case and explain how they apply to this case study? 

$3.$  Using the ethical decision$-$making model, list each step and analyze this case.