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Ethics and Law
in DENTAL HYGIENE
This page intentionally left blank
3RD EDITION

Ethics and Law


in DENTAL HYGIENE

Phyllis L. Beemsterboer, RDH, MS, EdD, FACD


Professor, School of Dentistry
Associate Director
Center for Ethics in Health Care
Oregon Health & Science University
Portland, Oregon
3251 Riverport Lane
St. Louis, Missouri 63043

Copyright © 2017 by Elsevier, Inc. All rights reserved. ISBN: 978-1-4557-4546-3

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center
and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.

This book and the individual contributions contained in it are protected under copyright by the Publisher (other
than as may be noted herein).

Notices

Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds, or experiments described herein. In using such information or
methods they should be mindful of their own safety and the safety of others, including parties for whom they
have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most
current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of
their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient,
and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any
liability for any injury and/or damage to persons or property as a matter of products liability, negligence or
otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the
material herein.

Previous editions copyrighted 2010, and 2002.

Library of Congress Cataloging-in-Publication Data

Names: Beemsterboer, Phyllis, author.


Title: Ethics and law in dental hygiene / Phyllis Beemsterboer.
Description: Third edition. | St. Louis, Missouri : Elsevier, Inc., [2017] | Includes bibliographical references and
index.
Identifiers: LCCN 2015047060 | ISBN 9781455745463 (pbk. : alk. paper)
Subjects: | MESH: Dental Hygienists—legislation & & jurisprudence | Dental Hygienists—ethics | Ethics, Dental |
Legislation, Dental | United States
Classification: LCC KF2910.D3 | NLM WU 33 AA1 | DDC 344.7304/13—dc23 LC record available at http://
lccn.loc.gov/2015047060

Content Strategist: Kristin R. Wilhelm


Content Development Manager: Laurie Gower
Content Development Specialist: Elizabeth Fifer
Publishing Services Manager: Hemamalini Rajendrababu
Project Manager: Maria Bernard
Designer: Renee Duenow
Marketing Manager: Traci Cahill

Printed in China

Last digit is the print number: 9 8 7 6 5 4 3 2 1


Contributors v

Contributors

Gail L. Aamodt, RDH, MS Michele Carr, RDH, MA


Associate Professor Dental Hygiene Program Associate Professor and Chair
Clinical Education Coordinator Division of Dental Hygiene
School of Dental Health Science College of Dentistry
Pacific University Ohio State University
Hillsboro, Oregon Columbus, Ohio

Karen Adams, MD Frank Catalanotto, DMD


Clinical Consultant Professor, Department of Public Health
Center for Ethics in Health Care University of Florida
OB Residency Program Director Gainesville, Florida
Oregon Health & Science University
Portland, Oregon Gary Chiodo, DMD
Vice President, Organizational Integrity
Kathryn Ann Atchison, DDS, MPH Peace Health
Vice Provost and Professor Assistant Director
New Collaborative Initiatives Center for Ethics in Health Care
University of California—Los Angeles Oregon Health & Science University
Los Angeles, California Portland, Oregon

Stephanie Bossenberger, RDH, MS Christina B. DeBiase, BSDH, MA, EdD


Professor Associate Dean—Academic and Postdoctoral
Department of Dental Hygiene Affairs
Weber State University School of Dentistry
Ogden, Utah West Virginia University
Morgantown, West Virginia
Linda Boyd, RDH, RD, EdD
Dean and Professor Janice P. DeWald, BSDH, DDS, MS
Forsyth School of Dental Hygiene Professor, Director and Chair
MCPHS University Caruth School of Dental Hygiene
Boston, Massachusetts Texas A&M University Baylor College of
Dentistry
Cheryl A. Cameron, RDH, PhD, JD Dallas, Texas
Vice Provost for Academic Personnel
Virginia and Prentice Bloedel University Professor
Professor, Oral Health Sciences, School of
Dentistry
University of Washington
Seattle, Washington

v
vi Contributors

Lawrence P. Garetto, PhD Carla Loiacono, RDH, MS


Professor Department of Dental Hygiene
Department of Oral Pathology, Medicine and Concorde College
Radiology Dallas, Texas
Indiana University School of Dentistry
Affiliate Faculty Phyllis Martina, BSDH, MBA
Fairbanks Center for Medical Ethics Senior Academic Relations Manager
Indianapolis, Indiana Colgate Oral Pharmaceuticals, Inc.
New York, New York
Debra L. Gerger, RDH, MPH
Department Chair Ann Louise McCann, RDH, PhD
Department of Dental Hygiene Director of Planning & Assessment
West Coast University Texas A&M University Baylor College of
Anaheim, CA, USA Dentistry
Department of Academic Affairs
Kim L. Halula, RDH, PhD Dallas, Texas
Associate Dean, College of Health Sciences
Marquette University Patricia J. Nunn, RDH, MS
Milwaukee, Wisconsin Associate Clinical Professor and Dental Hygiene
Program Director
Anne High, RDH, MS Texas Woman’s University
Instructor Denton, TX
Department of Dental Hygiene
Rochester Community and Technical College John Odom, PhD
Rochester, Minnesota Associate Professor Emeritus
Department of Primary Care
Monica L. Hospenthal, R.D.H., M.Ed. The Ohio State University College of Dentistry
Program Director and Professor Columbus, Ohio
Dental Hygiene Department
Pierce College Fort Steilacoom Pamela Overman, MS, EdD
Lakewood, Washington Professor and Associate Dean for Academic Affairs
School of Dentistry
Susan H. Kass, EdD University of Missouri-Kansas City
Program Coordinator Kansas City, Missouri
School of Health Sciences
Dental Hygiene David Ozar, PhD
Miami Dade College Professor, Philosophy Department
Miami, Florida Loyola University Chicago
Lake Shore Campus
Donna Lesser, RDH, EdD Chicago, Illinois
Director
Dental Hygiene Program
Moreno Valley College
Moreno Valley, California
Contributors vii

Alvin B. Rosenblum, DDS Michelle M. Singley, RDH, EdM


Professor of Clinical Dentistry Dental Hygiene Coordinator, Retired
Ostrow School of Dentistry Lewis and Clark Community College
University of Southern California Godfrey, Illinois
Los Angeles, California
Mary Turner
Toni M. Roucka, RN, DDS, MA Vice President of Instruction
Associate Professor Sacramento City College
Associate Dean for Academic Affairs Sacramento, California
Southern Illinois University School of Dental
Medicine Donna Wittmayer, RDH, BS, MS,
Alton, Illinois Professor Emeritus
Department of Dental Hygiene
Catherine Salveson, RN, MS, PhD Clark College
Associate Professor, Program Director for RN-BS Vancouver, Washington
School of Nursing
Oregon Health & Science University Pamela Zarkowski, BSDH, MPH, JD
Portland, Oregon Provost and Vice President for Academic Affairs
Professor, Department of Patient Management
Alexandra DE Sheppard, BA, DipDH, MEd, School of Dentistry
RDH University of Detroit-Mercy
Associate Clinical Professor and Assistant Director Detroit, Michigan
Dental Hygiene Clinical Education
Faculty of Medicine and Dentistry
University of Alberta
Edmonton, Alberta, Canada
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Reviewers ix

Reviewers

Ann E. Curtis, RDH, RD, MS, CAS Judith Frerichs Mayfield, RDH, MS
Associate Professor Dental Hygiene Instructor
Dental Health Programs El Paso Community College
University of Maine at Augusta El Paso, Texas
Bangor, Maine
Dr. Jodi Olmsted, RDH, PhD
Melissa Deyo, RDH, MAEd Assistant Professor
Past President School of Health Care
Wisconsin Dental Hygienists’ Association College of Professional Studies
University of Wisconsin
Erica L. Little, RDH, MPH Stevens Point, Wisconsin

ix
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Ancillary Writers xi

Ancillary Writers

PowerPoint Presentations Testbank

Sherry Castle Boyer Joseph W. Robertson, DDS


President, Castle Media Consultants, LLC Dentist in Private Practice
Adjunct Clinical Professor Troy, Michigan
School of Dentistry Co-Director and Faculty
University of Detroit Mercy School Dental Hygiene Program
Detroit, Michigan Oakland Community College
Adjunct Professor Waterford, Michigan
School of Dentistry
University of North Carolina
Chapel Hill, North Carolina

xi
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This book is dedicated to my husband,
Joseph R. Jedrychowski,
and
the Beemsterboer/Jedrychowski families
who mean everything to me.
PLB
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Preface xv

Preface

From its early beginnings in the twentieth century, has given way to more specialized titles and to groups
dental hygiene has enjoyed a rapid growth, as both a that work toward increasing the social responsibility
profession and a field of health care science. Dental and ethical conduct of oral health care professionals.
hygiene students no longer have to rely on one text- The importance of ethics is also evidenced by the
book to provide all the materials and references from many dental hygiene educators who are active in the
which to study and learn. Today, numerous textbooks American Society for Dental Ethics (ASDE), an asso-
and online resources, on a wide variety of subject ciation of educators, philosophers, and practitioners
content, are available to dental hygiene educators and who are dedicated to the ongoing study of ethical
students. As the study of dental hygiene has evolved, issues and education with the goal of promoting pro-
so has the world surrounding it. The ongoing develop- fessional responsibility and conduct for the public we
ment of health care law, the growing awareness of serve. The third edition of Ethics and Law in Dental
improving access to oral health care, and the emphasis Hygiene provides up-to-date ethics coverage for dental
on social justice have interwoven themselves into the hygiene students and practitioners.
processes and procedures of dental hygiene. The com-
plexity of the modern world has increased the chal- Audience
lenges of providing ethical care in the daily functioning
of the dental hygienist. Advanced education and train- This text is devoted to the topic of ethics and law for
ing in ethics and legal issues has never been more the dental hygienist, a professional who has a unique
important to help students navigate today’s health care place in the provision of oral health care services. The
realities. Ethics and law now require a dedicated title book provides information and guidance for entry-
that addresses the subject in the proper scope and level dental hygiene students as well as experienced
depth for the dental hygiene student. Ethics and Law practitioners looking to continue their professional
in Dental Hygiene meets this need in both the educa- development.
tional and professional markets, serving as a valuable
tool for new and practicing dental hygienists. Organization
This textbook is organized into three sections, with
Background and Importance the first two sections focusing on content and the
to the Profession third devoted to application. The first section presents
the foundational aspects of ethics and introduces an
Dental ethics as an area of study came into its own in ethical decision-making tool for the analysis of ethical
the 1980s as the result of the efforts of a group of schol- dilemmas. Legal concepts are discussed in the second
ars at Georgetown University in Washington, DC. section and provide information on state practice acts
From this small visionary group came an ethics study and risk management.
network organization, several workshop and consensus The third section provides 32 case scenarios
activities, and ultimately three dental ethics textbooks. authored by various contributors with expertise in
All three textbooks addressed the role of the dental dental and dental hygiene ethics for the reader to
hygienist in some way in the provision of dental health discuss and analyze. Questions to stimulate thought
care to the public. An increased emphasis on and and discussion are included as well, and the ethical
awareness of ethics in the various dental professions decision-making model can be applied to each of the

xv
xvi Preface

cases. Although hypothetical cases, the situations pre- often challenging language used within ethics
sented are a culmination of many years of experience and law.
in dentistry and dental hygiene and provide a variety
of material for lively and fruitful discussion sessions. New to This Edition
Ten “testlets” are also included to help prepare
students for the National Board Dental Hygiene • Returning chapters are fully revised and ex-
Examination (NBDHE). A testlet is a short clinical panded, including coverage of key topics such as
scenario with a series of associated test items that focus the Health Insurance Portability and Account-
on critical thinking and problem-solving skills. Lastly, ability Act (HIPAA), health disparities, and
a listing of suggested activities and projects helps interprofessionalism.
expand upon the topics presented in the textbook and • Additional case scenarios written by experts within
encourages additional thought and discussion. dental and dental hygiene ethics are provide for
discussion, analysis, and application.
Key Features • Increased number of “Testlets” are available to
encourage critical thinking, challenge problem-
• Coverage of ethics and law is balanced equally solving skills, and help prepare students for the
throughout and presented in a clear and concise case-based National Board Dental Hygiene Exami-
manner to assist in understanding these often nation (NBDHE).
complex topics. • The most recent editions of the American Dental
• Concepts are discussed in the context of real world Hygiene Association (ADHA) and American
relevance to help readers apply the knowledge to Dental Association (ADA) codes of ethics are pro-
everyday situations. vided in full.
• A six-step decision-making model equips readers • For instructors, there is a brand new online Evolve
with a framework to tackle ethical situations. website with teaching resources to work in coordi-
• Contributors include educators and practitioners nation with the book. Chapter-by-chapter Power-
who are renowned leaders in the ethics of dentistry Point slides, case study answers and rationales, and
and dental hygiene. a test bank using NBDHE exam-style questions
• A wealth of case studies and additional activities with answers referencing textbook page numbers.
cover a wide range of situations and provide readers Whatever point you are at in your dental hygiene
with opportunities to hone their ability to make career, Ethics and Law in Dental Hygiene is an excellent
sound ethical and legal decisions. foundation and a valuable reference to guide you
• Chapter key terms and a back-of-book glossary through this complex subject matter with ease and
help ensure content mastery of the unique and understanding.
Acknowledgments xvii

Acknowledgments

The collaborators for this edition are dental profes- I am grateful to my colleagues at the Center for
sionals who are devoted to the education of dental Ethics in Health Care at Oregon Health & Science
hygienists. My deepest appreciation goes to Cheryl University, especially Susan Tolle MD and members
Cameron and Pam Zarkowski, dental hygiene educa- from the American Society for Dental Ethics who
tors and administrators who also are attorneys. Bio- work tirelessly to advance the discipline of dental
ethics experts David Ozar and Frank Catalanotto were ethics. It is the friends who walk the journey with you
most generous with their time and expertise in chapter that bring joy and inspiration.
revisions. Phyllis L. Beemsterboer

xvii
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Contents xix

Contents

Section I: Ethics Deontology or Nonconsequentialism, 20


Virtue Ethics, 22
1 Ethics and Professionalism, 3 Summary, 23
The Health Care Provider, 4
The Dental Hygienist, 5 3 Ethical Principles and Values, 25
Professionalism, 6 Ethical Dilemmas, 25
Commercial Model, 6 A Principle, 26
Guild Model, 6 Principle of Nonmaleficence, 26
Interactive Model, 6 Application of Nonmaleficence, 26
Interprofessionalism, 7 Principle of Beneficence, 27
Competency in Dental Hygiene, 7 Application of Beneficence, 27
Standards for Clinical Dental Hygiene Principle of Autonomy, 28
Practice, 9 Application of Autonomy, 28
Professional Traits for the Dental Principle of Justice, 28
Hygienist, 10 Application of Justice, 29
Honesty and Integrity, 11 Values and Concepts, 29
Caring and Compassion, 11 Paternalism, 29
Reliability and Responsibility, 11 Veracity, 30
Maturity and Self-Analysis, 11 Informed Consent, 31
Loyalty, 11 Capacity, 32
Interpersonal Communication, 12 Confidentiality, 32
Tolerance for Others, 12 Applying Principles and Values, 33
Respect for Self, 12 Prima Facie Duties, 33
Legal Requirements for the Dental Other Values Used in Health Care, 33
Hygienist, 12 Summary, 34
Summary, 13
4 Social Responsibility, 35
2 Ethical Theory and Philosophy, 15 Disparities in Oral Health Care, 35
Moral Development, 15 Surgeon General’s Report on Oral
Theories of Cognitive Moral Health, 35
Development, 16 National Institutes of Health Report on
One View: Male Justice Orientation, 16 Oral Health Disparities, 36
An Alternate View: Female Ethic of Health Disparities and Professionalism, 36
Care, 17 Ethical Goals in Oral Health Care, 37
Cognitive Development Theory, 18 Social Justice, 38
Character, 18 Challenges to Ethical Practice and Social
Overview of Ethical Theories, 19 Justice and Role of the Dental
Consequentialism or Utilitarian Hygienist, 38
Ethics, 19 Summary, 39

xix
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Kawelo then looked towards
Wailua and saw that the sands
were in disorder and were
hollowed out in places, leaving
little gulches here and there, with
the rocks exposed. And when he
saw the people like the bending
of the surf, he chanted:

How numerous are the high He mea e nei la kaikoo nui o kai,
surfs today below! Ke auau nei ka moana,
The ocean is bathing in foam. He kai paha no Kahinalii,
Is it the sea of Kahinalii? 37 Ua ku ke a, ka halelo,
For the rocks are exposed and Ke ahua pohaku i Wailua nei la,
the sand is in hollows, O ua one maikai nei,
And the rocks are in heaps in Ua malualua, ua kahawai,
Wailua. I ka pohaku o Kauai,
The sands that once were level O Kauai nui moku lehua,
Are cut up and are in gulches; Aina make kau aloha ole,
Cut up by the rocks of Kauai, Pili makamaka ole ia Kawelo nei
Great Kauai, isle of lehua; 38 la.
Land of death and lacking in
love,
Whose people are not the
friends of Kawelo.

At the close of this chant, A pau keia paha ana, paha hou
Kawelo paused awhile and then aku la no o Kawelo:
continued:

O thou owl, O thou owl! Pueo—e, Pueo—e,


The owl that is wet by the rain, Pueo opili i ka ua,
Pueo kanikani i ka ua,
The owl that is hooting in the Pa na’u na Kawelo,
rain, Na ke koa i ke awakea,
You are hit by Kawelo, He kaha pue wai no Wailua,
By the soldier of the noonday, Ke alo hiki i Kaupea,
The soldiers of the waters of Kuhi au ka luhi kaua,
Wailua, O Onionikaua.
Of the path that leads to Kaupea Pau na kanaka i ka lae one,
Where you and I are made He loaa i loko o Kuikaa,
weary, Ke poo kapu o Hihimanu,
Onionikaua. 39 Nau na kui—e;
The men are all at the sand Nau na kui—e.
point,
They are found within Kuikaa,
The kapued head of Kuikaa.
Grind your teeth in rage,
Grind your teeth in rage.
[38]

All the people who were not O ka poe a pau i makau ole ia
afraid of Kawelo that held their Kawelo, pau loa lakou i ka make
ground were killed by the use of i ka laau palau a Kawelo, ia
his war club Kuikaa. As one side Kuikaa. A make kekahi aoao ia
was killed by Kawelo, the canoe Kawelo, hio ae la na waa, ia hio
leaned over on that side; Kawelo ana, e hahau hou iho ana o
then swung his club along the Kawelo i kana laau palau i
other side killing all the men kekahi aoao, pau loa i ka make.
there. In this slaughter, the two Ma keia make ana, ua make na
officers who were stationed at pukaua elua e noho ana i
Wailua were also slain. Kawelo Wailua. Ia wa, hoouna o Kawelo
then sent Kamalama and his ia Kamalama, ke kaikaina, na
adopted sons, Kaeleha, keiki, o Kaeleha, Kalaumeki, o
Kalaumeki and Kauluiki and his Kauluiki ma.
companions, after the fleeing
enemy.

CHAPTER III. MOKUNA III.

Commencement of the Hoomaka ke Kaua a


Battle Between Kawelo me ko Kauai
Kawelo and the Poe.
People of Kauai.

As soon as Kamalama heard the A lohe o Kamalama i keia olelo a


orders of Kawelo, he Kawelo, hoonoho iho ia ekolu
immediately set his forces in mahele kaua. O Kaeleha, a me
order of battle in three divisions. kekahi mau koa Ulu ma kekahi
Kaeleha and some of Kauluiki’s aoao o ka waa kaua; o
companions were placed on one Kalaumeki a me kekahi mau koa
side of the war canoe, Ulu ma kekahi aoao; o
Kalaumeki with the remainder of Kamalama i waena o ke kuamoo
Kauluiki’s companions were kaua. I ko lakou kaua ana, aole
placed on the other side while o lakou mea i make, eia nae, ua
Kamalama himself took up the komo ka makau i loko o Kauluiki
central position. In the battle that ma, i na koa o Kauai. Nolaila,
followed these preparations, haalele iho la lakou i ke kaua
none of Kawelo’s men were ana, hoi aku la a na waa o lakou.
killed; but Kauluiki and his
companions were so afraid of Ninau mai o Kawelo: “Pehea ke
the warriors of Kauai that they kaua?” Olelo aku ua poe Ulu nei:
gave up fighting and returned to “Aohe pono i koe, haalele aku
their canoe. When Kawelo saw nei makou, aneane e hee mai ko
them coming, he asked them: kaikaina a me au keiki i kela
“How is the battle?” Kauluiki and aoao. Nolaila, hoi mai nei makou
his companions answered: “We e hai aku ia oe, o na waa no o
are beaten. When we left, your kakou a lana aku i kai, alaila,
younger brother and adopted nana aku o ka hoi mai o ko
sons were on the point of being kaikaina, me au keiki, aka, i
routed by the opposing forces. make mai, hoi no kakou i Oahu.”
We have therefore returned to
inform you of this and to get our A lohe o Kawelo i keia mau olelo
canoe out to sea where we can a ka poe Ulu, koo aku la kona
wait for their return; but if they mau wawae i ka moena a paa,
get killed, we will be ready to paa ae la hoi na lima, hakahaka
return to Oahu.” When Kawelo o loko o ka maka moena, nana
heard this from Kauluiki and his mai la o Kawelo ma laila. Ike aku
companions, he stretched out his la ia i ke koa o kona kaikaina, o
feet against the mat and pulled Kamalama, a me na keiki,
the plaiting of the mat down, thus aneane e auhee kela aoao,
making a slit in the mat and mahalo aku la ia i ke koa o
looked through it. When he lakou. A mahope, ike aku la ia e
looked through, he saw the luku ana o Kamalama ma i kela
bravery of his brother Kamalama aoao, a o ke koena i koe, e holo
and adopted sons; they were on aku ana i luna o ka puu o
the point of routing the Kauai Nounou.
forces, and he admired the
Aia hoi i luna o ka puu o
courage of his [handful of] men.
Nounou, o Aikanaka ke ’lii, a me
After this he saw Kamalama and
Kauahoa, ke koa ikaika o Kauai.
his men killing the men on the
Nolaila, manao iho la o Kawelo,
other side, while the few of the
o make o Kamalama ia
enemy left were running up
Kauahoa, nolaila, paha aku la ia,
Nounou hill. On the top of this
penei:
hill, Aikanaka the king and
Kauahoa the great warrior of
Kauai had their camp. Kawelo
was therefore very anxious lest
Kamalama’s forces suffer at the
hand of Kauahoa; so he called to
him in a chant as follows:

A few are consumed, many are Pau iki, pau nui,


consumed, Pau loa, pau poko,
All are consumed in a short Pau a’u lehua i ka manu,
space of time. Ke aina mai la e ka manu.
Your lehua blossoms are Na pua lehua i aina e ka manu a
consumed by the birds, koe koena,
They are being eaten by the Kalohe ua kamalii la, ko lelehu,
birds, Lehulehu mai la ke one,
The lehua blossoms that are Hopu i ka papa hee i ka nalu, [41]
partly eaten by the birds, 40 Kakala e Kamalama,
The children are sporting with O oe la ke koi, owau ka helu ai,
your men. Pau ka pili, ele ka ai i ka maha,
The people are gathering on the O—e ohi ka pili,
sand, I lalo kuli o Kamalama,
They take up their boards to ride Pau ana ka ai i ke poho,
the surf. [40] Mo ka ihu i ka iliohae,
Kamalama is like a full-grown Hae ka puaa i kona kahu,
cock. Hae ka mano i ke kala,
Thou art the piercing rod; I will Hae ka puhi i ka maunu,
keep the record. Eueu kolea i ka pupua,
After they are slain, the record Pelua kuli, hana a noho,
will surely be great. Ia Kuahilau ka luahi a kaua,
Yes, gather up the spoils. Kaa i ke oho, helu papalua,
Kamalama’s knees are bent He la koa, he la hee,
down, He la malu nei e Kamalama,
The food will soon be prepared, Ke lolelua nei ka ihe i ka lima,
The nose is bitten by the barking Ke kui nei ka ihe i ka pali lehua,
dog, Moa keiki, kuku ka heuheu
The pig will attack its master. Okala ka hulu o ke kea i halala,
The shark will attack the kala He pukoa wawahi waa o
fish, Kamalama no Wailua nei,
The eel will attack the bait, Hoouka ia i na koa,
The plover will shake its tail, Hee kuamoo me ka huna lewa,
Bend the knees, make him sit, Auhee liilii, ioio moa i ka nahele
Kuahilau our opponent. I ka li a ke auhee nui,
Straighten out the hair, and thus E ao ka loko e Kamalama,
double your points. Aia mai ka maha laau
There is a day when one is O ka oa o Mamalahoa.
brave and a day when one is O kauwila o Puukapele,
routed. O ka hapupue o Haalelea,
This is a cool day, Kamalama, O kee la o Kalalau,
For the spear is darting I wai auau no Kamalama,
backwards and forwards from E Kamalama e kuu pokii, e hoi.
the hand.
The spear is stringing the cliffs of
lehua.
The down of a young chicken
stands up,
The feathers of the cock are
ruffled.
Kamalama is like a hidden reef
which breaks the canoes of
Wailua
Loaded down with warriors.
The highways are filled with the
fleeing soldiers
Scattered and peeping like
young chicks in the brush.
Forbear of the great slaughter,
Beware of thine inwards, 41
Kamalama.
Eat up the points of the spears
Made from the rafters of
Mamalahoa,
The kauwila wood of Puukapele,
The hapupue of Haalelea,
The kee of Kalalau.
They are as playthings for
Kamalama.
Kamalama, my younger brother,
come back.

In this chant of Kawelo’s, his Ma keia paha a Kawelo, hoi mai


three soldiers, Kamalama, la o Kamalama a me Kaeleha
Kaeleha and Kalaumeki, heard ma laua o Kalaumeki, a hiki
it, and they returned. Upon their lakou i kahi o Kawelo ma, ninau
arrival at the place where mai la o Kawelo: “Pehea ke
Kawelo and the others were kaua?” I aku o Kamalama: “Ua
standing, Kawelo asked them: pau o Kuahulu ma i ka make, a o
“How fares the war?” Kamalama na kanaka i koe, oia no kela e pii
replied: “Kuahulu 42 and his la i ka puu o Nounou, a o ka
companion and a good many of hoahanau no o kaua ke koa nui
their men are dead; what few are o luna i koe, o Kauahoa.”
left are those that are climbing
the hill, Nounou; and Kauahoa, A lohe o Kawelo i keia olelo a
our relative, is the greatest kona kaikaina, maopopo iho la ia
warrior that is left on the hill.” ia he hoopunipuni o Kauluiki ma,
When Kawelo heard his manao iho la ia he poe koa hohe
brother’s report, he realized at wale, nolaila, paha aku la o
once that the report given him by Kawelo, penei:
Kauluiki and the others was all a
lie, and he was therefore
satisfied that they were cowards.
Therefore he chanted the
following lines:

You certainly do not deserve Aole hoi no oukou kahi aloha,


even a small portion of pity No ka pohaku i kaa aku nei; [43]
Because of the rock that has just Komo hewa ko’u waa,
rolled. [42] Pau hewa ka’u ia me ka’u ai,
The loading down of my canoe Pau hewa ko’u kapa me ko’u
was a waste, malo.
The consuming of my food and Kai no he koa no ka la nui,
meat were without any benefit. Aole he koa no ka la iki;
My kapas and loin cloths were Wahawaha i ka laau nui,
worn without any returns. He iki hoi ke kihapai,
I had thought that you were O ka noho ana ka ia Kauai,
soldiers worthy of a great day, Noho i kalukalu o Puna,
But I see that you are only Lilo Puna ia Kaeleha,
soldiers for small affairs. Lilo Kona ia Kamalama,
You detested the great stick, Lilo Koolau ia Kalaumeki,
Your cultivated fields will Pau ka aina i na koa,
therefore be small Mihi i ka hune e Kauluiki ma.
In your occupation of Kauai, Aloha i ka hoi wale e na pokii e,
In the kalukalu of Puna. Nele e na pokii i ka aina ole la.
Puna shall be possessed by
Kaeleha,
Kona shall be possessed by
Kamalama,
Koolau shall be possessed by
Kalaumeki; 43
All the lands are possessed by
the brave ones.
Kauluiki and the others shall
repent of their want.
How I pity your return with
nothing, younger brothers,
For my younger brothers are
indeed without possessions.

When Kauluiki and the others A lohe o Kauluiki ma, pane aku
heard this, they said: “How much la lakou: “Ka! E aho no ka hoi ka
better our conditions would have noho ana me Kakuhihewa, he ai
been had we stayed with i kalo moa, he ole loa ka hoi ka
Kakuhihewa; we would surely holo ana mai nei me Kawelo. Ua
have eaten of the cooked taro, pau ka aina i na koa, o ke aha la
while in following Kawelo we get ka kakou?” Nolaila, manao iho la
nothing, for the lands will be lakou e hoi i Oahu nei.
given to the brave soldiers only,
and what will we get?” They then
thought of returning to Oahu.

CHAPTER IV. MOKUNA IV.

Relating to E Pili ana no


Kaehuikiawakea.— Kaehuikiawakea.—No
Kaihupepenuiamouo Kaihupepenuiamouo a
and Muno.— me Muno.—No
Walaheeikio and Walaheeikio a me
Moomooikio. Moomooikio.

When Kaehuikiawakea saw that Ike iho la o Kaehuikiawakea, ua


their chief warriors in Wailua make na pukaua o lalo o Wailua,
were slain, he climbed up the pii aku la ia i luna o ka puu o
Nounou hill and informed Nounou, e hai aku ia Aikanaka i
Aikanaka of the facts and how ka make o na pukaua a me na
most of their men and the two kanaka o lalo. Ma keia pii ana o
captains were slain. As Kaehuikiawakea i luna o ka puu
Kaehuikiawakea was climbing o Nounou, ike aku la o Kawelo, a
the hill, Kawelo saw him and so paha aku la ia ia Kamalama:
called out to Kamalama in a
chant as follows:

O little Kamalama, my younger E Kamalama iki kuu pokii,


brother, Kuu pokii e, kuu pokii.
My younger brother, my younger
brother!

Kamalama replied: “Yes.” O mai la o Kamalama: “O.” I aku


Kawelo then said to him: “Chase o Kawelo: “E alualu aku oe i kahi
after our relative, unloose his loin pokii o kaua, a wehe mai oe i
cloth, scratch his side and let kahi malo, a wawau aku oe ma
him go.” ka aoao, a hookuu aku.” A lohe
o Kamalama, alualu aku la ia, a
When Kamalama heard this, he loaa o Kaehuikiawakea, alaila,
chased and caught up with kahea aku la: “A make! A make!!
Kaehuikiawakea, and then called A make oe e Kaehuikiawakea!!!”
out: “You are dead! You are Ma keia mau leo puiwa a
dead!! I am going to kill you, Kamalama, ua makau loa o
Kaehuikiawakea!!!” When Kaehuikiawakea, a kokoke loa e
Kaehuikiawakea heard this, he pau kona mama. A hiki o
was so afraid that he was almost Kaehuikiawakea i luna o ka puu
unable to run any more. On his o Nounou, lalau aku la o
reaching the top of the hill, Kamalama, kaili ae la i ka malo,
Kamalama reached out and took a wawau mai la i ka aoao, a
his loin cloth, scratched his side hookuu aku la. A hiki o
and allowed him to go. Kaehuikiawakea i mua o
Aikanaka, huli iho la i lalo kona
alo. Ninau mai la o Aikanaka,
penei: “A hua a pane! A pane ka
waha, he hoolono ko onei.” [45]

When Kaehuikiawakea arrived in I mai o Kaehuikiawakea: “Ua


the presence of Aikanaka, he fell pau loa kakou, aohe kanaka i
face down. [44]Aikanaka then koe, ua pau loa i ka make.”
asked him: “Speak the word. Ninau aku o Aikanaka: “Owai na
Open your mouth and speak the waa?” “O Kamalama ka hai mua
word, I am listening.” ana mai i kai, i ka pae ana mai i
Kaehuikiawakea then said: “We uka, o Kawelo ka keia ope nui e
have all been slain. There are no waiho nei.”
men left; all are dead.” Aikanaka
then asked: “Whose double
canoe is it?” “When it was in the
sea, we were told that it
belonged to Kamalama; but
when it landed, the large bundle
which we saw on the canoe
turned out to be Kawelo.”

kaihupepenuiamouo kaihupepenuiamouo a
and muno. me muno.

These two men were warriors He mau koa keia no Aikanaka, i


belonging to Aikanaka, and they luna o ka puu o Nounou kahi i
were on the Nounou hill with noho ai. Ia Kaehuikiawakea e
him. While Kaehuikiawakea was olelo ana ia Aikanaka, ku ae la o
speaking to Aikanaka, Kaihupepenuiamouo a me
Kaihupepenuiamouo and Muno Muno, a iho aku la me ko laua
stood up and proceeded down mau lau kanaka elua. A hiki
the hill with their eight hundred lakou i lalo, kaua iho la me
men. Upon their arrival at the Kamalama, a pau loa iho la
bottom of the hill, they were met lakou i ka make ia Kamalama
by Kamalama and his men, and, ma. A koe aku la o
in a very short time, they were all Kaehuikiawakea, hoi aku la ia a
killed with the exception of luna o ka puu o Nounou, olelo
Kaehuikiawakea, who returned aku la ia ia Aikanaka: “Ua pau
to the top of the hill and again loa na kanaka i ka make, a owau
informed Aikanaka of the results, wale no koe. Aohe no kela he
saying, “All the men are slain kaua o lalo, he ahi maoli no. Ina
and I alone am left. That cannot e hou mai o Kamalama i ka ihe
be called a battle; it is like real ana, he umi kanaka e ku i ka
fire. Whenever Kamalama pahu hookahi ana, alaila maalili
throws his spear, it will go ka ihe.”
through about ten men before it
stops.”

walaheeikio and walaheeikio a me


moomooikio. moomooikio.

While Kaehuikiawakea was Ia Kaehuikiawakea e olelo ana ia


relating the outcome of the battle Aikanaka, ku mai la keia mau
to Aikanaka, these two men koa elua a liki i ke kaua me
stood up and after boasting of Kamalama. Iho aku la laua me
what they were going to do to ko laua mau kanaka, hookahi
Kamalama, they proceeded lau.
down the hill with their four
hundred men. At the bottom of Kaua iho la lakou, me
the hill, they were met by Kamalama, Kaeleha, Kalaumeki,
Kamalama, Kaeleha and he mau kanaka ikaika loa laua
Kalaumeki when the fighting ma ke kaua ana. He pololei ka
began. These two men, laua ihe ke o, aole e hala, he
Walaheeikio and Moomooikio, kuku ka ihe, he ku ka puamauu,
were very powerful men and ka naonao, ka nalo, ka ukulele.
were very skilful in the use of the Ma keia kaua ana, ua pau loa na
spear. They could hit a grass kanaka i ka make, a koe no ua
blade, an ant, a fly and even a mau wahi koa nei, a hoomau no
flea. In this battle their men in a laua i ke kaua me Kamalama.
short time were all slain, and the Ma keia kaua ana, ua pa ka lima
two were left alone. They o Kaeleha i ka laau, a emi hope
however continued on the fight mai la, a hoomau aku la o
with Kamalama. Kamalama me Kalaumeki i ke
kaua, a mahope emi mai la o
In this fight, Kaeleha’s hand was Kamalama, a aneane no e
struck by a blow from a club and make, i na wahi koa.
he withdrew, leaving Kamalama
and Kalaumeki to continue the A ike o Kawelo i ka nawaliwali o
conflict. Soon after Kaeleha Kamalama, a i ke koa o
withdrew Kamalama also Kalaumeki alaila, paha mai la o
withdrew, and in fact, he Kawelo, penei:
narrowly escaped being slain by
the two men. When Kawelo saw
that Kamalama was almost
spent and how Kalaumeki
bravely continued with the fight,
he chanted as follows:

When Kalaumeki is passed, Ia hookaa o Kalaumeki i hope,


The sea becomes calm, the Pohu ke kai, malino ke au,
waves become still, Hoolana ka waa i ke po’i,
The canoes are floating in the Nalo koli’a ka puu o Kamae,
line of surf. I ke ehu o na wawae,
The hill of Kamae is become hid Ku aku la i ke kai,
By the dust from the feet. O ua koa nui nei, o Kamalama.
He is beaten by the sea,
The great soldier, Kamalama.

When Kamalama heard this A lohe o Kamalama i keia paha


chant by Kawelo, he became a Kawelo, huhu iho la o
very angry and he returned. Kamalama, a hoi aku la. Ike mai
When Kanewahineikiaoha saw la o Kanewahineikiaoha i ka hoi
Kamalama returning, she said to ana o Kamalama, olelo aku la ia
Kawelo: “Say, I think your ia Kawelo: “E, ua huhu paha ko
younger brother is angry with kaikaina ia oe, ei’ aku la ke hoi
you, for there he is coming mai la.” A ike o Kawelo, paha
back.” When Kawelo saw this, aku la ia penei: [47]
he chanted as follows: [46]

The rain cloud of Koolau is Ea mai ana ke ao ua o Koolau,


making its appearance. Ea mai ana ma Nihoa,
It appears from Nihoa, Ma ka mole mai o Lehua,
From the lower end of Lehua. Ua iho la pulu ke kahawai,
It has rained and the valleys are Pulu a’u lehua i ka makoa,
wet. Kahe ka wai ke hanini nei i kai,
Wet are my lehuas with the He mea e nei wai nui o uka.
makoa rain. Ke o nei ka leo o ka pihaa,
The water is running, it is Na kuu kaikaina punahele
flooding the lowlands, Na ke koa nui, o Kamalama,
The waters from the uplands are E Kamalama kuu pokii e,
raging, Hoi mai, kamau lia.
For the sound from the drift logs Nolaila paha ka ikaika ole.
is heard.
It is caused by my favorite
younger brother,
The great soldier, Kamalama.
Say, my younger brother
Kamalama,
Come back and partake of some
food;
Perchance it has something to
do with thy weakness.

When Kamalama heard this A lohe o Kamalama i keia paha


chant from Kawelo, he turned a Kawelo, huli aku la ia e kaua
around and retraced his steps hou, a loaa aku la o Kalaumeki,
until he met Kalaumeki and kaua iho la lakou, a hee o
again resumed fighting. After a Kamalama ma, a no keia hee
short while, Kamalama and ana, ua hiki ke kaua i ke alo o
companion were routed, and in Kawelo. A hiki o Walaheeikio i
this way the fighting was carried mua o Kawelo, paha aku la o
to the very presence of Kawelo. Kawelo, penei:
Upon the arrival of Walaheeikio
in the presence of Kawelo,
Kawelo chanted as follows: 44

Why not take my sister as your Aia hoi ha kau wahine o kuu
wife, kaikuahine,
The ward of Malaiakalani, O ka hanai a Malaiakalani,
Take her as your wife? O kau wahine ia, e—a?

Walaheeikio then refused to Hoole mai la o Walaheeikio ia


accept the offer made by Kawelo: “Aole paha nau e haawi
Kawelo, saying: “It is not for you mai ka wahine a ke koa; o oe no
to present the warrior with a wife. ka makou a make ae, hai no o
We are going after you until we Aikanaka ia oe i luna o ka lele,
kill you; when you shall be puni no o Kauai nei ia makou, ai
offered by Aikanaka upon the no i kalo moa.” Alaila, paha hou
altar for a sacrifice. Then the aku la o Kawelo, penei:
whole of Kauai shall be ours,
and we will eat the cooked taro.”
Kawelo then chanted as follows:

Why not break the point of your E o la hoi e uhai ka maka o ko


spear then ihe,
And throw it at Kawelo? Alaila, pahu mai ia Kawelo.

Walaheeikio replied: “The point I aku o Walaheeikio: “Aole paha


of my spear shall not be broken e uhai ka maka o ka’u ihe ia oe,
by you; because you stand there no ka mea, o oe no e ku mai nei,
as big as the end of a house, this o ka hakala hale, ua like, aole e
spear will not miss when I throw hala keia ihe ia oe ke pahu aku.”
it at you.” Kawelo then chanted Alaila, paha hou o Kawelo,
back the following: penei:

Why don’t you throw your spear E o la hoi e hou mai ua ihe au,
at me then? A kai ae i ka pola o ka malo,
When I shall let it pass at the A ku aku i ka lepo nui,
end of my loin cloth, Hoi aku a lohe o Aikanaka,
Where it will glance to the great Kahi i noho ai ia Kauai nei,
earth. He mai nui nou ka hilahila.
Then when it is reported to
Aikanaka,
Under whom you are living in
Kauai,
Shame, like sickness, will
overcome you. 45

When the man heard this, he A lohe ua wahi kanaka nei, hou
threw his spear at Kawelo. When mai la ia i kana ihe, a ike o
Kawelo saw the spear coming, Kawelo, hoaka ae la ia i ka ihe i
he struck it with his hand making ka pola o ka malo, a ku aku la ka
it touch the end of his loin cloth, ihe i ka lepo, aole ia Kawelo,
then it glanced to the earth, [49]hilahila iho la, a holo aku la.
missing Kawelo. This so shamed Ma keia holo ana o Walaheeikio,
the man that he immediately mai ke alo aku o Kawelo, hahau
[48]turned and started to run aku la o Kawelo i kana laau ia
away. At this attempt on the part Kuikaa, a make iho la o
of Walaheeikio to escape, Walaheeikio.
Kawelo struck him with his war
club, Kuikaa, killing him instantly.

Upon the death of this warrior, Make kela koa, koe o


Moomooikio came up and took Moomooikio, alaila, paha aku o
his place. When Kawelo saw Kawelo, penei:
him, he chanted as follows: 46

Say, Moomooikio, E Moomooikio—e,


Here, take my wife and let her be Eia kau wahine o kuu wahine,
your wife, O Kanewahineikiaoha,
Kanewahineikiaoha. O kau wahine ia, e—a?
Will you accept her as your wife?

[Here the narrative is the same [Maanei ua like na olelo ana me


as that of the other warrior, that ko kela koa, me ko Walaheeikio,
of Walaheeikio, therefore that nolaila, e waiho i ke kakau ana
part is omitted.] maanei.]

After the death of Walaheeikio A make iho la o Walaheeikio a


and Moomooikio by Kawelo, me Moomooikio ia Kawelo holo
Kaehuikiawakea ran off to the aku la o Kaehuikiawakea a hiki i
top of the Nounou hill and again luna o ka puu o Nounou, olelo
informed Aikanaka of the death aku la ia Aikanaka, i ka make o
of the two warriors. When keia mau koa elua. I mai la o
Aikanaka heard this, he said: “At Aikanaka: “Akahi a komo ke anu
last, the cold feeling has entered ia’u, ua naha aku la ka hale e
me, for the house that has malu ai.”
sheltered me is broken.”

CHAPTER V. MOKUNA V.

Relating to No Kahakaloa.—Kona
Kahakaloa.—His Death Make ana ma o Kawelo
by Kawelo. Ala.

While Kaehuikiawakea was Ia Kaehuikiawakea e olelo ana ia


speaking with Aikanaka, the Aikanaka, ku mai la keia koa o
warrior Kahakaloa, stood up and Kahakaloa a paha, e olelo ana,
chanted his boast that Kawelo aole e pakele o Kawelo ia ia.
will never escape him; Wahi a Kahakaloa: “I nahea ka
continuing, he said: “When did Kawelo ao ana i ke koa, a kakou
Kawelo ever learn the arts of i noho iho nei a holo aku nei i
warfare? While he was here Oahu, a moe aku la i ke
living with us before he sailed for kaikamahine a Kalonaikahailaau;
Oahu, where he married the ina o kana hauna laau a na ka
daughter of Kalonaikahailaau, he makuahunowai ona, aole ia e
knew nothing about fighting. If pakele ia’u. No ka mea, ua kaua
the strokes of the war club no maua me ka makuahunowai
learned by him are those of his ona, ua koele na laau a maua,
father-in-law, then he will never aohe make, aohe make.” A pau
escape me, because I have ka olelo ana a Kahakaloa, iho
fought against his father-in-law mai la ia me kanaha kanaka
and our clubs only tapped one elima, a hiki ia i lalo, kaua iho la
another; he was not killed and I lakou.
was not killed.” When he finished
boasting, he proceeded on down Luku mai la o Kamalama i na
the hill with two hundred men, kanaka a pau loa, a koe o
and when they reached the Kahakaloa, ike aku la o Kawelo
bottom, the fighting began. ia Kahakaloa, paha aku la ia
Kamalama then slew all the men penei:
with the exception of Kahakaloa
whom he did not tackle. When
Kawelo saw Kahakaloa, he
chanted as follows:

The great haka; 47 the small O ka-haka-nui, o ka-haka-iki, o


haka; the long haka; ka-haka-loa,
The haka for the putting up of O ka-haka-kau aipu,
calabashes; Keia la paha e—a?
Perhaps on this day, it shall be
done.

Kahakaloa then said to Kawelo: I mai o Kahakaloa ia Kawelo:


“My name was not given me as a “Aole paha i olelo ia mai ko’u
place to hang up calabashes. inoa o Ka-haka-kau-aipu; o
Kahaka, chief of Kauai, is my Kahaka alii o Kauai nei ko’u
name.” Soon after this, they both inoa.” Ia wa, ku like laua, ku o
stood up, Kawelo with his war Kawelo me kana laau o Kuikaa.
club, Kuikaa, and Kahakaloa Ku no hoi o Kahakaloa me kana
with his war club. They both laau palau, a hoala i na laau
raised their war clubs together. palau a laua, kakii mai la o
Kahakaloa swung his war club Kahakaloa i kana laau palau, a
sideways, hitting Kawelo in the loaa iho la ka a-a o Kawelo,
middle, staggering him. Kawelo newa aku la ia. Ia wa, e hue lepo
then raised his club with a ae ana o Kawelo i kana laau, o
[50]swirl
from the ground, cutting Kuikaa, moku kahi
the small toe, the small finger [51]manamana iki o ka wawae,
and the tip of the ear off the ma ia aoao no, moku ka ili
same side. Kawelo then fell to manamana iki o ka lima, ma ia
the ground and laid there. As aoao hookahi no, moku ka
Kawelo was lying on the ground, welelau o ka pepeiao.
Kaehuikiawakea said to
Kahakaloa: “Strike him another Mahope o laila, haule iho la o
blow, so as to kill him, for I see Kawelo i lalo, a waiho iho la. A
his eyes staring at us.” When waiho o Kawelo i lalo, olelo aku
Kahakaloa heard this, he o Kaehuikiawakea ia Kahakaloa,
answered by chanting the e hahau hou iho oe i laau hou, i
following lines: make loa o Kawelo, eia no la ke
aa mai nei na maka. A lohe o
Kahakaloa i keia mau olelo,
pane mai la ia:

He is dead, for it is the blow from Ua make he laau na ka ui.


the young; Hookahi no laau a ka ui make,
The young makes but one blow O iho auanei a hiki i lalo i o Milu,
to kill, I aku i hahau alua ia e
Else he will go down to Milu 48 Kahakaloa.
And say that he was struck Make ai ke koa nui o Kawelo.
twice 49 by Kahakaloa.
Thus was Kawelo the great
soldier killed.

Kahakaloa then said to I aku o Kahakaloa ia


Kaehuikiawakea: “Let us return Kaehuikiawakea: “E hoi kaua e
and partake of some food and ai a maona, alaila, iho mai au e
when our hunger is satisfied, hoomake i kuu luahi;” alaila, hoi
then I will come down and kill my aku la laua. A hiki laua i luna o
opponent.” 50 The two then ka puu o Nounou, olelo aku la o

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