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Ethical aspects in dermatopathology


Dr. Mona Abdel-Halim

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Like any branch in medicine, dermatopathology has its ethical aspects. I was thinking about some issues:

1. Dermatologists doing dermatopathology might fall in unethical behavior when they take biopsies for their cases irrespective to their real need, just for running their business and increasing their profits.

2. Dermatologists doing dermatopathology may automatically interfere with the management plans of patients referred to them for biopsy taking. This may cause conflicts with original clinicians treating the case. In my practice, I have quitted management of dermatological patients. I only do dermatopathology, diagnose the cases, send the patient back to the clinician with his report for management. This comforted the clinicians!! and provided me with the satisfaction that dermatopathology provides without the hassle of therapy!!

3. Another issue concerns what will you do if a clinician sent you a patient for biopsy taking and you found that the lesion is clinically obvious and no biopsy is needed? In such circumstances, I call the clinician and explain to him my opinion and we discuss the case together. Usually clinicians accept my opinion and no biopsy is taken, for the sake of the patient.

4. Do u consider taking a punch biopsy from a lesion that need to be excised completely for proper histopathological evaluation ethical or not? For example, a pigmented lesion clinically suspicious of a melanoma? I consider it unethical, the patient will have to do a re-biopsy, pay again, and most importantly, a proper diagnosis will be delayed...


What else????

We should always keep ethical issues in our mind,,, nothing maintain a doctor's integrity and patients' trust like sticking to ethics and practicing only in the best interests of our patients.

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