The Ethics of Therapy Selection in Dermatology

Michael M. Wolz, Mark R. Pittelkow

Department of Dermatology, Mayo Clinic, Rochester, USA.

DOI: 10.4236/ijcm.2014.516132                

Abstract

Off-label use of medication is common in many areas of medicine and particularly in dermatology. Off-label use of medication, whether by prescription or use of samples, creates special ethical issues that include informed consent, patient autonomy and the fundamental adage “first, do no harm”. The choice of medication is also influenced by the patient and appropriate use ultimately depends on a thorough discussion of the risks and benefits as well as a mutually agreed treatment plan.

Keywords

Ethical Issues, Moral Policies, Situational Ethics, Conflict of Interest, Beneficence

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	United States v. Caronia, 703 F.3d 149 (2d Cir. 2012).
[2]	Gilhooley, M. (2011) Commercial Speech and Off-Label Drug Uses: What Role for Wide Acceptance, General Recognition and Research Incentives? American Journal of Law & Medicine, 37, 258-277.
[3]	Mamede, S., van Gog, T., van den Berge, K., Rikers, R.M., van Saase, J.L., van Guldener, C., et al. (2010) Effect of Availability Bias and Reflective Reasoning on Diagnostic Accuracy among Internal Medicine Residents. JAMA, 304, 1198-1203. http://dx.doi.org/10.1001/jama.2010.1276
[4]	Alikhan, A., Sockolov, M., Brodell, R. and Feldman, S. (2010) Drug Samples in Dermatology: Special Considerations and Recommendations for the Future. Journal of the American Academy of Dermatology, 62, 1053-1061. http://dx.doi.org/10.1016/j.jaad.2009.07.053
[5]	Chew, K.D., O’Young, T.S., Hazlet, T.K., Bradley, K.A., Maynard, C. and Lessler, D.S. (2000) A Physician Survey of the Effect of Drug Sample Availability on Physician’s Behavior. Journal of General Internal Medicine, 15, 478-483. http://dx.doi.org/10.1046/j.1525-1497.2000.08014.x
[6]	Venkataraman, S. and Stremersch, S. (2007) The Debate on Influencing Doctors’ Decisions: Are Drug Characteristics the Missing Link? Management Science, 53, 1688-1701. http://dx.doi.org/10.1287/mnsc.1070.0718
[7]	Sams, W.M. and Freedberg, I.M. (2000) The Dermatology-Industry Interface: Defining Boundaries. Journal of the American Academy of Dermatology, 43, 550-554. http://dx.doi.org/10.1067/mjd.2000.107502
[8]	Resneck Jr., J.S. and Vanbeek, M. (2010) Individual Drug Sampling Does Not Supplant the Need for Head-to-Head Trials in Dermatology. Journal of the American Academy of Dermatology, 62, 1062-1063. http://dx.doi.org/10.1016/j.jaad.2009.10.023
[9]	Li, V.W., Jaffe, M.P., Li, W.W. and Haynes, H.A. (1998) Off-Label Dermatologic Therapies. Usage, Risks, and Mechanisms. Archives of Dermatology, 134, 1449-1454. http://dx.doi.org/10.1001/archderm.134.11.1449
[10]	Hyman, P.M. and Carvajal, R. (2009) Drugs and Other Product Choices. Dermatologic Therapy, 22, 216-224. http://dx.doi.org/10.1111/j.1529-8019.2009.01234.x
[11]	Payette, M. and Grant-Kels, J.M. (2012) Generic Drugs in Dermatology: Part I. Journal of the American Academy of Dermatology, 66, 343.e1-343.e8.
[12]	Wolz, M. (2013) The Philosopher in the Clinic. International Journal of Dermatology, 52, 629-630. http://dx.doi.org/10.1111/j.1365-4632.2012.05651.x
[13]	Snyder, L. (2012) American College of Physicians Ethics, Professionalism, and Human Rights Committee. American College of Physicians Ethics Manual: Sixth Edition. Annals of Internal Medicine, 156, 73-104.