Dermatoethics

This material is intended to serve as a resource for Program Directors and Residents who are looking for a structured curriculum in ethics, and to fulfill ACGME expectations in this realm.

RECOMMENDED TOPICS FOR 3-YEAR DERMATOETHICS CURRICULAR CYCLE

A. BASIC FOUNDATIONS (C)
* Working definition of ethics
* Defining basic moral philosophy of consequentialism, virtue-based and duty-based moral decision-making
* How to analyze an ethics case

B. PROFESSIONALISM
* Professional boundaries (C)
* Physician impairment, including physician well-being, burnout, substance abuse, depression, disruptive behavior (C)
* Cultural and religious determinants of dermatologic healthcare (C)
* Self-prescribing, prescribing and caring for family, friends, and colleagues (C)
* Communications techniques (active and reflective listening, re-interpretation, summarizing; delivering bad news; dealing with non-adherent patients) (E)

C. EDUCATIONAL ETHICS
* Academic honesty: Plagiarism in the digital age, preparing for Board and in-service examinations (C)
* Responsibilities of the trainee to the patient; disclosure, supervision, first-time procedures (C)
* Faculty-resident-student and mentor-mentee relationships; healthy and unhealthy dynamics (E)
* Ethics of residency and fellowship matches (E)

D. ETHICS OF THE BUSINESS OF DERMATOLOGY
* Conflicts of interest and fiduciary interests (C)
* Ethics of self-promotion, marketing, advertising (C)
* Dermatologist-industry relationships (C)
* Ethical issues in cosmetic dermatology, differential waiting times, physician dispensing (E)
* Ethical issues in dermatopathology: client billing, contractual joint ventures, Stark laws and ant-kickback statutes (E)
* Ethical billing and coding and ethical issues in insurance and managed care (E)
* Direct-to-consumer pharmaceutical marketing (E)

E. RESEARCH AND PUBLICATION ETHICS
* Basic concepts of human subjects research, role of IRB, ethics of clinical trials (C)*
* Publication ethics: duplicate publication, “salami-slicing”, self-plagiarism, ghostwriting, authorship issues (C)

F. CLINICAL ETHICS
* Privacy and confidentiality: including basic definitions, HIPAA regulations, digital privacy, electronic mail, social media, patient photography and image storage, telemarketing, consequences of data breaches (C)**
* Informed consent: including substituted judgment, decisional capacity, refusal of care
* Ethical issues in caring for minors (C)
* Medical errors and disclosure, patient safety (C)
* Unreasonable requests for care (E)
* Lying for and to patients (E)
* Ethics of genetic testing, prenatal screening, preimplantation genetic diagnosis (E)
* Ethical issues in teledermatology and global dermatology (E)
* Ethical issues in hospital consultations (E)
* Ethical issues in complementary medicine (E)
* Ethics of physician extenders (E)
* Ethics of cosmetic surgery and enhancement (E)
* Drug sampling (E)

C - core subject
E - elective subject
** - most or all may already be taught by institution

Resources for a 3-year Ethics and Professionalism curriculum

based on
University of Connecticut’s curriculum

Sessions and Reading Assignments

INTRODUCTION

1.Introduction and Basics: How to recognize and analyze an ethical dilemma

Bercovitch L, Perlis C, Lober C. Preface, What Do We Mean by Ethical? In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. ix-xiv.
Aldrich NZ, Mostow EN. Teaching Ethics in Clinic: Keeping You Smart and Honest In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 125-30.
Stoff BK, Scully K, Housholder AL, et al. The American Academy of Dermatology Ethics Pledge: I will put my patients’ welfare above all other interests, provide care that adheres to professional standards of practice, provide care for those in need, and foster collegiality through interaction with the medical community. J Am Acad Dermatol 2016;75:445-8.
Kantor J, Lushniak BD. Excellence in medicine and the case for aspirational ethics. JAMA Dermatol. Published on line June 29, 2016. doi:10.1001/jamadermatol.2016.2135
Bercovitch L, Long TP. Dermatoethics: A curriculum in bioethics and professionalism for dermatology residents at Brown Medical School. J Am Acad Dermatol 2007;56(4):679-82
Grant-Kels JM, Bercovitch L. Why a new section dedicated to ethics in the JAAD? J Amer Acad Dermatol 2011;64:432-433.
Garg A, Grant-Kels JM. Ethical considerations in dermatology residency. Clin Dermatol 2012;30:202-209
Bercovitch L, Long TP. Ethics education for dermatology residents. Clin Dermatol 2009;27:405-410
Aldrich N, Mostow E. Incorporating teaching dermatoethics in a busy outpatient clinic. J Am Acad Dermatol 2011;65(2):423-4
Meffert JJ.Ethics? Morals? Values? Clinics in Dermatology 2009;27(4):327-330.
Greenberg RD.The American Academy of Dermatology Ethics Committee: how it works and what you need to know. Clinics in Dermatology 2009;27(4):331-335.
Bercovitch L, Long TP. Ethics education for dermatology residents. Clin Dermatol 2009;27(4):405-410.

RESIDENCY EDUCATION

2. See one - do one - teach one: Responsibilities of the trainee to the patient

Kossintseva I, Barankin B. Ethics Education for Residents: Growing Pains and Learning Crises. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 119-24.
Garg A, Grant-Kels JM. Ethical considerations in dermatology residency. Clin Dermatol 2012;30:202-209.
LaRosa C, Grant-Kels JM. See one, do one, teach one: the ethical dilemma of residents performing their first procedure on patients. J Am Acad Dermatol 2016;75(4):845-848.

3. Mentorship-ethical issues & problematic relationships

Sbicca JA, Lane AT. The Mentor-Mentee Relationship: The Devil is in the Details. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 109-12.
Maloney ME. Ethical mentorship: the dilemma of success or failure. Clin Dermatol 2012:30:210-215
Chopra V, Edelson D, Saint S. Mentorship malpractice. JAMA 2016;315(14):1453-4.
Grant-Kels JM. Mentorship: Opinion of a silver-haired dermatologist. J Am Acad Dermatol 2015;73:1066.

4. Ethical issues re: academic honesty, integrity & airplane notes

Grant-Kels JM, Kels BD. The inner golfer in dermatology: "You might as well praise me for not robbing banks." Airplane notes and the Board certifying examination. J Am Acad Dermatol 2012;67:276-8.
Smith RJ, Lipoff JB. “Pretend you didn’t hear that”- managing ethical dilemmas from the bottom of a medical hierarchy. J Am Acad Dermatol 2016;74:766-8.
Lipoff JB, Grant-Kels JM. Reply 2013;68(5):867-9.
Bercovitch. Counterpoint: Should dermatology residents accept educational support sponsored or funded by pharmaceutical companies? J Am Acad Dermatol 2013;68(5):866-7.
Lipoff JB, Grant-Kels JM. Should dermatology residents accept educational support sponsored or funded by pharmaceutical companies? J Am Acad Dermatol 2013;68(5):854-7.
Chiaravalloti A, Kels BD, Grant-Kels JM. Ethical issues of honesty in advertising: affiliation or exploitation? J Amer Acad Dermatol 2016;75(3):645–647.

PROFESSIONALISM

5. Professional boundaries: Recognizing & preventing burnout; Ethics of self promotion

Krupp BH. Professional Boundaries: Safeguaring the Physician-Patient Relationship. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 61-6.
Kowalewski CL, Meffert JJ. Marketing the Physician: From Antitrust to Distrust. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 147-52.
Chiaravalloti A, Kels BD, Grant-Kels JM. Ethical issues of honesty in advertising: affiliation or exploitation? J Amer Acad Dermatol 2016;75(3):645–647.

6. Physician impairment & disruptive physicians: How to respond to unethical behavior of colleagues.

Krupp BH. Feet of Clay: The Impaired Dermatologist. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 97-108.
Grant-Kels JM, Kels BD. The impaired physician reporting dilemma: Legal, moral and ethical considerations for the practicing dermatologist. J Amer Acad Dermatol 2011;65:833-835.
Kantor J, Rapini RP. Ethical approaches to possible unethical behavior in a physician colleague: A systematic approach. J Am Acad Dermatol 2016;74:1026-8.

7. Self prescribing & prescribing for family members/curbside consults

Krupp BH. Professional Boundaries: Safeguaring the Physician-Patient Relationship. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 61-6.
Osswald S. Taking Care of Uncle Bob's Rash: Should One Treat Family Members? In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 67-70.
Grant-Kels JM, Anderson JK, Kels BD. The unsolicited ominous diagnosis: Legal, moral, and ethical considerations. J Am Acad Dermatol 2012;66(6):985-7.
Grant-Kels JM, Kels BD. The curbside consultation: Legal, moral, and ethical considerations. J Am Acad Dermatol 2012;66(5):827-9.
Bercovitch L. Should one offer an unsolicited dermatologic opinion? Ethics for the locker-room dermatologist. J Am Acad Dermatol 2011;65(1):134-6.
Kelsey A, Grant-Kels JM, Payette M. A high tech ethical twist on the curbside consult. J Am Acad Dermatol. 2015;72:349-51.

8. Social media ethics

Sbicca JA, Wesson SK. The Dermatologist and Social Media: The Challenges of Friending and Tweeting. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 77-82.
Garg A, Grant-Kels JM. Ethical considerations in dermatology residency. Clin Dermatol 2012;30:202-209.
Payette M, Albreski D, Grant-Kels JM. You’d know if you friended me on Facebook: Legal, moral and ethical consideration of online social media. J Am Acad Dermatol 2013;69(2):305-7
Luo J, Logan C, Long TP, Bercovitch L. Cyberdermatoethics I: ethical, legal, technologic, and clinical aspects of patient-physician e-mail.^. Clin Dermatol 2009;27:359-366.
Grenier N, Bercovitch L, Long TP. Cyberdermatoethics II: a case-based approach to teledermatology ethics. Clin Dermatol 2009;27:367-371.

9. Ethical issues of multiculturalism & ethnic & religious diversity

Prajapati V, Barankin B. Respecting Differences: Dermatology in a Diverse Society. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 83-90.
Shahriari N, Lakdawala N, Grant-Kels JM. Multiculturalism and diversity: How to ethically care for a prejudiced patient. J Amer Acad Dermatol 2016;75:234-6.
Yeung H, Chen SC, Katz KA, Stoff BK. Prescribing isotretinoin in the United States for transgender individuals: Ethial considerations. J Amer Acad Dermatol 2016;75:648-51.
Mundluru SN, Safer JD, Larson AR. Unforeseen ethical challenges for isotretinoin treatment in transgender patients. Int J Womens Dermatol 2016;2:46-48.

BUSINESS

10. Office dispensing & pricing; Ethics of marketing & promotion; Ethical billing & coding; Conflicts of interest & fiduciary interests

Sidorsky T. The Price is Right: Office Dispensing and Product Pricing. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 137-42.
Cantor J. My Elixir, MD: Morphing a Medical Degree Into a Skincare Brand. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 143-6.
Shannon ND, Perlis C. No Strings Attached? Managing Conflicts of Interest in Medicine. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 185-92.
Resnik BI. Ethical coding. Clin Dermatol 2009;27(4):372-374.
Whitaker-Worth D, Shahriari M, Slade K, Grant-Kels JM. The ethical controversies of office-based dispensing in academic health centers. Clin Dermatol 2012;30:528-532.
Castanedo-Tardan MP, Baumann L. Ethics of selling skin care. Clin Dermatol 2009;27(4):355-358.
Chiaravalloti A, Kels BD, Grant-Kels JM. Ethical issues of honesty in advertising: affiliation or exploitation? J Amer Acad Dermatol 2016;75(3):645–647.

11. Cosmetic dermatology & access to medical dermatology services; Spa dermatology ethical issues

Meffert JJ, Villegas M. Boutiques, Botox, and Basal Cells: Can Dermatology Set Its Priorities. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 131-6.
Sidorsky T, Bercovitch L. Spa, MD: When Dermatology Meets Aromatherapy. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 157-62.
Kels BD, Grant-Kels JM. Conundrum: Who should care for the dermatologic needs of the Medicaid patient? Facts and controversies. Clin Dermatol 2013; 31: 769-771.
Stoff B, Bercovitch L, Grant-Kels JM. The case for equal access to urgent dermatology appointments for Medicaid beneficiaries: When professional duty conflicts with economic reality. J Am Acad Dermatol. 2015;72:181-3.
Baumann L. Ethics in cosmetic dermatology. Clin Dermatol 2012;30:522-527.

12. Ethical issues in managed care & accountable care organizations; Ethical issues of the Affordable Care Act

Brodell LA, Brodell RT, Minogue B. Gatekeepers, Dermatologists, and Their Patients: Mixed Messages in Managed Care. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 163-8.
Pariser D. Ethical considerations in health care reform: Pros and cons of the affordable care act. Clin Dermatol 2012;30:151-5.
Fenichel S. The ethics of national health insurance: a personal essay. Clin Dermatol 2009;27(4):401-404.

13. Ethical issues in dermatopathology

Wiland IV HO, Kels BD, Grant-Kels J. Ethical Adventures in 21st Century Dermatopathology. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 169-76.
Wiland IV HO, Kels BD, Grant-Kels J. Defining the Gray Zone. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 177-84.
Wiland IV HO, Grant-Kels JM. Ethical issues in dermatopathology. Clin Dermatol 2012;30:476-481.
Maley A, Swerlick R, Parker D, et al. Should dermatopathologists participate in diagnostic error disclosure to patients? An ethical analysis. J Am Acad Dermatol 2015;72(5):901-4.
Bercovitch L, Grant-Kels JM, Kels BD. Electronic health record donations by laboratories: Is legal necessarily ethical? J Am Acad Dermatol 2012;66(3):474-8.
Grant-Kels JM, Kels BD. The empty specimen bottle: Legal, moral, and ethical considerations for the dermatologist and dermatopathologist. J Am Acad Dermatol 2011;65(3):621-3.
Mannava KA, Berkovitch L, Grant-Kels JM. Kickbacks, stark violations, client billing, and joint ventures: Facts and controversies. Clin Dermatol 2013; 31: 764-768.
Grant-Kels JM. "Dermatologists' Blind Side: The ethical implications of in house dermatopathology laboratories. J Amer Acad Dermatol 2013;69:1046-1048.
Fabbro SK, Stoff BK. The dermatopathologist’s role in genetic testing for hereditary cancer syndromes: Utility versus patient liberty. J Am Acad Dermatol 2016;74:1282-5.

RESEARCH

14. Publication ethics (other topics covered by institutional required on-line courses)

Katz K, Garner S. Respecting Human Subjects: Responsibilities of the Clinical Investigator. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 193-6.
Gillum JD, Berhard JD, Dellavalle RP. Reading Between the Lines: Can Peer Reviewers Be Expected to Detect Fraud. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 215-220.
Suarez AL, Bernhard JD, Dellavalle RP. Hiding Behind the Curtain: Anonymous Versus Open Peer Review. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 221-6.
Suarez AL, Bernhard JD, Dellavalle RP. Ghost Busting in Dermatology Publications: Providing Byline Integrity. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 227-32.
Suarez AL, Bernhard JD, Dellavalle RP. Telling the Same Tale Twice: Deja vu and the Shades of Grey in Self-Plagiarism. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 233-6.
Slade KL Carreau NA,, Heald P. Ethics of clinical trials in dermatology. Clin Dermatol 2012;30:226-230.
LaChance A, Murphy M.Ethical Conundrums in research. Clin Dermatol 2012;30:220-225.
Olubukola B,Grant-Kels JM, Parrish L. Ethical dilemmas in journal publication.Clin Dermatol 2012;30:231-236.
Straight TM. Clinical research regulation: challenges to the institutional review board system. Clin Dermatol 2009;27(4):375-383.
Weyers W. Medical experiments on humans and the development of guidelines governing them: the central role of dermatology. Clin Dermatol 2009;27(4):384-394.
Shahriari N, Grant-Kels JM, Payette M. Predatory journals: How to recognize and avoid the threat of involvement with these unethical “publishers”. J Amer Acad Dermatol 2016; 75(3):658–659.
Chiaravalloti A, Kels BD, Grant-Kels JM. Ethical issues of honesty in advertising: affiliation or exploitation? J Amer Acad Dermatol 2016;75(3):645–647.

CLINICAL ISSUES

15. Medical errors; when & how to disclose

Shama S, Duncan L, Bercovitch L. Communicating with Patients About Adverse Medical Events: If, When, and How to Say "I'm Sorry". In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 37-44.
Maley A, Swerlick R, Parker D, et al. Should dermatopathologists participate in diagnostic error disclosure to patients? An ethical analysis.J Am Acad Dermatol 2015;72(5):901-4.
Wang AS, Eisen DB. Surgical complications: disclosing adverse events and medical errors. J Am Acad Dermatol. 2013;68:144-146.
Dintzis SM, Stetsenko GY, Sitlani CM, et al. Communicating pathology and laboratory errors: Anatomic pathologists’ and laboratory medicacal directors’ attitudes and experiences. Am J Clin Pathol 2011; 135: 760-5.
Gallagher TH, Waterman AD, Ebers AG, et al. Patients’ and physicians’ attitudes regarding the disclosure of medical errors. JAMA2003;289:1001-1007.
Dintzis SM, Gallagher TH.Disclosing harmful pathology errors to patients. Am J Clin Pathol2009; 131: 463-5.
Kachalia A, Kaufman SR, Boothman R, et al. Liability claims and costs before and after implementation of a medical error disclosure program. Ann Intern Med 2010;153:213-221.

16. Lying for patients: Is it ever ethical? Unreasonable requests for care

Bercovitch L. "Give Me Enbrel or Give Me Death?" Confronting the Limits of Autonomy. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 9-12.
Fried RG, Perlis C. Therapeutic Privilege: If, When, and How to Lie to Patients. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 33-6.
Weston G, Grant-Kels JM. Rothe MJ. The Good, The Bad, and The Ugly of Medication Coverage: Is altering a diagnosis to ensure medication coverage ethical? Int J Women’s Dermatol – in press
Santoro FA, Rothe MJ, Strober BE. Ethical considerations when prescribing biologics in dermatology. Clin Dermatol 2012;30:492-495.

17. Pediatric dermatology ethics; Ethics of genetic testing in dermatology

Bloom KE, Bercovitch L. Autonomy, Isotretinoin, and iPLEDGE: The Ethics of Burdensome Regulation and Use of Teratogenic Medication. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 19-24.
Bloom KE, Bercovitch L. "Who Speaks for the Child?" Consent, Assent, and Confidentiality in Pediatric Dermatology. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 25-32.
Shur N. Hope, Hype, and Genotype: Genetic Testing for Dermatological Diseases In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 197-204.
Wolz MM. The modern minor: Consent and decision-making in pediatric dermatology. J Am Acad Dermatol 2013;69(6):1043-5.
Kelly J, Makkar HP. Ethics in Pediatric Dermatology. Clin Dermatol 2012;30:471-5.
Fabbro SK, Stoff BK. The dermatopathologist’s role in genetic testing for hereditary cancer syndromes: Utility versus patient liberty. J Am Acad Dermatol 2016;74:1282-5.
Wang AR, Bercovitch L. The third chair in the examination room: Practical ethics of decision making for the pediatric dermatologist. Curr Dermatol Rep 2014;3:182-186

18. Teledermatology ethics; Global dermatology ethical issues

Weinberg JL, Gormley RH, Kovarik CL. The Computer Will See You Now: Ethics of Teledermatology. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 45-50.
Weinberg JL. Dermatologists Within, Beyond, and Struggling with Borders: The Global Dermatologist. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 91-6.
Stoff BK, McMichael JM. Short-term international volunteerism in dermatology: Ethical considerations. J Am Acad Dermatol 2014;71(4);822-5.
Boyd AS. Reality in short-term international dermatology missions. J Am Acad Dermatol 2015;72(2):369.
Stoff BK, McMichael JM. Expanding the reality of short-term international volunteerism in dermatology. J Am Acad Dermatol 2015;72(2):369-370.
Nordlund J. Volunteering for humanitarian projects. Clin Dermatol 2009;27(4):395-400.

19. Ethical issues in hospital consultations

Krug LE, Helms SE. Hospital Consultations: Embracing Professionalism Even When It Hurts. In: Bercovitch L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 51-4.
Shaw DJ, Maciag M, Bercovitch L.” I didn’t sign on to die”: The dermatologist’s ethical obligations during a deadly epidemic. J Am Acad Dermatol 2016;74:183-5.
Hansra NK, Shinkai K, Fox LP. Ethical issues in inpatient consultative dermatology. Clin Dermatol 2012; 496-500.
Helms AE, Helms SE, Brodell RT. Hospital consultations: Time to address an unmet need? J Am Acad Dermatol 2009;60(2):308-11.

20. Ethical issues relating to use of physician extenders

Rosenberg S, Perlis C. The Extender Is In: Delegating Ethically -- Ethical and Professional Issues Relating to Physician Extenders in Dermatology. In: Bercovtich L, Perlis C, editors. Dermatoethics: Contemporary Ethics and Professionalism in Dermatology. London: Springer; 2012. p. 55-60.
Slade K, Lazenby, M, Grant-Kels JM. Ethics of utilizing nurse practitioners and physician assistants in the dermatology setting. Clin Dermatol 2012;30:516-521.

21. Ethics in Clinical Photography

Lakdawala N, Fontanella D, Grant-Kels, JM. Ethical considerations in dermatologic photography. Clinics in Dermatology 2012;30:486-491.
Lakdawala N, Bercovitch L, Grant-Kels JM. A picture’s worth a thousand words: Dermatologic photography legal, moral and ethical considerations. J Amer Acad Dermatol 2013;69:473-475.

22. Ethical issues in dermatologic surgery, cosmetic surgery & enhancement

Baumann L. Ethical issues in cosmetic dermatology. Clin Dermatol 2012;30:522-527.
Dhossche JM, Brodell RT, Ward KH. Regarding The use of donated products to train residents to perform injectable cosmetic procedures. J Am Acad Dermatol 2015; 72(1):197-8.
Holmes WD, Whalen JD. Ethics in Dermatologic Surgery. Clin Dermatol 2012;30:482-5.

23. Drug sampling ethical issues; The dermatologist & pharma, Conflicts of Interest

Vashi NA, Latkowsi J-AM . The ethics of the medical-pharmaceutical relationship. Clin Dermatol 2012;30:188-91.
Reid EE, Alikhan,A, Brodell RT. Drug sampling in dermatology. Clin Dermatol 2012;30:192-201.
Miner A, Menter A. The ethics of consulting with pharmaceutical companies. Clin Dermatol 2009;27(4):339-45.
Meffert JJ. No more pens: what the 2009 Pharmaceutical Research and Manufacturer's Association code changes really mean. Clin Dermatol 2009;27(4):346-9.
Draelos ZD.Disclosure: a modest proposal. Clin Dermatol 2009;27(4):336-338.

24. Refusal of care; Ethical issues in geriatric dermatology

Stoff BK, Seidler A, Kinlaw K.A patient with dementia: Decision-making capacity and surrogate decision makers J Am Acad Dermatol 2012;67:745-7.
Fontanella D, Grant-Kels, JM, Patel T, Norman R. Ethical issues in geriatric dermatology. Clin Dermatol 2012;30:511-515.
Danesh MJ, Change ALS. The role of the dermatologist in detecting elder abuse and neglect. J Am Acad Dermatol;73:285-93.
Linos E, Berger T, Chren M-M. Point: Care of potential low risk bccs at the end of life. J Am Acad Dermatol 2015;73;158-61.