Abstract
64667 Ethics of Treating Actinic Keratoses in Patients of Advanced Age
Journal of the American Academy of Dermatology, Vol.93(3 Suppl), pp.AB197-AB197
09/2025
DOI: 10.1016/j.jaad.2025.05.781
Abstract
Treating actinic keratoses (AKs) in elderly patients presents a unique ethical dilemma, requiring careful consideration of medical, financial, and humanistic factors. As AKs are precursors to squamous cell carcinoma (SCC), the potential for progression warrants management. However, balancing this risk with the principles of beneficence, non-maleficence, and distributive justice is crucial. Beneficence requires offering appropriate care to prevent AKs from progressing to SCC, despite that only 0.1-10% of AKs evolve into SCC. Non-maleficence reminds us to avoid unnecessary harm, especially in elderly patients who may experience significant discomfort from treatments like cryotherapy, topical chemotherapy, and photodynamic therapy, which can lead to scarring, dyspigmentation, or pain. For patients of advanced age, the risks of discomfort and potential complications from treatment often outweigh the benefits, as these patients may have comorbidities that pose a greater risk to their overall health. Distributive justice also becomes a key consideration, especially with a national shortage of dermatologists. Allocating time and resources to treat low-risk lesions like AKs may divert care from patients with more urgent needs. The cost of treating AKs also places a financial burden on patients and the healthcare system, with treatment costs rising steadily. Shared decision-making that involves the patient, caregivers, and physician is vital to ensure that care aligns with the patient’s values and goals, while considering the ethical principles guiding healthcare. This discussion highlights the importance of incorporating patient-centered ethics into dermatologic care, particularly for the elderly.
Details
- Title: Subtitle
- 64667 Ethics of Treating Actinic Keratoses in Patients of Advanced Age
- Creators
- Samer Wahood - Brown UniversityShivani Jain - Louisiana State University Health Sciences Center New OrleansIdowu Olugbade - Brown UniversityMegan Hoang - Brown UniversityNicole Negbenebor - Department of Dermatology, University of Iowa, Iowa City, IA 52242Esther Henebeng - Brown University
- Resource Type
- Abstract
- Publication Details
- Journal of the American Academy of Dermatology, Vol.93(3 Suppl), pp.AB197-AB197
- DOI
- 10.1016/j.jaad.2025.05.781
- ISSN
- 0190-9622
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 09/2025
- Academic Unit
- Dermatology
- Record Identifier
- 9984848110902771
Metrics
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