Ethics of suggesting image-guided superficial radiation therapy in the pathology report

With the increasing adoption of image-guided superficial radiation therapy by dermatology practices, recommendations for its use have started to appear in some dermatopathology reports for nonmelanoma skin cancers. Although this strategy may heighten awareness among patients regarding new treatments, such as image-guided superficial radiation therapy, it raises ethical concerns related to beneficence, nonmaleficence, justice, integrity, and transparency. In this commentary, we discuss the ethical and financial implications of recommending image-guided superficial radiation therapy in a pathology report.