Total body skin exams (TBSEs): Saving lives or wasting time?

The central ethical issue raised by this scenario is whether it is morally obligatory to perform TBSEs, or at least offer them, to all new dermatology patients and at routine screening visits for patients at risk for skin cancer. Those supporting TBSEs make claims that the practice increases detection of skin cancer (general beneficence or utility), represents a professional duty to patients (deontology), and upholds patient preferences (autonomy). Those supporting lesion-directed exams over TBSEs suggest that the time saved from more focused exams permits seeing more patients while only making a small sacrifice in skin cancer detection, a utilitarian claim.

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