At the annual AAD (American Academy of Dermatology) meeting in Miami Beach, Fla, one of the more interesting panel discussions was titled, "Ethical Economics in Dermatology and Dermatologic Surgery." Audience members used keypads to respond to questions from the podium. The event took place Saturday, March 6, 2010.

A panel of physicians, together with the audience, explored the ethical ramifications of the vignettes and the tallied audience responses. Ethics forum uses audience response keypads to elicit votes, generate discussion:

Clifford Warren Lober, M.D., who is also an attorney, defines the term "ethics" and pointed out that most ethics textbooks -- even those for medical and law schools -- don't actually define the term. When a definition of the word is found, it typically uses general words, such as "correct," "good" and "moral," he said, but that doesn't leave people with a measurable standard.

"Ethics are behavioral ideals defined by fundamental beliefs," he says. "These beliefs are either arbitrarily accepted as true in and of themselves or are derived inductively or deductively from other fundamental beliefs."

Ethics, he adds, are inherently subjective.

"If we change our fundamental beliefs, our ethics will change," he says. "Ethics will certainly differ in different societies. Human sacrifice is either an ideal to please the gods or absolutely abhorrent."

And just because something may be legal, such as abortion or the death penalty, doesn't mean it's ethical.

"Never conclude that something is ethical because it is legal or unethical because it is illegal," Dr. Lober says.

Scenarios shared by presenters and voted on by attendees ran the gamut, from funny to contentious. All, however, were applicable in some way.

Read it all.

What Comdex is to computer professionals, the annual AAD (American Academy of Dermatology) scientific meeting is to derms, and by no means is the AAD anything less than a good show. The organizers choose venues that provide good support to attendees inasfar as elbow room on the exhibit floor and several fair-to-middling fast food joints (overpriced) on the various decks and in the four halls. As I type this, in between quickie meetings with a few esteemed physicians, the scientific sessions are quietly bustling. The AAD this year seemed to fill every room at the 4-hall Miami Beach Convention Center. The attendee count was over 19,000, according to the AAD.

For the aesthetic practitioner, new products in the laser- and light-based devices category included offerings from Sciton, Palomar, and Viora, among others. These devices go straight for the body contouring crowd and those who employ "touch-up laser" technologies when treating post-lipo conditions. A wide range of skin care treatments dot the show floor, with a cast of corporations that one expects -- J&J, Allergan, Neutrogena -- and the many more smaller entrepreneurships that seemed to be on every aisle. The scientific sessions that I have attended were mostly full.

I did not attend the keynote by Donna Shalala, the former Secretary of Health and Human Services, and would have preferred Dave Barry in her place, as he was originally scheduled to speak here. However, Shalala is probably more in keeping with the serious side of dermatology and health care issues.

For those of us who watched the steady stream of speeches and pitches from video monitors throughout the halls, the new AAD president is Lynn Drake, MD, Professor and Chair of the Department of dermatology at the University of Oklahoma Health Sciences Center in Oklahoma City.

Throughout the upcoming week, check this blog and the PSP Web site home page for additional news and updates that came out of this year's AAD meeting.

The growing media attention paid to the married between cosmetic surgery and stem cells has been very upbeat and almost blissfully "forward thinking." PSP is no stranger to this interpretation of where we are headed -- adding stem cells into the aesthetic medicine mix sounds very promising. Therefore, it satisfies my journalistic senses when a physician offers a common-sense view of where we stand with this "marriage." From WFAA-TV: Dallas doctor uses stem cell injections in cosmetic surgery:

Dr. Jeffrey Caruth, an OBGYN practicing cosmetic surgery, started the procedure by removing fat from several parts of her body to create volume in her face and chest.
 
Under local anesthetic, she was awake during the entire surgery. Her hands were strapped down to keep her from touching the sterile area. It was a procedure Jones called painless.
 
“You know when you're hungry and your tummy is grumbling before it's time to eat, it kind of felt like that,” she said.

Caruth said stem cells help solve a problem that has plagued prior procedures.
 
“The problem has been with traditional fat grafting that you put a volume of fat into the face, the buttocks and then in a month or two or three there is significant volume loss due to death of the fat cells you put in,” he said.
 
To help the fat survive, it was injected with Jones' stem cells for regenerative purposes. Caruth used an enzyme to pull the stem cells out of her fat. A machine then created a concentrated solution of stem cells, which are injected into a fresh batch of fat for double the power.
 
“You're going to get twice the graft survival versus other methods,” Caruth said.

Jumping down the page, I appreciate the comments from Jeffrey Kenkel, MD, a well-known aesthetic practitioner who puts the whole stem cell slash plastic surgery debate into perspective:

...While he has great hope for stem cells, he said they aren't predictable enough yet to guarantee results.
 
“There is a tremendous amount of excitement about stem cells," he said. "We just don't have a lot of information about them, about how they work and how we control them to do what we want them to do."
 
Kenkel agrees stem cells will change medicine in the near future, but said more scientific and objective research is needed.
 
“Are the stem cells going to stick around and actually control how that person heals and what kind of results they have?" he said. "We just don’t' have the answer to those questions yet."

Read it all.