Patient donations not an ethical dilemma

US physicians say they are concerned about the ethics of patients giving financial donations to medical institutions, but it's up to the patient. Dr Scott Wright and Dr. Joseph A. Carrese of The Johns Hopkins University and colleagues conducted in-depth interviews with 20 physicians at Johns Hopkins. All had relationships with several patients who had made philanthropic contributions. The analysis of the physicians' responses identified several ethical issues including: Physicians felt as if their relationship with the patient had been transformed as a result of the philanthropic gift. Physicians were concerned the purity of the physician-patient bond might be tainted or patient expectations could change. The doctors often felt unprepared, and even uncomfortable, in discussing financial support, even when broached by the patient. Physicians also said they may feel pressure to treat philanthropic patients differently than other patients as a way of demonstrating appreciation for the grateful patient's generosity. Doctors also expressed concern about accepting gifts from sick patients, because although patients sincerely want to give, by virtue of their illness they may be in a vulnerable state. However, the findings published in the Journal of General Internal Medicine showed a majority of the physicians interviewed said ultimately there were no ethical issues involved with the facilitation of grateful patient philanthropy since, at the end of the day, the decision to give lies with the patient.