Original Research

Journal of General Internal Medicine

, Volume 28, Issue 5, pp 645-651

Ethical Concerns Related to Grateful Patient Philanthropy: The Physician’s Perspective

  • Scott M. WrightAffiliated withDivisions of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine Email author 
  • , Leah WolfeAffiliated withDivisions of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine
  • , Rosalyn StewartAffiliated withDivision of General Internal Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine
  • , John A. FlynnAffiliated withDivision of General Internal Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine
  • , Richard PaisnerAffiliated withDivisions of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine
  • , Steve RumAffiliated withDivisions of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine
  • , Gregory ParsonAffiliated withDivisions of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine
  • , Joseph CarreseAffiliated withDivisions of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of MedicineProgram on Ethics in Clinical Practice, Johns Hopkins Berman Institute of Bioethics, Johns Hopkins University School of Medicine

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ABSTRACT

BACKGROUND

Philanthropic contributions to academic medical centers from grateful patients support research, patient care, education, and capital projects. The goal of this study was to identify the ethical concerns associated with philanthropic gifts from grateful patients.

METHODS

A qualitative study design was selected. Investigators conducted in-depth semi-structured interviews with 20 Department of Medicine physicians at Johns Hopkins who were identified by Development Office staff as experienced and successful in this realm—those having relationships with multiple patients who have made philanthropic contributions. Interview transcripts were independently coded by two investigators. Content analysis identified several themes related to ethical concerns.

RESULTS

Eighteen informants (90 %) were Associate Professors or Professors; two (10 %) were females. Four thematic domains emerged related to ethical concerns associated with philanthropy from grateful patients: (i) impact of gift on the doctor–patient relationship; (ii) gift acquisition considered beyond the physician’s professional role; (iii) justice and fairness; and (iv) vulnerability of patients. Despite acknowledging at least one of the aforementioned concerns, eleven physician informants (55 %) expressed the view that there were no ethical issues involved with grateful patient philanthropy.

CONCLUSIONS

In this paper, we report that physicians involved in grateful patient philanthropy are aware of, and in some cases troubled by, the ethical concerns related to this activity. Further studies could examine how best to prepare faculty for the challenges that may accompany these gifts so as to help them maintain expected professional and ethical standards when accepting grateful patient philanthropy.

KEY WORDS

philanthropy ethics patient care