Journal of Bioethical Inquiry

, Volume 13, Issue 2, pp 261–270 | Cite as

Medical Students’ Opinions About the Commercialization of Healthcare: A Cross-Sectional Survey

  • M. Murat Civaner
  • Harun Balcioglu
  • Kevser Vatansever
Original Research


There are serious concerns about the commercialization of healthcare and adoption of the business approach in medicine. As market dynamics endanger established professional values, healthcare workers face more complicated ethical dilemmas in their daily practice. The aim of this study was to investigate the willingness of medical students to accept the assertions of commercialized healthcare and the factors affecting their level of agreement, factors which could influence their moral stance when market demands conflict with professional values. A cross-sectional study was conducted in three medical schools in Turkey. The study population consisted of first-, third-, and sixth-year students, and 1,781 students participated in total. Students were asked to state if they agreed with the assertions of commercialized healthcare. Of all students, 87.2 per cent agreed with at least one of the assertions, and one-fifth (20.8 per cent) of them agreed with more than half of the assertions. First-year students significantly agreed more with some assertions than third- and sixth-year students. Being female, having mid-level family income, choosing medicine due to idealistic reasons, and being in the third or sixth years of medical study increased the probability of disagreement. Also, studying in a medical school that included integrated lectures on health policies, rights related to health, and health inequities, along with early field visits, increased the probability of disagreement. This study suggests that agreement with the assertions of commercialized healthcare might be prevalent among students at a considerable level. We argue that this level of agreement is not compatible with best practice in professional ethics and indicates the need for an educational intervention in order to have physicians who give priority to patients’ best interests in the face of market demands.


Commercialization Privatization Medicine Professionalism Medical education Professional ethics 



Authors do not have competing interest to declare. An earlier version of this paper was orally presented at an international conference and a national symposium:

•M. Civaner, Y.I. Ulman, H. Balcıoglu, and K. Vatansever. 2009. Medical students’ opinions about commodification of healthcare services and the alteration during medical education. EACME Conference, September 10–11, Venice, Italy.

•M. Civaner, Y.I. Ulman, H. Balcıoglu, and K. Vatansever. 2011. Tip ogrencilerinin saglik hizmetlerinin metalastirilmasi hakkindaki dusunceleri: Tip egitimi boyunca degisim [in Turkish].Topluma Dayalı Tıp Eğitimi—Eğitim Araştırmaları Sempozyumu, Tıp Eğitimini Geliştirme Derneği, May 5–7, Antalya, Turkey.

Yesim Isil Ulman, the second author of the presentation, has withdrawn from the study of her own will and has documented her decision (the signed document is available at request). The authors are grateful to Yesim Isil Ulman for her contributions and also to Raymond De Vries, Marcello Ienca, and Ademola Kazeem Fayemi for their critical review.


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Copyright information

© Journal of Bioethical Inquiry Pty Ltd. 2016

Authors and Affiliations

  1. 1.Department of Medical EthicsUludag University School of MedicineBursaTurkey
  2. 2.Department of Medical EducationAnkara University School of MedicineAnkaraTurkey
  3. 3.Department of Medical EducationEge University School of MedicineIzmirTurkey

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