Gifts Accepted Ethical or Not
Gifts Accepted Ethical or Not
Gifts Accepted Ethical or Not
Giving gift to anyone is a way to show appreciation, gratitude, to show interest or sometimes
strengthen bond with others. But is it ethical to accept gifts in an organisation, even in case of
a noble profession like Medicine? The act gift giving is practiced from ancient times. But
when these gifts are offered to the doctors from their patients, the doctor’s tend to face ethical
dilemma.
According to previous studies, about 20% of the physicians receive gifts. The most common
of them includes: Chocolates, Baked items, Alcohol, expensive gift items and sometimes
even money. The different practices for accepting gifts exist: never, always and conditional.
It is considered as a “Professional misconduct” accepting gifts from the patients which also
suggests “boundary crossings” that eventually leads to “boundary violations”. But when the
gift is rejected by the doctor, the giver might feel offended or it is even considered as
impolite, but still not only doctor’s but all the professionals must make a habit of politely
deny to accept the gifts as this is good practice in their own benefit. There is a generalized
agreement that accepting any gifts from person related to the organization we are working for
in inappropriate. There are no practices, guidelines or articles that suggest acceptance of gift
is ethical. It is collective thought that, doctors should reject gifts given the patient-doctor
relationship does not allow any kind of ‘Give and Take’. When gifts are presented to the
doctors from patients they should consider these issues:
Within the medical practices, the main argument that arises from accepting gifts from
individual patients is need for justice and equality while dealing with patients. If doctors will
accept gifts from patients who can afford them, then the question arises, will doctor be able to
give same attention and priority to all the patients equally? Accepting gifts will develop some
“favourite” patients, and therefore develop risk for others. Doctors will then spend more time
and attention to those ‘favourite’ patients which will lead to violation of the doctor’s code of
conduct. This will also lead to internal conflicts and rivalries amongst other doctors as well as
staff. A doctor who becomes a friend can no longer take critical decisions related to
acceptance of gifts.
Offering gifts does not always show ‘gratitude’, or ‘thankfulness’ or to develop a bond. It can
also be offered to satisfy personal interests or benefits. Gifts can be offered to doctors in the
form of bribe to do illegal things. Such as:
6. In many hospitals, babies born in poor families are given to rich families who bribe
the doctor.
This is a reality in many hospitals where children born in poor families are given to
rich families who offer money in return to the doctors. The poor family is told that the
child is dead upon his/her birth. As rich people offer more money, some doctors agree
to help them even if it something their profession don’t allow.
The doctor’s must not encourage the patients to give or lend money or any kind of gifts,
which will directly or indirectly benefit them. Also, the doctors must not pressurize patients
or their family members to make donations to any organisation or people. If a doctor accepts
gift once, it will not be a onetime event. It will occur again and again. The patient will start
expecting some kind of particular behaviour from the doctor, which may be difficult to
achieve. A boundary must be decided in a doctor-patient relationship to avoid such situations.
As the intention of giving gift is not clarified by the patient, it becomes an issue. Such
practices can spoil the reputation of ‘doctors’ profession as whole. As all patients are same
for a doctor, be it a poor, rich, black, white or even a family member of the doctor, accepting
gifts from anyone can create differences in behaviour, judgement and preferences amongst
the patients. The doctor must abide by the rules of his profession.
Suggested Strategies:
The patient may easily interpret the rejection of gifts as personal rejection; therefore the
doctor should carefully choose words and a tone of voice which will convey refusal of gifts in
such a way that will not affect the doctor-patient relationship. There are several strategies for
refusing a gift from a patient or drawing a boundary line for future:
i) Use of soft tone such as “I appreciate your gratitude over the years, but I cannot
accept such gifts, as it is against my ethical or professional standards. These gifts are
likely to influence me, and indirectly other patients will face injustice.”
ii) By saying that it is against their personal principles: “I appreciate your gesture, but I
have a general principle that I do not accept gifts from patients. The best gift you can
give me is being satisfied with whatever treatment I provide you and by following my
prescriptions and suggestions strictly.”
iii) By reassuring the patients that even if they bring gifts to the doctor, all the patients are
same for him and all will be treated with equal care and attention.
CONCLUSION:
Accepting gifts from patients remains an issue that divides the doctors. Gifts should
not be accepted in any situation be it in medical profession or any organisation, one
should be faithful towards organization as well as job. When the patient offers gift to
the doctor, the problem is that the receiver is swayed to make decisions. The doctors
should maintain professionalism and straightway reject all the gifts offered to them.
So technically, accepting gifts was and will always remain unethical in my opinion.
References:
1. Spence.Sean.A (2005, Dec 24-31). Patients Bearing Gifts: Are There Strings
Attached? Retrieved from URL https://www.jstor.org/stable/25455752
2. Andrew Caddell, Lara Hazelton (2013, Dec). Accepting gifts from patients.
Retrieved from URL https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC3860914/
pdf/0591259.pdf
3. Dr. Penny Browne (2017, Nov 14). Bequests from patients: an ethical dilemma.
Retrieved from URL https://www.avant.org.au/news/bequests-from-patients-an-
ethical-dilemma/
4. Elizabeth Gaufberg (2007, Aug 1). Should Physicians Accept Gifts from Patients?
Retrieved from URL https://www.aafp.org/afp/2007/0801/p437.html