The role of doctors, nurses and physicians in general is to help out their patients and make them healthy. The patients pay for their treatment, but some may feel that their payment is not enough or may want to give extra. This exchange of money for service is extremely personal since this service is the provider of their continued health, or at least genuine attempts to do so. Since it is so personal, patients may feel that they are still in debt to their healthcare providers even if proper payment was done. These patients may give their healthcare professional a gift to show their thanks. Should the healthcare professional accept or reject these gifts? Currently, it seems that the decision is up to the healthcare professional’s discretion.
To begin with, some sort of loose definition must be set for the types of gifts that are being discussed. Gifts that would be deemed as just a thanks between a healthcare professional and a patient are also the most common types of gifts (Spence). These are chocolate and liquors, which have low monetary value and cannot be exchanged easily for their face value; meaning, once the healthcare professional receives these gifts they are most likely stuck with them. This is important, because gifts other than money usually have some thought process behind them and requires more effort to go out and acquire them. This would mean that the patient is thinking about the doctor and that their thanks are most likely genuine. There can still be hidden motives behind these ‘genuine’ gifts, but both sides of the argument have to be laid down before it can be further discussed.
If a gift were to be accepted it may taint the rest of the healthcare procedure. As Weijer writes: “The physician-patient relationship is a fiduciary one; that is, the physician owes an obligation of fidelity to the patient” (Weijer). He goes on to say that profiting from outside the established monetary channels that pay for the doctor to do his job interferes with his obligations to his patient. It may also give the patient the idea that since they gave their doctor a gift, that the doctor now is in a sort debt to them. This debt would of course need to be paid in the form of extra attention to the patient. If the debt is not paid the patient may resent the doctor and think of him as greedy or ungrateful. This resentment may lead the patient to hurt the doctor in ways he or she does not deserve. It could lead to the slandering of the doctor, which could deny him potential clients all for a reason that has nothing to do with the doctor’s ability to supply a comfortable atmosphere for his practice, or his ability to perform his general duties as a doctor. Some doctors or health professionals get into their profession, because they get pleasure from helping people. They might see these gifts as gratitude from the patients to whom they have provided such good service that the patients want to express their thanks in additional ways such as gifts. In some cases this could be true, but in cases such as the one being discussed where the patient has ulterior motives, it could end up hurting both the patient and the doctor. The patient would be hurt because he or she gives this gift with the expectation of increased attention which the doctor does not deliver. The doctor sees that they have upset the patient instead of helping them like he or she thought he or she would, and he or she becomes upset too. Nobody wins in this situation, and it only causes pain.
There is also the possibility of a ‘corruptible’ doctor who does see all these gifts as bribes, and gives increased attention to those willing to imburse him additionally. In this situation the doctor-patient relationship becomes completely corrupted and the fidelity (that Weijer stated as so important) is almost non-existent. The doctor may feel no obligation or duty to help patients that do not imburse him additionally, and therefore give them less attention than needed...
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