title: Ethical concerns related to grateful patient philanthropy: the physician's perspective.
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.
authors.affiliation: Divisions of General Internal Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA. swright@jhmi.edu
authors.forename: Scott M
authors.initials: SM
authors.lastname: Wright
authors.forename: Leah
authors.initials: L
authors.lastname: Wolfe
authors.forename: Rosalyn
authors.initials: R
authors.lastname: Stewart
authors.forename: John A
authors.initials: JA
authors.lastname: Flynn
authors.forename: Richard
authors.initials: R
authors.lastname: Paisner
authors.forename: Steve
authors.initials: S
authors.lastname: Rum
authors.forename: Gregory
authors.initials: G
authors.lastname: Parson
authors.forename: Joseph
authors.initials: J
authors.lastname: Carrese
mesh_terms: D000046:Academic Medical Centers / Q000941:ethics*; D001291:Attitude of Health Personnel; D015142:Baltimore; D004991:Ethics, Institutional; D005260:Female; D005653:Fund Raising / Q000941:ethics; D037921:Gift Giving / Q000941:ethics*; D006801:Humans; D008297:Male; D010819:Physician's Role; D010817:Physician-Patient Relations / Q000941:ethics*; D036301:Qualitative Research