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Published on: April 20, 2016
Ethical Issues and Recommendations in Grateful Patient Fundraising and Philanthropy
Megan E Collins1, Steven Rum, Jane Wheeler
1M.E. Collins is assistant professor, Wilmer Eye Institute, Johns Hopkins University School of Medicine, and core faculty, Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland. S. Rum is vice president for development and alumni relations, Fund for Johns Hopkins Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. J. Wheeler is director, Business Development and Communications, Fund for Johns Hopkins Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland. K. Antman is provost, Boston University Medical Campus, and dean, Boston University School of Medicine, Boston, Massachusetts. H. Brem is Harvey Cushing Professor of Neurosurgery, and director, Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. J. Carrese is professor of medicine, Johns Hopkins University School of Medicine, and core faculty, Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland. M. Glennon is associate vice president, Fund for Johns Hopkins Medicine, Baltimore, Maryland. J. Kahn is Andreas C. Dracopoulos Director, Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland. E.M. Ohman is professor of medicine and vice chair, Department of Medicine-Development and Innovation, Duke University School of Medicine, Durham, North Carolina. R. Jagsi is professor of radiation oncology and director, Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, Michigan. S. Konrath is associate professor of philanthropic studies, Lilly Family School of Philanthropy, Indiana University, Indianapolis, Indiana. S. Tovino is Lehman Professor of Law and director, Health Law Program, William S. Boyd School of Law, University of Nevada-Las Vegas, Las Vegas, Nevada. S. Wright is professor of medicine, Johns Hopkins University School of Medicine, and chief, General Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland. J. Sugarman is Harvey M. Meyerhoff Professor of Bioethics and Medicine, Berman Institute of Bioethics, Johns Hopkins University, and Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Abstract:
Grateful patients provide substantial philanthropic funding for health care institutions, resulting in important societal benefits. Although grateful patient fundraising (GPFR) is widespread, it raises an array of ethical issues for patients, physicians, development professionals, and institutions. These issues have not been described comprehensively, and there is insufficient guidance to inform the ethical practice of GPFR. Consequently, the authors convened a "Summit on the Ethics of Grateful Patient Fundraising," with the goal of identifying primary ethical issues in GPFR and offering recommendations regarding how to manage them. Participants were 29 experts from across the United States who represented the perspectives of bioethics, clinical practice, development, law, patients, philanthropy, psychology, and regulatory compliance. Intensive discussions resulted in articulating ethical issues for physicians and other clinicians (discussions with patients about philanthropy; physician-initiated discussions; clinically vulnerable patients; conflicts of obligation and equity regarding physician's time, attention, and responsiveness and the provision of special services; and transparency and respecting donor intent) as well as for development officers and institutions (transparency in the development professional-donor relationship; impact on clinical care; confidentiality and privacy; conflicts of interest; institution-patient/donor relationship; concierge services for grateful patients; scientific merit and research integrity; transparency in use of philanthropic gifts; and institutional policies and training in responsible GPFR). While these recommendations promise to mitigate some of the ethical issues associated with GPFR, important next steps include conducting research on the ethical issues in GPFR, disseminating these recommendations, developing standardized training for clinicians regarding them, and revising them as warranted.
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