Ethical questions arise as doctors ask patients for donations

WASHINGTON — It’s a new development in the relationship between cancer patients and their doctors: Patients who have successfully been treated are being asked for a donation to a medical center or for more research — by their doctors.

“It’s a tricky, tricky area,” Dr. Arthur L. Caplan, head of the division of medical ethics at New York University’s Langone Medical Center, tells WTOP.

A recent study of more than 400 oncologists found that nearly half said they had been taught to identify patients who might have the money to make substantial donations, and about one-third of them had been asked to appeal directly to patients for donations, The New York Times reports.

“It’s not really new; it’s just accelerating,” Caplan tells WTOP, adding that the practice is probably here to stay. As funding for the National Institutes of Health remains basically flat and the cost of research goes up, “you see more and more areas of medicine, like oncology, turning to gifts,” Caplan says.

Development offices know, Caplan says, that an appeal from the doctor who has just treated you, putting in long hours in the process, is much harder to ignore than a fundraising letter that arrives weeks after your treatments are over.

But, he adds, “The most charged ethical problem is when your doctor, who you’re grateful to, and you want to please because you’ve worked with him or her, is asking for a gift.”

Patients are “pretty vulnerable that the time the treating doctor might come and ask them … They don’t want to be ungrateful.”

Cancer treatments are expensive, and being asked for a donation from a doctor who makes considerably more money than his or her patients can be grating, Caplan says. It can be uncomfortable for doctors, too. About half the doctors who had been asked to make appeals in the study refused.

He says patients aren’t alone in this, either.

“Doctors get approached too — the development office comes after us and does make requests, and people know who gave and who hasn’t.”

It may change the face of giving, and not in a good way, Caplan says.

“Philanthropy, you want to say, is an altruistic choice, but what we don’t want to see it become, for doctors or patients, is a coerced mandate. I don’t think we really have aired it out fully.”

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