Miller W L, Grødeland A B, Koshechkina T Y
University of Glasgow.
J Med Ethics. 2000 Oct;26(5):305-11. doi: 10.1136/jme.26.5.305.
To study the attitudes of health care staff in four postcommunist countries towards taking gifts from their clients--and their confessed experience of actually taking such gifts.
Survey questionnaire administered to officials including health care staff, supplemented by focus-group discussions with the general public.
Ukraine, Bulgaria, Slovakia and the Czech Republic.
A quota sample of 1,307 officials including 292 health care staff, supplemented by stratified national random samples of 4,778 ordinary members of the public and in-depth interviews or focus-group discussions involving another 323.
Explicit justifications and willingness to accept offers, reported frequency of offers, and personal confessions to accepting "money and expensive presents" as well as smaller gifts.
Health care staff were far more inclined than the average official or public servant to accept "money or an expensive present" if offered, far more inclined to justify asking clients for "extra payments", and far more inclined to confess that they had actually taken gifts from clients recently. Judged by their own confessions, hospital doctors were only rivalled by traffic police and customs officials for taking money or expensive gifts from their clients.
Poor pay does not explain why doctors so often took large gifts from their clients. Moral self justification, opportunity, and bargaining power are much more effective explanations.
研究四个后共产主义国家医护人员对于收受患者礼物的态度，以及他们坦白的实际收受此类礼物的经历。
对包括医护人员在内的官员进行问卷调查，并辅以与普通公众的焦点小组讨论。
乌克兰、保加利亚、斯洛伐克和捷克共和国。
1307名官员的配额样本，其中包括292名医护人员，辅以4778名普通公众的分层全国随机样本，以及另外323人的深度访谈或焦点小组讨论。
接受礼物的明确理由和意愿、报告的收受礼物频率，以及坦白收受“金钱和昂贵礼物”以及较小礼物的情况。
如果收到“金钱或昂贵礼物”，医护人员比普通官员或公务员更倾向于接受，更倾向于为向患者索要“额外费用”找理由，也更倾向于坦白最近确实收受了患者的礼物。根据他们自己的坦白判断，医院医生在收受患者金钱或昂贵礼物方面，仅次于交警和海关官员。
薪资低并不能解释医生为何经常收受患者的大额礼物。道德上的自我辩解、机会和议价能力是更有效的解释。
