Pediatric Ophthalmology and Ocular Genetics, Wills Eye Institute, Philadelphia, PA, USA.
Can J Ophthalmol. 2011 Feb;46(1):21-7. doi: 10.3129/i10-097.
Fee splitting and co-management are common practices in ophthalmology. These arrangements may conflict with the ethical principles governing the doctor-patient relationship, may constitute professional misconduct, and at times, may be illegal. Implications and perceptions of these practices may vary between different cultures. Full disclosure to the patient may minimize the adverse effects of conflicts of interest that arise from these practices, and may thereby allow these practices to be deemed acceptable by some cultural morays, professional guidelines, or by law. Disclosure does not necessarily relieve the physician from a potential ethical compromise. This review examines the practice of fee splitting in ophthalmology, its legal implications, the policies or guidelines governing such arrangements, and the possible ethical ramifications. A comparative view between 3 countries, Canada, the United States, and Oman, was conducted; illustrating that even in disparate cultures, there may be some universality to the application of ethical principles.
酬金拆分和共同管理在眼科中很常见。这些安排可能与规范医患关系的道德原则相冲突，可能构成专业不当行为，有时甚至可能是非法的。这些做法的影响和看法在不同文化之间可能有所不同。向患者充分披露可能会将这些做法引起的利益冲突的不利影响降到最低，从而使这些做法在某些文化道德规范、专业准则或法律上被认为是可以接受的。披露并不一定能使医生免受潜在的道德妥协。这篇综述考察了眼科中酬金拆分的做法、其法律含义、管理此类安排的政策或准则，以及可能的伦理后果。对加拿大、美国和阿曼这 3 个国家进行了比较性观察；结果表明，即使在不同文化中，伦理原则的应用也可能具有一定的普遍性。
