Many organizations solicit private donations from benefactors and philanthropists. Is there a stadium in the country that does not bear the name of a prominent donor? There are also anonymous donors who are not cursed with egos that require their names to be emblazoned in giant font on a building’s façade. But, most donors want recognition which is often used as an incentive when soliciting the donation.

Donors understandably receive perks and privileges that ordinary folks will never be offered. If you give a ton of money to a theater, you might receive prime season tickets as a gift. If you make a sizable donation to a symphony orchestra, you may be invited to a private event to meet the conductor and leading musicians. If you make a robust financial contribution to your city’s art museum, you won’t have to worry about competing for limited tickets to view the visiting Picasso exhibit. You may very well have your own private tour.

There is nothing venal about any of this. If you give money, then you get stuff. But, sometimes this quid pro quo is improper and unethical. For example, if I donate to a campaign, and the candidate wins, am I entitled to a higher level of constituent service? (Of course, this example is hypothetical, as no politician would ever confer special favors to a donor.)

The New York Times reported recently a donation scheme in my own profession that I found to be ethically problematic. Hospitals across the country determine which of its hospitalized patients are wealthy and then contact them asking for money, sometimes while these folks are still in the hospital! The article states that physicians and nurses — actual medical professionals — have played a role connecting patients with hospital fundraisers.

First of all, there is an unseemliness to trolling through public data on sick patients to ascertain their history of political donations and property records to determine if they have sufficient net worth. This stealth review of data sounds more like the skulduggery that we have all learned is part of Facebook’s culture. And, while it is possible that a grateful patient who is approached and then gives a mighty donation might not enjoy any future special treatment from the institution.

But, it is also possible that the donor, like the example of a museum donor I cited above, might be given a higher class of service. While we expect to reward donors to cultural and educational institutions, would we condone a donor to a hospital receiving special treatment which might include better medical care? Shouldn’t all patients receive the same level of quality? Do you think it might be possible that a donor would be more likely to get a private room, get access to the best surgeon, get a complaint resolved expeditiously, get phone calls to the hospital returned promptly or get better access to appointments after hospital discharge? And, if a potential donor declined to contribute, particularly if his doctor initiated the solicitation, might this affect the doctor-patient relationship?

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower.

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