Acceptance of sponsorship and donation
Sponsorships and donations can contribute towards the advancement of medicine and supplement patient care. However, they may also easily lead to conflict of interest situations if the issues are handled without prudence.
Scenario 1 | Sponsorship from medical equipment supplier
Dr D is a consultant ophthalmologist in a public hospital who is often involved in the procurement of medical equipment for his department. The procurement department of the hospital would seek Dr D's views while drafting the specifications in the tender and in the course of purchase.
On one occasion, during the procurement of an equipment for oculoplastics in which Dr D is one of the members of the assessment panel, Dennis, the sales director of a potential supplier, asked Dr D to assess favourably on the equipment produced by his company. At the same time, Dennis invited Dr D to join a site visit to the company's laboratory in New York and take the convenience to attend an important medical conference there. The passage and accommodation of the visit would be sponsored by Dennis’ company. Should Dr D accept Dennis’ invitation?
Dr D should not accept Dennis’ invitation as he would violate Section 4 of the Prevention of Bribery Ordinance if he accepts an advantage, i.e. the sponsorship for attending a conference and the trip to New York in return for recommending the medical equipment of Dennis' company to the hospital. Dr D should report the matter to Hospital Authority (HA) or the ICAC as Dennis’s offering of sponsorship under the circumstances would constitute an offence of corruption for offering the bribe to Dr D.
Dr D may breach the Code of Professional Conduct of the Medical Council of Hong Kong (Oct 2022) which specifies that doctors should avoid accepting any inducement from commercial firms that might compromise the independent exercise of their professional judgement and it is improper for individual doctors to accept from such firms monetary gifts or loans or equipment or other expensive items for their personal use.
According to HA's guidelines on acceptance of donation and sponsorship, overseas site visit relating to the selection of medical equipment before or during tendering exercises should be funded by the HA and should not be sponsored by any of the potential vendors. In any case, HA employees should not solicit or accept, directly or indirectly, any advantage or gift which would, or might reasonably be seen to, compromise their integrity or judgement or influence the discharge or non-discharge of their duties and responsibilities.
Scenario 2 | Donation from patient
Ernest, a wealthy businessman, suffered from a sore throat for a prolonged period. Recently, his family doctor found out that there was a sign of cancer in his throat and advised him to receive treatment as soon as possible. Ernest was referred to consult at a public hospital and was then admitted to the Clinical Oncology Unit. Under the treatment of Dr E, the Chief of Service of the unit, Ernest recovered rapidly. Before being discharged from hospital, he approached Dr E and proposed to donate a big sum of money to the unit as a token of thanks for Dr E's treatment. Dr E thought that he could benefit the unit as well as his staff members by setting up a welfare fund for subscribing medical journals, subsidising part of the expenses for overseas visits and sponsoring staff functions in festive seasons. Should Dr E accept Ernest’s offer?
Dr E should not accept Ernest’s offer.
Under no circumstances should patients be given preferential treatment because of the offer of a donation to the hospital.
Dr E might breach Section 4 of the Prevention of Bribery Ordinance as the donation is offered to him on account of his official capacity as a public doctor.
In hospitals under the Hospital Authority (HA), there are explicit policies and guidelines that acceptance of donation from patients still under treatment in HA should be avoided as this involves an obvious conflict of interest situation. The reputation of HA and the medical professional would be ruined if outsiders were to perceive that there is an exchange of advantages involved.
According to HA’s established guidelines, there should be clear segregation of duties between staff providing healthcare and staff handling donation. Dr E should always refrain himself from handling donations irrespective of the donors’ status to minimise any risk of actual or perceived conflict of interest. He should refer the donation enquiry to the responsible department of the hospital for further handling.
For medical schools in the universities, donations and sponsorships should mainly be for teaching and research activities, and under no circumstances should personal benefits be involved.
To guard against conflict of interest situations arising from acceptance of sponsorship and donation, medical professionals should take into account the following principles:
- Value of the benefit must be commensurate with the purpose of sponsorship / donation;
- Due consideration must be given to the nature of the sponsor / donor's business and its relationship with the department / hospital;
- There should be no conditions attached to a donation or sponsorship that could affect the hospital's ability to carry out its activities fairly;
- The recipient of the sponsorship / donation must not be involved in any procurement procedures or decision making processes which may affect the commercial interests of the offeror; and
- When the situation in (d) is unavoidable, the recipient concerned should make a declaration of interest to his organisation under the established guidelines and policies.