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J Med Philos. 2015 Feb;40(1):26-43. doi: 10.1093/jmp/jhu049. Epub 2014 Dec 10.

Medical bribery and the ethics of trust: the Romanian case.

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University of Exeter, Exeter, United Kingdom


Medical bribery seems to be a global problem from Eastern Europe and the Balkans to China, a diffuse phenomenon, starting with morally acceptable gratitude and ending with institutional bribery. I focus my attention on Romania and analyze similar cases in Eastern European and postcommunist countries. Medical bribery can be regarded as a particular form of human transaction, a kind of primitive contract that occurs when people do not trust institutions or other forms of social contract that are meant to guarantee their rights and protect their interests. Concluding with strategies to fight medical bribery, I will underline better public policies for financing health and social care, and an ethic of trust that may help to restore trustworthiness of institutions and to rebuild interpersonal trust. This should be complemented by an educational program dedicated to understanding the negative consequences and mechanisms of corruption and the importance of ethical behavior.


gratitude; medical bribery; patient–physician relationship; postcommunism; trust

[Indexed for MEDLINE]

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