Academic

Gifts and Bribes--Skeel

By David Skeel and Bill Stuntz

If you ever read the verses on bribes and gifts in the book of Proverbs, as I did for a Sunday school lesson last week, you will quickly run into apparent contradictions. ?Whoever is greedy for unjust gain troubles his own household, but he who hates bribes will live,? instructs one verse (Prov. 15:27). But another that says ?A gift in secret averts anger, and a concealed bribe, strong wrath.? (Prov. 21:14). How can good bribes? or gifts, if you prefer? be distinguished from bad ones?

The easiest case is gifts simply to show respect or humility, as when the Magi brought gifts to the baby Jesus (Matthew 2:11-12). These, the Bible makes clear, are good and often admirable.

But with gifts that expect or hope for something in return, distinguishing the good from the bad seems much harder.

Take three examples from everyday life: 1) law firms often invite law students that they are recruiting to lavish dinners and give them other nice perks; 2) pharmaceutical companies give samples of drugs, meals, and trinkets (like coffee mugs, pens or notepads) to doctors who might prescribe their drugs; and 3) many employees earn personal frequent flyer miles when they book flights for their business travel. Are these good gifts or bad ones?

When I posed this question to the Sunday school class, the students (most of whom were young professionals) felt strongly that the law firm dinners and frequent flyer miles are perfectly ethical, but they were divided about the ethics of the pharmaceutical company goodies. One difference between the law firm dinners and the other two gifts is that the only affected parties are the ones at the dinner? the law student and the law firm partners. The gift? a nice meal? is designed to persuade, but there is nothing obviously pernicious about this. It is not designed to ?pervert the ways of justice,? as another Proverb puts it. (Prov. 17:23).

With the pharmaceutical company and frequent flyer miles, by contrast, the gift potentially affects three parties, including one who is not present. When a doctor who receives goodies from a pharmaceutical company decides which drug to prescribe, that decision affects a the doctor?s patient, who could get an inferior or pricier drug as a result. Similarly, when an employee decides which airline to fly, possibly booking a more expensive flight on her frequent flyer airline, that decision affects another party, her employer. The effect on an absent party is one common way that a gift could pervert justice.

So why did frequent flyer miles seem fine to everyone, but not pharmaceutical company gifts? I think the answer may be related to the likelihood of harm to the absent party. With frequent flyer miles, the employer could dictate the employee?s choice of travel if they wished, and most are happy to allow employees to choose their airline and to receive personal frequent flyer miles. (Consistent with this, I think, one woman said that the one time she had misgivings about receiving personal frequent flyer miles was when she was taking a missions trip that was paid for by individual supporters).

With pharmaceutical gifts, defenders noted that drugs are closely regulated by the FDA, so patients aren?t completely vulnerable, at least with respect to drug quality. If an insurance company is paying the costs, they too are likely to constrain the doctor?s referral decision. But a patient who pays for the drugs herself may be prescribed a drug whose choice is influenced by a pharmaceutical company?s gifts.

If I were a doctor, I don?t think I would accept gifts from pharmaceutical companies, given that the gifts have no purpose other than to influence referral decisions, and that studies show that gifts do indeed influence referrals. But in the end, this issue, like many involving gifts, seems to me to come down to a matter of conscience: does the gift seem likely to distort my judgment? Is it designed to entice me to do something inappropriate?

The most difficult gift issue I face in my own line of work is the gifts that are occasionally given to me by students. In my experience, most of these have not caused difficulty. Nearly all have come from foreign students, and most have come when the student is no longer in one of my classes. But some years ago I had a much closer call. A Chinese student in a small seminar of mine (which was not anonymously graded? another important factor) gave me a lovely silk tie. I was deeply uncertain whether to return the gift, so I asked a colleague who was much wiser about these things than I for advice. He assured me that the gift was simply a token of respect, and that I shouldn?t worry about keeping it under these circumstances.

I did keep it (and still have it), and I think this was the right decision, although under other circumstances it might well not be. I think this is what the Bible is getting at one when it suggests that gifts are sometimes fine, but ?for a piece of bread a person will do wrong.? (Prov. 28:21).

Full post as published by Less than the Least on June 06, 2008 (boomark / email).