CIVE criteria of receiving gifts from patients

The Ethics of Receiving Gifts from Patients: A Lesson in the CIVE Criteria

One afternoon, a doctor I was shadowing received a simple gift from a patient he had treated for a few weeks. It was a box of premium dates from a well-known gift shop. After the patient left, the doctor turned to me and said, “Do you know the CIVE criteria for receiving gifts from patients?”

I shook my head, curious. “No, I don’t.”

He continued, “These are guidelines I learned at a seminar in the U.S. They help doctors navigate the sensitive situation of accepting gifts from patients. It's a cultural minefield, so we need to be careful. The CIVE criteria break it down into four key points.”

Receiving gifts from patients is common in many cultures, and while it may seem like a simple gesture of gratitude, doctors have to carefully evaluate each situation. The CIVE criteria offer a structured approach to make these decisions.

C: Culture

The first thing to consider is culture. Does accepting or rejecting the gift show respect or disrespect to the patient?

In our culture, refusing a gift is often seen as disrespectful, which makes this criterion particularly important. In this case, the gift of a box of dates aligns with the cultural expectation of respect, so accepting it is appropriate.

I: Interest

Next, it’s essential to assess if accepting the gift could benefit the patient in any unintended ways.

Could this gift influence the doctor’s behavior? For example, might the patient expect faster service, special treatment, or access to more expensive medications?

In this case, the dates don’t create such a situation, but the potential for conflict of interest must always be considered.

V: Value

The value of the gift matters too. A small, inexpensive gift like dates or coffee is typically acceptable, but high-value items should raise concerns.

E: Ethics

Finally, ethics must always guide the decision. Would accepting this gift compromise my professional judgment or change the way I treat this patient or others?

Medical ethics are the cornerstone of patient care, and no gift should ever influence a doctor’s clinical decisions or moral obligations.

As the doctor explained, “While the CIVE criteria help us make informed decisions, it’s usually best to avoid accepting gifts when possible, especially if there’s any doubt about the implications.”

The CIVE criteria provide a useful framework for evaluating gifts, balancing cultural sensitivity with ethical responsibility. Receiving a gift from a patient can be a delicate situation, and it’s important to navigate it with care. Ultimately, respecting the patient’s intent while upholding the integrity of the medical profession should always be the priority.