Ethical Pricing: a Confucian Perspective
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Ethical Pricing: a Confucian Perspective Gabriel Hong Zhe Wong 1 Received: 29 June 2019 / Revised: 10 August 2020 / Accepted: 11 August 2020 # National University of Singapore and Springer Nature Singapore Pte Ltd. 2020
Abstract Based on an analysis of a landmark case Lim Mey Lee Susan v Singapore Medical Council in Singapore where a doctor was professionally disciplined for over-charging a wealthy patient, a judgement upheld by the Singapore High Court, this paper will discuss the notion of an ‘ethical price’ (EP) and its determination with respect to the provision of healthcare services. It will first examine the limitations of a legal approach for setting an ethical limit to pricing. From there, it will argue that Confucian philosophy provides a useful ethical framework to explore EP, with focus on the context of Singapore. The following question is addressed: What is an ethical pricing standard for medical practice from a Confucian perspective? The strengths and limitations of a Confucian value base as regards the determination of an objective EP will be analysed through an examination of the shortcomings of the doctor’s behaviour in the Susan Lim case as well as other case scenarios. The paper will conclude with some practical suggestions on how Confucian-based ideas can be applied to decision-making on pricing and the importance of this for medical professionalism and ethics teaching. Keywords Confucianism . Ethical pricing . Singapore
‘Do not ponder upon self-interest and fortune; sympathise and help wholeheartedly.’—Sun Simiao, on the absolute sincerity of great physicians (Tsai 1999).
* Gabriel Hong Zhe Wong [email protected]
1
Yong Loo Lin School of Medicine, National University of Singapore, Singapore
Asian Bioethics Review
Introduction In Singapore, the provision of medical services has been increasingly commercialised following the growth of private healthcare providers and the promotion of healthcare tourism (Lim 2005). Additionally, the corporatization of public healthcare has made increasing profit a major goal of healthcare, due to the need to satisfy financial stakeholders. These developments increase the impetus for medical educators to inculcate responsible and ethical pricing values so that future practitioners will not be overly influenced by financial incentives at the expense of patients’ interests. The Singapore’s Medical Council (SMC) case against Dr Susan Lim provides a backdrop for reflecting on these issues. This case involved the suspension of Dr Lim for over-charging her patient for palliative care service (discussed further below). The aims of this paper are to analyse Dr Lim’s behaviour and the SMC judgement based on Confucian economic philosophy and ethical principles to agitate towards a Confucian standard for ethical pricing, and to consider the applicability of Confucian thought to medical professionalism and medical education. The philosophy and justification underpinning the philosophy of fair pricing and its relevance to medical education are less well-discussed. By
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