Journal articles on the topic 'Monetary unions – Europe – Public opinion'

The decisions of the Council of Europe on December 5"', 1978, that would lead to the establishment of the European Monetary System, raise a multitude of questions. Among these, the creation of a European currency unit, the ECU, and the announcement of the establishment in the near future of a European Monetary Fund, the E.M.F., are the most symbolic decisions in terms of public opinion as well as the most important in their economic and political implications. In this article, we will show that the development of the ECU and the creation of a E.M.F. with substantial decisional autonomy are the two conditions necessary for strengthening the European monetary union.

At their Maastricht summit, heads of state of the European Community (EC) countries agreed to establish a single currency and a common central bank by the end of the century. For students of international political economy, the treaty on monetary union offers intriguing puzzles: Why did EC governments commit themselves to such a far-reaching sacrifice of sovereignty? Why did national political leaders in some cases outrun public opinion in their enthusiasm for monetary integration? This study seeks a political explanation of the choices that produced the late-1980s movement for monetary union in Europe. It examines the conversion to monetary discipline in several EC states during the 1980s, arguing that the shift toward anti-inflationary rigor was a necessary precondition for discussions on monetary union. The article outlines three general options for a European monetary regime, based variously on unilateral commitments, multilateral arrangements, and full integration. Treating national preference formation as endogenous and requiring explanation, the article weighs five propositions that explain the motives and preferences of national leaders.

Abstract Within the context of the continuing integration process in Europe, this paper addresses the question of whether policies in the EU should head towards autonomy, coordination or harmonization. Taking the path dependence effect into account, it is the authors’ opinion that Europe has gone too far in its integration process to be able to continue with policies being fully under the competences of individual member countries. However, the habitual question still arises: does fiscal policy need to be harmonized to a level comparable to monetary policy as these two policies, necessarily, complement each other? This paper argues that it does not. There are three main arguments discussed. Firstly, the authors build on the theory of fiscal federalism. Secondly, there are significantly different regimes of welfare states and extents of social policies among European countries, which strongly determine the character of public finance. And thirdly, the tax systems across Europe are also highly divergent, with many features of continuing tax competition.

Geography is the science that studies all natural and human phenomena in one place Geography studies the natural factors that affected the land inhabited by man, Describes human populations in terms of their relationship to the environment Political geography is the study of political units and their problems from the point of view of geography, The survey studies the relief and climate areas that affect the conditions of states and the phenomena in them. As for the political decision, it is very measure that the state takes to prevent any interference in the affairs of its society, and the political decision is formulated in a thoughtful way to solve a specific problem or crisis that passes in the country The process of making and implementing decisions goes through multiple stages، starting with the preparatory stage, identifying the variables related to the problem to be studied, then choosing the goal and drawing the strategy (identifying alternatives)،then comes the decision-making stage،i.e. translating the decision into practical reality through actions، activities and work programs, Responsibility for the decision-making process is borne by a group of official and nonofficial bodies، the official bodies the constitution, then the legislative and executive authorities As for the unofficial bodies ، they include political parties, pressure groups، and public opinion،for political decisions to be correct, they must serve the public interest, be built on scientific foundation، and take in to account the objective circumstances..objective circumstances. Ukraine experienced a state of internal crises after the dissolution of the Soviet Union، as crises became represented by the dissolution of parliament and re-elections،which are frequent and accelerating events ،As the international Monetary Fund provided aid to reform the economic conditions of Ukraine after the transitional period it passed through،Ukraine became the coveted country and an open field for occupation by powerful countries. This is due to the weakness of Ukrainian politics. Ukraine distinguished location, which made it control the center of land and sea transportation between Asia and Europe،Russia decided that it was difficult to leave Ukraine to the west so Russia intervened militarily under the transfer from the Russian parliament on 28\2\2014 to protect Russian minorities and maintain influence in the city of Sevastopol, which is the last base in Crimea, The motive of the attack was to protect the region from the interference of other countries، to realize the dream of Russian to get on ports in the warm waters of the Indian Ocean, and to save world trade routes where Russia's ships have been frozen for months in the Arctic annually. Russia made the decision to attack Ukraine، and the first thing it started was the bombing of the Donbas region، which is located in eastern Ukraine، which is characterized by its mineral wealth and the presence of coal mines ، and thus Russia worked to create a state of paralysis in the airports located in eastern and northern Ukraine. Keywords: Geography, Foreign Policy, Russia and Ukraine

The implemention of a monetary union in Europe, to take full benefit of the Single Market’s potential benefits, has not up till now delivered the expected outcomes. On the contrary, the euro area has been afflicted by many difficulties, including weak growth, unemployment, and inequality. Many blame the euro’s malfunctioning design, and especially its inability to promote economic convergence and provide amendment and stabilization mechanisms. The latter view prevailed when shaping the austerity policies imposed on the countries more affected by the financial and sovereign debt crises, intensifying an economic recession with dramatic social consequences. Citizens’ distrust in the European Union’s institutions grew, along with support for nationalistic political forces opposing the European integration project. Some of EMU’s needed reforms will both promote convergence, and help smooth economic activity and maintain citizens’ wellbeing when crises occur. The creation of an autonomous budget for the euro zone was mentioned in a European Commission discussion paper on the future of the EU. This is an eminently political matter, very sensitive to domestic public opinions. In fact, the existence of a budget for the euro zone, in recognition of the fact that this subset of EU countries has specific needs, distinct from those of other non-EMU members, would translate into a situation requiring the design of different budgets within the EU. Such issue is at the heart of the intense debate between holders of different views concerning the future of the EU and of the euro zone, especially in what concerns the question of which of these geometries will in the future be the engine for further economic and political integration in Europe. This paper assesses one of the main deficiencies of the euro’s governance model – lack of automatic stabilization – and discusses proposals to overcome it.

ABSTRACTThe paper aims at a more complete, yet still parsimonious, explanation of macro-economic policy failure and success during the ‘stagflation’ period of the 1970s. Focusing on four countries, Austria, Great Britain, Sweden and West Germany, it is shown that both runaway inflation and rising unemployment could be avoided whenever it was possible to achieve a Keynesian concertation between fiscal and monetary expansion on the one hand and union wage restraint on the other. The actual policy experiences of the four countries are then explained in terms of the linkage between a ‘coordination game’ played between the government and the unions in which macro-economic outcomes are determined, and a politics game in which the government tries to anticipate the electoral responses of different voter strata to these outcomes.

In the late 20th century, a wave of democratic transformation swept away dictatorships of the right and left across Europe, Africa and much of Asia; and for the first time in human history most citizens lived under governments they had chosen in free elections. Liberal democracy, characterized by multiparty elections, individual liberties, free enterprise and independent trade unions, seemed poised to dominate the future, but today populist movements challenge the liberal consensus and global public opinion surveys indicate a loss of faith in democratic values. The rapid decline in labor union membership across the developed world may be a contributing factor. Social scientists have documented the function of labor unions as “schools” of democracy where working-class high school graduates learn crucial civic skills, boosting their political participation and reducing the gap between socioeconomic classes. This may explain why AFL President Samuel Gompers’s observation, that “there never yet existed coincident with each other autocracy in the shop and democracy in political life” remains true 125 years later, and highlights a major threat to democracy today.

AbstractThis article examines how the Finnish Social Democratic Party has adapted to European integration. The analysis illustrates that the Social Democrats have successfully argued to their electorate that the objectives of integration are compatible with core social democratic values. Considering that Finland was hit by a severe recession in the early 1990s, discourse about economic integration and monetary stability facilitating the economic growth that is essential for job creation and the survival of domestic welfare state policies sounded appealing to SDP voters. Determined party leadership, support from trade unions and the lack of a credible threat from the other leftist parties have also contributed to the relatively smooth adaptation to Europe. However, recent internal debates about the direction of party ideology and poor electoral performances – notably in the European Parliament elections – indicate that not all sections within the party are in favour of the current ideological choices.

Public-sector workers in many countries earn more, on average, than their private-sector peers with similar characteristics. In terms of economic theory, these rewards represent economic rents most of which paid by a nation’s taxpayers. In contrast to economic rents accruing to recipients at the top of income distribution, most of these payments flow from one group of workers to another. For this reason, we call these payments “horizontal” economic rents. The level of horizontal rents is analyzed in this paper for 28 OECD countries, mostly representing Europe, based on public-private sector pay gap data from a number of studies. We found that measured as a ratio of public-sector overpayments to GDP, the highest horizontal rents are paid to government workers in Mediterranean EU countries. These rents are relatively low in larger EU countries, such as Germany and the United Kingdom and negative in Scandinavian countries, possibly reflecting the recognition of the non-monetary benefits of public employment, such as job security. Analyzing the determinants of horizontal rents, we found that their levels are lower in countries with stronger trade unions, as measured by trade-unions density and higher in countries with larger foreign-born populations. Macroeconomic variables, including GDP per capita, trade openness, labor force participation and government indebtedness were found to not measurably influence the level of horizontal rents. Further research is seen to be connected with a wider range of the countries under analysis, including the developing countries, and the other groups of employees with the horizontal economic rent, as well as the possible ways to decrease or to invalidate it as regards the practices analysis of the countries with the negligible or negative rent such as Denmark, Norway, Sweden, Portugal, and Iceland.

The partnership between the EU and the AU in the fi eld of protection against natural disasters leads to the rapprochement of Africa and Europe, strengthening economic cooperation, sustainable development, when both continents coexist in peace, security, democracy, prosperity, solidarity and human dignity. A comparative analysis of the risk of nature management in the EU and AU countries has shown that countries with a high level of economic development do not have a clear advantage. Moreover, the AU countries oft en look more favorable. The overall picture for the EU and the AU, both in terms of absolute indicators and in terms of the percentage ratio of natural hazards, protection from natural disasters and risk of nature management, is also not in favor of the European Union. The leadership of the EU, the European Commission and its specialized disaster management units often overestimate their economic capabilities. Dangerous natural processes catch the highly developed states of Europe unawares and cause significant damage also because of the very high level of development of the EU territory. In the AU, firstly, a significant part of the territory is pristine natural landscapes, oft en completely unpopulated, secondly, in many countries the adaptation mechanisms of the local population to natural disasters are widely developed, and thirdly, the AU countries practically do not spend their own resources to combat natural disasters, and provide this process at the expense of external fi nancial and humanitarian aid from donors — the UN, World Bank, International Monetary Fund, various public organizations and, actually, from the EU. Nevertheless, the eff ective functioning of the entire disaster management system requires a strong economy in the EU and the AU as a whole, as well as in individual countries. Its basic subsystems should be: 1) market management — leadership at the level of company management, mentoring, creation of institutional conditions for development of innovative entrepreneurship, consulting and teaching entrepreneurs new methods of managing and running business; 2) financing — private investments, business projects, access to credit; 3) national-cultural and cross-cultural processes — entrepreneurial culture, formation of new progressive ideas on the principles of sustainable development, tolerance of entrepreneurial risk, self-employment, encouragement of success in innovation, establishment of business innovation summits; 4) regulation and promotion — regulatory framework, ease of starting and doing business, access to information and consulting infrastructure, new information and communication technologies, transport accessibility; 5) development and growth of human capital — universities and research centers as catalysts of innovation, promotion of employment and interaction with employers for employment of university graduates in innovative companies, talent management, availability of outsourcing; 6) new areas of activity — domestic market, large, medium, small companies as customers, including the state (state order, state procurement), logistics.

The purpose of the article – to disclose the meaning of the difference between the official, publicly declared position and the real (national) interests of Western European countries regarding their attitude to January 1863 Polish Uprising. Research methods: are analysis and synthesis, comparative, deduction, generalization. Main results: are despite the official statements by Western European governments to support the Poles' demands during the uprising of 1863 (in satisfaction of the Russian empire of their national rights), no real efforts were made. This state of affairs is clarified, with a meticulous analysis of true intentions of foreign policy of European countries. In the context of the implementation of policy in the nineteenth century, European governments could no longer ignore public opinion. After all, in the nineteenth century there was the epoch of affirmation in Europe of the ideals of the French Revolution and the formation of the institutions of civil society (free press, trade unions, public organizations, political parties, etc.). Involving information from narrative sources on events of 1863 clearly reveals the peculiarities of foreign policy and convinces that, in making final decisions, governments of the countries were guided by their own national interests (and not by the mind of public). Therefore, the Polish uprising became an opportunity to compete for the redistribution of influences among the leading countries of Europe and the interests of the Poles turned out to be only an instrument for achieving completely different goals. Concise conclusions: are the support of Western European governments in the Polish uprising were driven by public demands, but the real goal of each of the countries involved diplomatically to address this problem was to strengthen their own political stance in international affairs on the continent. Practical significance: this article will contribute to a better understanding of complex issues when assessing the position of Western European countries in the international politics of the mid-nineteenth century. Originality: compares information from publicly-published and diplomatically-concealed sources. Scientific novelty: the knowledge about the significant difference between the diplomatic statements and the real intentions of the foreign policy efforts of the Western European countries in the international relations of the middle of the nineteenth century were supplemented. Article type: analytic.

Lobbying is one of the strategies applied by groups of interest. Like any other strategy it is to help achieve the goals that a particular group identifies and articulates. Paradoxically, the greatest value and the strongest enemy of lobbying is its popularity. On one hand lobbying is a series of activities that group elites willingly (e.g. in the U.S.) employ to achieve their interests. On the other hand, though, referring to the notion of lobbying in various contexts, whether in PR, marketing or journalism, it raises numerous questions. The latter, i.e. the journalistic context distorts it most severely. It is journalism that applies the name of lobbying to mysterious, to put it mildly, and dubious interactions between the private and the political sectors, thereby implying a rather derogatory ‘image’ of this instrument in public opinion, which is especially the case in Central and Eastern Europe, including Poland. However, lobbying is more than a handy tool to achieve particular, strictly business interests, it is also an important route to implement social interests. It can be easily used by large economic groups of interest, trade unions or business organizations, wrestling with the strong third party of industrial relations, the state. By this token lobbying becomes a component of industrial relations, and by no means is it a worse party, one that is less socially-oriented and more like an ‘old boys’ network’, but a party which can efficiently contribute to a specified social interest to be implemented in the labor market. In order to make it possible, though, appropriate regulations, conditions, and factors of a legal, organizational and cultural nature need to be developed. A profound change in this field does not seem feasible in Poland, which becomes clear when reading the long-awaited law on lobbying currently in the legislative process. Maybe we should not be very surprised, given that our industrial arena is highly susceptible to hybrid and ephemeral solutions, and the issue of making appropriate use of lobbying also leaves a margin for uncertainty and deformation. Despite these concerns and limitations caused by industrial relations it is worth improving and creating the proper environment for lobbying activity in Poland, which the authors of this paper try to demonstrate.

Political links between labor unions and leftist political parties have weakened over the last four decades in Western Europe, reducing the former’s influence on the latter. Unions’ prolonged organizational decline suggests that their capacity to pressure left parties should become more limited. We examine whether unions can use general strikes to influence public opinion when left parties in government pursue austerity policies. Executing a distributive lag time series analysis of quarterly public opinion data from 1986 to 2015 in Spain, we find that Socialist governments incurred significant public opinion penalties in the wake of a general strike. Not only did PSOE prime ministers lose confidence from the public, but they also witnessed a significant reduction in voting intentions. In contrast, Spain’s conservative governments incurred no such public opinion penalties in response to general strikes. We conclude that general strikes carry significant political costs for left governments that stray from union ideals.

This paper argues that the colonial legacy is ever present in contemporary Europe. For a generation, most Europeans largely tried, publicly, to forget the colonial past, or remembered it only through the rose-coloured lenses of nostalgia; now the pendulum has swung to memory of that past – even perhaps, in the views of some, to a surfeit of memory, where each group agitates for its own version of history, its own recognition in laws and ceremonies, its own commemoration in museums and monuments, the valorization or repatriation of its own art and artefacts. Word such as ‘invasion,’ ‘racism’ and ‘genocide’ are emotional terms that provoke emotional reactions. Whether leaders should apologize for wrongs of the past – and which wrongs – remains a highly sensitive issue. The ‘return of the colonial’ thus has to do with ethics and politics as well as with history, and can link to statements of apology or recognition, legislation about certain views of history, monetary compensation, repatriation of objects, and—perhaps most importantly—redefinition of national identity and policy. The colonial flags may have been lowered, but many barricades seem to have been raised. Private memories—of loss of land, of unacknowledged service, of political, economic, social and cultural disenfranchisement, but also on the other side of defeat, national castigation and self-flagellation—have been increasingly public. Monuments and museums act not only as sites of history but as venues for political agitation and forums for academic debate – differences of opinion that have spread to the streets. Empire has a long after-life.

Photo by National Cancer Institute on Unsplash INTRODUCTION Gift-giving by patients or their families to physicians has happened since there were patients and physicians, and in many places, it’s still quite common. It’s also potentially problematic, and the why and how of it offer important insight into the physician-patient relationship and human relationships more broadly. Yet ethicists, regulators, and the public have not paid much systematic attention. In the United States, no federal or state legislation directly addresses it. Only in the past two decades did the American Medical Association (AMA) release guidance to physicians about it. That guidance, which permits physicians to accept certain gifts by certain patients under certain circumstances, namely, when it will not influence their medical judgment or cause hardship to the gift-giver, is vague and incomplete – indeed, it’s all of 200 words.[1] Other physician professional organizations have little to add.[2] A few academics and opinion columnists have studied or reflected on the psychology of gift-giving and -receiving and recommended everything from categorical rejection of patient gifts[3] to erring on the side of accepting them, provided they are of modest value, and the motivation behind them can be discerned.[4] However, insufficient attention has been paid to the when and where of those gifts or the significance of clinic-, hospital- or other systems-level ethical safeguards. ANALYSIS When deciding whether they will accept a gift from a patient or their family, physicians must balance the possibility that the gift could cloud medical judgment, lead to favoritism, exploitation, and slippery slopes, or pressure other patients to give, and perhaps even debase the meaning of medical treatment, against the prospect that gift-giving could increase patient trust and satisfaction, as well as empower patients and respect their autonomy and culture.[5] Performing this harm-benefit calculation case by case is challenging and time-consuming. Unsurprisingly, many physicians opt simply to tell would-be gift-giving patients that they appreciate the sentiment, but, as a rule, they accept no gifts. I submit many physicians do this also because they are unaware of how meaningful giving a gift can be for patients or anyone in a disadvantaged position with respect to the gift recipient. They may also not know that there are simple accountability mechanisms they can institute that may prevent many of the possible adverse consequences of gift-giving and -receiving in the context of the physician-patient or physician-patient-family relationship. Unfortunately, many instances in which accepting a gift would have led to net benefit are foregone. It is my belief a consensus could quickly be formed about which types of gifts would clearly be wrong to accept. Few would defend the physician who agrees to use a patient’s villa in the Bahamas or welcomes expensive jewelry or lewd photos. The timing and intent of a gift also matter. Few would forgive the physician who accepted even a modestly valuable voucher to eat at a patient’s restaurant while their eligibility for transplant was being debated or after they had run out of opioid painkillers and were denied a prescription renewal. On the other hand, I doubt even Charles Weijer or the College of Physicians and Surgeons of Prince Edward Island, which views accepting gifts from patients as “boundary crossing,”[6] would demand an orthopedic surgeon turn down the happy picture a pediatric patient drew after recovering from a hip injury and resuming sports. They are also unlikely to criticize an oncology team that graciously receives a fruitcake baked by the sister of an elderly cancer patient after the decision was made and agreed to, around Christmastime, not to initiate another round of chemotherapy. These unlikely refusals may be because rejecting those gifts, all things considered, would seem cruel. But it might also be because there is disagreement about what constitutes a gift: whether it must be a tangible object (are heartfelt thank-yous and hugs not also “gifts”?) or whether it must be something that requires the physician actively do something, e.g., get on a plane. These disagreements about definitions may also partially underlie disagreements about practice. Suppose a patient in a sparsely populated, heavily wooded part of Maine takes it upon himself to offer a sack of apples from his orchard to his internist, who regularly waives fees for those who cannot pay them or will make a house call at any time of the night. In that case, the internist may not consider the apples a gift. He may not think of them as payment or re-payment either. They may exist in some in-between category, much like the knitted slippers brought in by a patient in whose culture “thank you” is seldom said. But clearly, some things are widely perceived as gifts or to have substantial gift-like character. Should they, at least, be rejected? I don’t think so. The act of gift-giving and -receiving can be a sort of ritual and gradually lead to trust and closeness.[7] Perhaps a shy patient whose wife previously sent chocolates to his physician around Christmastime will come to see the physician as a part of his extended family. Perhaps he needs to do so to feel comfortable talking about his erectile dysfunction. Gifts can be expressions of caring.[8] Perhaps an elderly Texan patient imagines her younger physician, whom she has known for thirty years and often sees at the grocery store, as her son and asks to prepare a homecoming mum (traditionally a chrysanthemum flower corsage) for his children’s school dance. Perhaps doing so will give her purpose, make her feel useful, as all her own children have moved away. Giving gifts may also provide patients with a sense of control and help them feel as if less of a power imbalance exists between them and their physician. Perhaps a young judge, who is not used to not being in control, and was previously misdiagnosed with rheumatoid arthritis, is now struggling to come to terms with his Lupus. Perhaps giving the physician who made the correct diagnosis a moderately-priced bottle of scotch restores his confidence or sense of pride to. Gifts are also undoubtedly important to the recipient. When medical providers receive a gift, they may interpret it as a sign that they are valued. While it would be wrong to practice medicine to receive gifts or expect them, there are times, like when ERs and ICUs are overwhelmed because of a viral pandemic,[9] which threatens the will to continue working, and most anything (within reason) that bolsters resolve can be considered good. There is also no obvious distinction between the satisfaction physicians normally receive on seeing their patients recover or being thanked or smiled at and what they feel when they receive a small or “token” gift, like a plate of homemade cookies. The point is that the physician-patient relationship is a human one. Many advocate it should be personal, that physicians should be emotionally invested in their patients, care about and have compassion for them in ways that professional oaths do not fully capture.[10] This dynamic is particularly important in primary care or when the physician-patient relationship continues for long periods. According to one Israeli study, many patients even wish for a relationship with their physician akin to friendship. Those who felt they had such a relationship were more satisfied with their care than those who believed the relationship was business-like.[11] The precedent for this “friendship between unequals” goes back at least to the time of Erasmus, some five hundred years ago.[12] There may be good reasons for physicians to draw the line before friendship, but if accepting certain gifts builds intimacy, and that intimacy does not cross over into an inappropriate relationship, e.g., a sexual or romantic relationship, and if it has the chance to improve healthcare outcomes through improved mood or early disclosure of problems, I think it should be done. Physicians have a prima facie duty to do good for their patients.[13] Most physicians want to do good for their patients and respect their traditions and preferences. I suspect that accepting the gifts from the patients in the examples above would do a lot of good, or at least that rejecting them could do significant harm, including making them or their families feel estranged from the medical community, impeding future care. Physicians might be more comfortable accepting gifts if receiving gifts would not subject them to scrutiny or penalty. They also may feel better if they knew that receiving gifts would not harm their patients and that rejecting gifts might. They should document all gifts they receive.[14] This will enable them to detect if gifts from a particular patient are increasing in frequency or lavishness or changing markedly in character, which could warrant attention. I maintain this “Gift Log” should be maintained in common with everyone at the clinic or in the relevant hospital department and potentially made available to hospital administration for audit. Investigation might be necessary if a gift is given (and accepted) with no explicable context, e.g., not near holiday season or after a treatment milestone is achieved. When possible, gifts should be shared communally, such as placing fruit baskets or chocolates in the staff room. Other gifts, like artwork, can be displayed on the walls. Others should be encouraged to hold physicians accountable if they feel patients who have given gifts receive preferential treatment, including something as seemingly small as priority for appointment bookings. Appearances matter and even the appearance of impropriety can affect the public’s trust in medicine. The culture of medicine has already changed such that nurses now reproach physicians they feel violate the standard of care,[15] and this would be an extension of that trend. Depending on the set-up of the practice, a staff member can be designated for receiving gifts and politely declining those that ought to be declined. Staff members should tell patients, who give gifts in full view of other patients, that they cannot do so in the future. Physicians can politely rebuff patients who wish to give inappropriate gifts, or gifts at inappropriate times and suggest they donate to charity instead. Medical practices and hospitals should develop a gift policy in consultation with staff and patients to avoid needlessly rejecting gifts that benefit both doctor and patient and to avoid pressuring patients into giving gifts. The policy should be flexible to account for the crucial human element in any provider-patient relationship and the cultural nuances of any practice setting. Psychiatrists, who work with particularly vulnerable patients, may need to be more vigilant when accepting gifts.[16] CONCLUSION Though we tend to think health innovation occurs in urban medical centers and spreads outward, there may be something big-city physicians can learn from their rural colleagues about personalized patient-physician relationships. The value of gifts is only one example. Normalizing the acceptance of patient gifts in appropriate restricted circumstances has the added benefit of shining a spotlight on the acceptance of patient gifts in dubious ones. By bringing an already fairly common practice into the open and talking about it, we can create policies that respect patients as persons, prevent abuse, and deconstruct the stereotype of the austere and detached physician. While there is no reason to think that gift-giving would get out of control if appropriate safeguards are put in place, the medical community can always re-evaluate after a period, or an individual medical practice can re-evaluate based on the circumstances of their practice environment. Gift-giving, especially when gifts are of small monetary value, should be recognized as a culturally appropriate gesture with meaning far beyond that monetary value. It is best governed by reasonable gift-giving policies, not banned altogether. - [1] Council on Ethical and Judicial Affairs. “Ethics of Patient-Physician Relationships.” In AMA Code of Medical Ethics, 11. Chicago: American Medical Association, 2021. https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/code-of-medical-ethics-chapter-1.pdf. [2] Sulmasy, Lois Snyder, and Thomas A. Bledsoe. “American College of Physicians Ethics Manual.” Annals of Internal Medicine 170, no. 2_Supplement (January 15, 2019): S1–32. https://doi.org/10.7326/M18-2160; Committee on Bioethics. “Pediatrician-Family-Patient Relationships: Managing the Boundaries.” Pediatrics 124, no. 6 (December 1, 2009): 1685–88. https://doi.org/10.1542/peds.2009-2147. [3] Weijer, Charles. “No: Gifts Debase the True Value of Care.” Western Journal of Medicine 175, no. 2 (August 2001): 77. [4] Lyckholm, Laurie J. “Should Physicians Accept Gifts From Patients?” JAMA 280, no. 22 (December 9, 1998): 1944–46. https://doi.org/10.1001/jama.280.22.1944; Spence, Sean A. “Patients Bearing Gifts: Are There Strings Attached?” BMJ 331, no. 7531 (December 22, 2005): 1527–29. https://doi.org/10.1136/bmj.331.7531.1527; Gaufberg, Elizabeth. “Should Physicians Accept Gifts from Patients?” American Family Physician 76, no. 3 (August 1, 2007): 437; Caddell, Andrew, and Lara Hazelton. “Accepting Gifts from Patients.” Canadian Family Physician 59, no. 12 (December 2013): 1259–60. [5] See above commentators and Drew, Jennifer, John D. Stoeckle, and J. Andrew Billings. “Tips, Status and Sacrifice: Gift Giving in the Doctor-Patient Relationship.” Social Science & Medicine 17, no. 7 (January 1, 1983): 399–404. https://doi.org/10.1016/0277-9536(83)90343-X. [6] College of Physicians and Surgeons of Prince Edward Island. “Respecting Boundaries.” Accessed April 4, 2021. https://cpspei.ca/respecting-boundaries/. [7] The Atlantic’s Marketing Team. “What Gifting Rituals from Around the Globe Reveal About Human Nature.” The Atlantic, 2018. https://www.theatlantic.com/sponsored/hennessy-2018/what-gifting-rituals-around-globe-reveal-about-human-nature/2044/. [8] Parker-Pope, Tara. “A Gift That Gives Right Back? The Giving Itself.” The New York Times, December 11, 2007, sec. Health. https://www.nytimes.com/2007/12/11/health/11well.html. [9] Harlan, Chico, and Stefano Pitrelli. “As Coronavirus Cases Grow, Hospitals in Northern Italy Are Running out of Beds.” Washington Post. Accessed April 4, 2021. https://www.washingtonpost.com/world/europe/italy-coronavirus-patients-lombardy-hospitals/2020/03/12/36041dc6-63ce-11ea-8a8e-5c5336b32760_story.html. [10] Frankel, Richard M. “Emotion and the Physician-Patient Relationship.” Motivation and Emotion 19, no. 3 (September 1, 1995): 163–73. https://doi.org/10.1007/BF02250509. [11] Magnezi, Racheli, Lisa Carroll Bergman, and Sara Urowitz. “Would Your Patient Prefer to Be Considered Your Friend? Patient Preferences in Physician Relationships.” Health Education & Behavior 42, no. 2 (April 1, 2015): 210–19. https://doi.org/10.1177/1090198114547814. [12] Albury, W. R., and G. M. Weisz. “The Medical Ethics of Erasmus and the Physician-Patient Relationship.” Medical Humanities 27, no. 1 (June 2001): 35–41. https://doi.org/10.1136/mh.27.1.35. [13] Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. 7th edition. New York: Oxford University Press, 2012. [14] Caddell and Hazelton, 2013. [15] See, e.g. Peplau, Hildegard E. “A Glance Back in Time: Nurse-Doctor Relationships.” Nursing Forum 34, no. 3 (1999): 31–35. https://doi.org/10.1111/j.1744-6198.1999.tb00991.x and Ahmad, Ahmir. “The Doctor-Nurse Relationship: Time for Change?” British Journal of Hospital Medicine (2005), September 27, 2013. https://doi.org/10.12968/hmed.2009.70.Sup4.41642. [16] Hundert, Edward M. “Looking a Gift Horse in the Mouth: The Ethics of Gift-Giving in Psychiatry.” Harvard Review of Psychiatry 6, no. 2 (January 1, 1998): 114–17. https://doi.org/10.3109/10673229809000319.