Petty corruption in health care.

"Petty corruption and honesty in all health care systems" is the original title of one of the bioethics networks within the worldwide study projects of the International Association of Bioethics. As the coordinator of this network, it still puzzles me why the word "petty" is in the title when in the past few years-through interviews and questionnaires involving 18 countries-it has become evident to me that not only trivial but important, significant corruption exists in many health care systems. Obviously endless polemics can take place about the meaning of corruption and the definition of petty. Despite this possibility I accept the guidance of Webster's Dictionary according to which "corrup-tion" is "evil or wicked behaviour; depravity; bribery or similar dishonest dealings" while "petty" means primarily "relatively worthless or unimportant; trivial, insignificant".' In view of this, it is quite evident that the extent of corruption in health care does not differ considerably from any other kind of corruption occurring in other any field of human endeavour, let it be politics, business, science or law enforcement. One "slight" difference, however, might be that most forms of corruption, contrary to the corruption in health care, neither endanger nor cost, lives. Another perhaps, is the widespread and profound belief and trust in the medical profession which is hardly comparable to any other calling. The betrayal of this trust, even if one's life is not endangered , leaves one in a grave state of disappointment, which may mean for the individual at times, the last straw, the total disappearance of human solidarity and compassion. Fortunately, however, it seems that the majority of physicians and other health professionals , though not displaying moral virtuosity and striking moral superiority, are worthy descendants of Hippocrates. As for the members of the corrupt minority, they should be exposed, ostracised, punished, re-educated or simply eliminated from these noble professions that cannot and should not exist without some basic and universal moral principles. Corruption is a worldwide phenomenon. From Brasilia to Thailand, from Venezuela to Ethiopia, it poisons the life of millions, hinders social progress, and makes a mockery of such basic moral principles as decency, justice and benevolence. It destroys decent human relationships, creates an atmosphere of the law of the jungle, promotes subservience, pessimism and anxiety, leads to moral chaos and makes the functioning of society almost impossible. where corruption cannot be found to any great extent. Neither in health …