Intended for healthcare professionals

Letters Payment to improve adherence

Ethical problems with paying patients to improve adherence to treatment

BMJ 2013; 347 doi: (Published 19 November 2013) Cite this as: BMJ 2013;347:f6837
  1. George Szmukler, professor of psychiatry and society1
  1. 1Institute of Psychiatry, King’s College London, London SE5 8AF, UK
  1. george.szmukler{at}

To offer patients financial incentives for taking antipsychotic drugs presents serious ethical problems,1 the most important of which can be termed “incommensurable values”2 or “commodification.”3

A stark example of commodification would be selling a baby. Such a transaction involves an exchange between “goods” lying in different spheres of valuation, one high and one low. Aligning …

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