Crowdfunding is a type of finance where many smaller contributions are combined to support a single project. Crowdfunding has grown in popularity thanks to the development of social media and other online platforms. Crowdfunding is a beneficial and well-liked method for promoting philanthropic or ideological causes. Healthcare crowdfunding is becoming more common in this area.
The majority of successful crowdfunding initiatives have a medical theme. Campaigns to directly pay for a person’s medical expenses and those aiming to hasten the development of and access to experimental interventions are examples of this. Using sophisticated search capabilities, potential donors can select through campaigns based on specific diseases, age, geography, or patient backgrounds.
Similarly to emerging technologies in other industries that seek to match supply and demand more efficiently, medical crowdfunding promises to better reach potential donors with unmet needs in ways that may increase overall giving. Despite its many promises, medical crowdfunding presents several moral and legal challenges for patients, doctors, institutions, and society. As medical crowdfunding continues to gain popularity, understanding these challenges will become increasingly crucial.
This Viewpoint examines these challenges, focusing on crowdfunding direct medical expenses. We provide a detailed list of actions that may be taken to make medical crowdfunding more morally sound and sustainable.
It is troubling that so many people are turning to medical crowdfunding to fill in the holes left by safety net organizations like charities, health insurers, or other organizations that operate for this purpose. Crowdfunding may enable needed care for patients who have no other way to pay for it by filling these gaps.
The equity of these approaches must be weighed against the risk of unfairly favoring those with access to online resources and large social networks, which could result in an underrepresentation of cases where patients lack the resources to organize successful crowdfunding campaigns with the greatest need.
It has also been criticized that end-stage organ dysfunction patients who travel abroad to take advantage of black markets in organ sales or who travel domestically to list transplants in multiple areas have received similar criticism; since these techniques are incredibly accessible to wealthy patients, they have drawn heavy criticism.
Cases where patients or families can start effective crowdfunding and social media campaigns to secure scarce or experimental resources, potentially leading to preferred treatment or increased access to new treatments, highlight less obvious equality issues. Thus, crowdsourcing may lead to a redistribution of resources favoring the most vociferous, visually appealing, or emotionally appealing causes, potentially pushing out more good medical reasons.
There are currently no recommendations to help clinicians navigate the sometimes challenging requests made by patients or families to engage in crowdfunding campaigns, aside from equity concerns. Does their profession require doctors to assist their patients’ fundraising efforts through crowdfunding, such as by providing them with regular clinical updates to publish online? Can a doctor legitimately ask to remain anonymous in crowdfunding campaigns?
How should doctors react if they learn that the information being utilized in crowdfunding campaigns is inaccurate or deceptive from a medical standpoint? Should crowdfunding websites require medical applications to be verified by doctors, or should they ensure donors have access to all the information they need to make an informed decision?
Patients’ health conditions are frequently in flux, and ensuring the authenticity of the information utilized in medical crowdfunding campaigns presents unique issues. Notably, under state law, several charitable solicitation laws forbid mentioning a doctor, medical facility, or hospital in support of a cause without permission. These laws frequently place a specific ban on soliciting donations for charity using false information.
If the patient’s condition materially changes, the crowdfunding campaign should be updated to avoid communicating inaccurate information and to avoid misrepresenting the use of the funds requested. This might be particularly challenging when the crowdfunding campaign’s organizer needs to get regular medical updates. However, people in charge of enforcement may need to pay more attention to noncompliance in this area.
Crowdfunding operations occasionally become illegal, posing the most severe ethical issues. Although this issue is not specific to medical crowdfunding, it is particularly evident in campaigns for medical causes where cries for help may have an exceptionally high emotional intensity and when there is a substantial financial motivation to win support and money by inflating facts.
Clinicians may face ethical dilemmas if they learn about false or exaggerated health claims, even though they are not legally required to monitor the accuracy of information used in medical crowdfunding campaigns for their patients. Clinicians could feel conflicted in this situation about their responsibility to protect patient privacy versus their perceived social responsibility from thwarting dishonest crowdfunding attempts.
Although not unique to these situations, doctors may struggle with conflicting obligations arising from their service to two constituencies—the patient and society—which may be expressed particularly clearly in certain circumstances. The dual agency of doctors, who simultaneously have responsibilities to society as professionals and specific patients, is frequently unclear.
Clinicians may legitimately feel under additional pressure to protect the credibility and honor of the medical community by forbidding its use as a tool in misleading crowdfunding.
Clinicians interested in revealing the least amount of information in the least intrusive, discreet, and effective manner in situations of false crowdfunding involving a patient should have clear disclosure pathways. Additionally, the systems for monitoring medical crowdfunding portals need to be improved. To be responsive to the requirements of all parties involved, governing authorities should take note of these concerns and develop more specific laws to optimize the advantages and equality of medical crowdfunding while lowering dangers.
Such policies should ideally be used in conjunction with initiatives to gather information and spot patterns regarding the amounts and distribution of funds that pass through these campaigns each year, the characteristics of the populations it is most frequently used, on the extent to which this approach has altered the landscape of medical giving, and consequently, its potential effects on unmet health care needs and disparities.
It will be challenging to use medical crowdfunding effectively while containing costs. Significant obstacles include rules, legal ambiguity, a lack of control, reporting, physician expertise, and guidance from governing organizations.
Many moral and legal problems that make this situation difficult remain unresolved. Clinicians who pay more attention to these problems can ensure that the dangers of medical crowdfunding are avoided and that its benefits are realized. For that reason, it is long past time for additional discussion and empirical investigation on this subject, and their significance will only grow.