Nonprofit hospitals increasingly rely on philanthropy to supplement decreasing clinical revenues and a decline in the growth of government research funding. Grateful patient fundraising programs, as they are known, employ a strategy in which hospitals seek donations from satisfied patients, often using public data to identify those who are wealthy and requiring their physicians to discuss giving opportunities with them. In a recent issue of Narrative Inquiry in Bioethics, 12 physicians discuss their experiences with grateful patient fundraising and take up legal and ethical issues.

Our patient, weighing over 600 lbs., was above the weight limit of our hospital system’s scanner tables and those of all the other major medical centers that we called in our large city. What to do next? Our radiology department’s answer was, “Well, there’s always the zoo.”