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In Whose Best Interest? The Ethics Surrounding the AHF Lawsuit

In the coming weeks, roughly 17,500 of the brightest medical minds in America will don their gowns and mortarboards and be formally welcomed as the latest initiates into the fraternity of practicing physicians. The ceremonies celebrating the accomplishments of these young men and women will be many, but they will likely not be varied. Keynote speakers may differ and the university names on the diplomas may change, but most of our nation’s 141 accredited medical schools will follow a very similar script which includes—among other things—the recitation of the Hippocratic Oath, in which the newly minted doctors promise to uphold the ethical standards of their profession and do no harm to their patients.

However, while the Hippocratic Oath will be used to swear in the vast majority of American physicians, there will be a select few who will instead recite another oath—the Oath of Maimonides. A 12th century rabbi, philosopher and physician who lived and worked in North Africa, Maimonides is a man known as much for his Talmudic scholarship as his contributions to medicine, and it is this melding of the spiritual and the medical that imbues his oath with a sense of shared humanity and compassion that is lacking from its Hippocratic cousin. In its opening lines, the Oath of Maimonides proclaims:

“The eternal providence has appointed me to watch over the life and health of Thy creatures. May the love for my art actuate me at all time; may neither avarice nor miserliness, nor thirst for glory or for a great reputation engage my mind; for the enemies of truth and philanthropy could easily deceive me and make me forgetful of my lofty aim of doing good to Thy children.”

It would serve us well to keep the words of Maimonides in the back of our minds as we look at the most recent scandal involving the AIDS Healthcare Foundation (AHF) and their polarizing president, Michael Weinstein. Last month, the AIDS Healthcare Foundation was thrust into an unwelcome spotlight when a lawsuit filed by 3 former AHF employees alleging that the company was violating the Federal Anti-Kickback Statute was made public. According to the suit, AHF handed out cash or other incentives to clients who tested positive and were successfully linked to care at an AHF facility, while also providing its employees with bonuses of between $50 and $100 for facilitating that linkage. These bonuses, the lawsuit argues, are in direct violation of federal law and were instituted in an attempt to game the system and fraudulently increase the amount of funding AHF received from Medicaid, Medicare and federal HIV/AIDS grant programs to the tune of $20 million a year since 2010.

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