Document Type : Research Article


1 Associate Professor Center for Culture and Medical History, Biotechnology, Nutrition, Infectious Diseases and Tropical Medicine Research, Tabriz University of Medical Sciences

2 Faculty of Architecture, Islamic Art University of Tabriz

3 Assistant Professor of Islamic Azad University of Ahar

4 Legal Deputy of Department of Justice of East Azarbaijan

5 Legal Affairs of Payam Noor University of East Azarbaijan


Imposing unnecessary medical and healthcare costs upon patients is in direct contrast with patient rights and the spiritual and historical values of medical practice and it seriously undermines the honor regarding doctors and healthcare teams. All medical oaths and affidavits have repeatedly emphasized on the fact that medical teams and staff must take precedence over the patient’s rights and gains rather than their own. Such oaths clearly state that healthcare imposers must fulfill their duty regarding the patient’s physical and mental comfort.
   In the event of fee splitting, the medical staff not only neglect and undermine the medical affidavits but also seriously damage the hard gained doctor-patient trust and the historical honor of their profession.
   Within the law and justice system in practice in the Islamic Republic of Iran, fee splitting in considered unacceptable and illegal and fee splitters may be pursued by law. The same is true in different societies and most medical councils and accepted ethical codes and guidelines. It is clearly stated in the fifth paragraph of the medical affidavit vowed by all Iranian medical students and doctors that fee splitting is considered amoral and even illegal and that healthcare and medical practices are not to be used as a means of gathering wealth for oneself. All Islamic religious leaders have also questioned the lawfulness of money and wealth earned by fee splitting. The act of fee splitting is also recognized as unethical and unlawful in the guidelines and codes affected by universal medicine societies.


Main Subjects

  1. آموزگار، مرتضی، تعقیب کیفری و انتظامی پزشک مقصر، انتشارات مجد، 1385.
  2. زاهدی، فرزانه و لاریجانی، باقر، تسهیم درامدها و اخلاق پزشکی، مجله دیابت و لیپید ایران، دوره 6 (شماره 1)، 1385.
  3. عباسی، محمود، جزای پزشکی، انتشارات موسسه حقوقی پزشکی سینا، 1383.
  4. عباسی، محمود، مجموعه قوانین و مقررات پزشکی و دارویی، انتشارات حقوقی، 1379.
  1. عباسی، محمود، «مطالعه تطبیقی مسئولیت ناشی از سهم‌خواری در پزشکی» در چکیده مقالات دومین کنگره اخلاق پزشکی ایران، 30-28


  1. Budd JH. What is wrong with fee splitting? JAMA. 1966 Jan 10;195 (2):117-8.
  2. Dickens BM, Cook RJ. Conflict of interest: legal and ethical aspects. Int J Gynaecol Obstet. 2006 Feb;92(2):192-7.
  3. Hannah HW. Fee splitting, kickbacks, rebates, and commissions, J Am Vet Med Assoc. 1998 Apr 1;212(7).
  4. Kunstadter RH. Fee splitting now outlawed in Illinois. Proc Inst Med Chic. 1971 Sep;28 (11):463-4.
  5. Revenaugh RP. Billing under the new fee-splitting legislation. IMJ Ill Med J. 1971 Sep; 140 (3): 228-9.
  6. Schulte DJ. Illegal and unethical referral fees and fee splitting. J Mich Dent Assoc. 2006 Nov; 88 (11):16.
  7. Thompson RE. The ethical aspects of gain sharing with physicians. Physician Exec. 2004 May-Jun;30(3):20-2.
  8. Tillis BP. Editorial: It's fee splitting, it's illegal. N Y State Dent J. 1974 Oct;40(8):458.
  9. Weber RD. Practice management contracts/illegal fee-splitting, Mich Med. 1998 Mar;97(3):8-10.