It has been noted that a number of ceremonies and rituals are associated with the exchange of gifts in ancient societies. This is partly true in industrial societies as well. It has been argued that gifts today retain many of their previous principal economic, social, and symbolic functions. A gift establishes a debt relationship between donor and recipient. It has been argued that all gifts demand reciprocity.
The only previous quantitative research into gift-giving behaviour in Taiwan was carried out by Lee (1989) and it supports the claim that gift-giving is common in Taiwan. In order to analyse gift-giving behaviour in Taiwan, it is important to understand the traditional Taiwanese notions of guanxi (social relationship), renqing (favours), mianzi (face), and hao (reciprocity). However, it is argued that present-day gift-giving practices in Taiwan are not only ruled by traditional customs but are also influenced by Western culture.
The present study surveyed 290 doctors and 480 members of the community who were selected from the whole of Taiwan. There were two mailed self- administered structured questionnaires, one for doctors and the other for the community sample. Questions mainly concerned gift-giving practices and personal experiences of giving gifts to doctors (personal experience in receiving gifts in the doctors' questionnaire), attitudes towards the practice of gift-giving, and socio-demographic details. The SPSS/PC+ package (Version 4.0.1) was employed for data analysis.
The results of the present study show that giving gifts, especially money, to hospital doctors is extremely prevalent in Taiwan. Gifts are mainly employed to show appreciation and to satisfy personal needs (e.g. being treated better by a specific doctor). Furthermore, not only gifts but also guanxi may be used as economic exchange to "buy" better medical services. Those of higher socio-economic status are more likely to take advantage of gifts and guanxi.
A gift may symbolise a tip or a bribe, though this distinction is clearly known by both the giver and the receiver. The norm of reciprocity seems to obligate both the givers and the doctors. It appears that the giver's expectations are usually satisfied and consequently the practice of gift-giving is reinforced.
The present study has touched upon many issues which could be investigated in subsequent studies. The results of the present study help us understand the doctor- patient relationship, the formation and impact of certain health policies and the way hospitals function in the context of local cultural values.