Abstract
Proportionality is a fundamental principle of criminal law. The issue whether the application of criminal liability to patients and doctors for participating in illegal gift “transactions” with the use of descriptive, analytical, logical, and comparative methods was examined. Focusing on utilitarianism and retributivism, the content of proportionality was presented: the balance between benefit to society and harm to the offender, the effectiveness of punishment, the implementation of justice as retribution, and the dangerousness of the offence and the offender. The conclusion was made that the criminal liability for gratitude gifts in the healthcare system is not proportionate. Consequently, recommendations were made for the establishment of disciplinary or administrative liability for symbolic gifts of gratitude in the healthcare sector of Lithuania.