ABSTRACT
Sade’s article appeared only six years after the introduction of Medicare and Medicaid in the Social Security Amendments of 1965, which greatly expanded access to medical care but which many American doctors at the time viewed as a threat to their autonomy as independent practitioners. What made Sade’s article controversial was how explicitly he dismissed the traditional view of medicine as a profession. In the traditional view, far from being a commodity, medicine is a profession that carries duties and obligations beyond those of pure market exchanges. The most important of these duties is for doctors to ensure that their decisions and actions serve the welfare of their patients, even if there is a cost to doctors themselves. The fact that medicine carries ethical duties to patients beyond those of ordinary market transactions is what has traditionally exempted it from formal regulation as a business. The public generally grants professions a certain degree of trust to govern themselves.
