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Victor W. Sidel, MD
Albert Einstein College of Medicine Bronx, NY

JAMA. 1997;277(9):712.

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In Reply.

—Mr Vuylsteke appears to support my view that health professionals have an obligation to act individually and collectively, and to act ethically on social and political issues that affect the health of their patients and the health of their communities. I agree that "a health care system that promotes denial of care to patients to increase corporate profits" must be opposed. However, I do not agree with the implication that linking a physician's income to the continued or improved health of his or her patients, even though that was proposed in Nazi Germany, is necessarily unethical. Much health care in Nazi Germany indeed was unethical, particularly the restrictions on those who could practice and on those who could be cared for. But a health care system that links physician income in part to the health of patients or to the health of the community may, in my view, be entirely . . . [Full Text PDF of this Article]

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