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The values of American culture have changed and this has led since 1970 to a competition with traditional medical values. The social forces that have stirred a reconsideration of core medical values come from 1. economic, 2. institutional and 3. life style sources and is related to efforts by non-service providers to gain profits from medical services and the attempts by both governmental and non-governmental sources to control the cost of medical care.
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Milton Kramer (2013) studied this question.
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