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December 1, 1989

Fifty Hours for the Poor

JAMA. 1989;262(21):3045. doi:10.1001/jama.1989.03430210087037

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Doctors, lawyers, and the clergy belong to the classic learned professions, which are historically distinguished from trades and businesses. Although this distinction has blurred in modern times, one of the characteristics of a true profession remains its special relationship with the poor.

Edmund Pellegrino, director of the Kennedy Institute of Ethics, states that a fundamental difference between a business and a profession is that "at some point in the professional relationship, when a difficult decision is to be made, you can depend on the one who is in a true profession to efface his own self-interest."

The privilege to practice law or medicine has carried with it the obligation to serve the poor without pay. Doctors and lawyers today have tended to become overly concerned with their professional incomes and practice efficiencies, but they must not forget their higher duties. Many members of our professions have always cared for the