Ronald Dworkin:

The changing work environment in which many doctors practice medicine leads to such moments of uncertainty—and all but guarantees that they will occur more frequently. As more doctors work for large companies, they have bosses they must answer to. Rules for how to practice medicine have multiplied exponentially, and their bureaucratic enforcement makes doctors afraid to violate them. With science forming the bulk of their medical and post-graduate education, doctors also feel bewildered when faced with questions that touch on the moral, the political, and the philosophical.