Commerce can be defined as an exchange of goods and services using money as the medium for the exchange. People engage in commerce to make money. It has the potential to remain morally neutral. But when the emphasis on making money becomes the goal or value that directs the process, rather than the value of the endeavor itself, things can become distorted. Making money as a primary goal is understood and recognized for the venture capitalist, but it is less attractive when identified as the goal of medical care. Society, or at least medical practitioners, hold their profession to duties beyond the pursuit of personal gain. Medical duties toward beneficence, justice, and respect for autonomy are deemed far too important to be distracted by the desire for financial reward. Any conduct that seems to place the physician's self-interest above that of the patient's reduces the respect and moral authority claimed by the profession.