Moral perceptions and judgments are based on a society's values. Professional ethics generally complement social codes and reinforce moral perceptions. In the area of health care, the doctor-patient relationship is inherently unequal, placing added responsibilities on those providing care. In countries like India where practice protocols and referral pyramids are not defined and where patient awareness is rudimentary, the obligations on a physician increase manifold. This is further complicated by a healthcare system that includes both sophisticated, multi-specialty corporate hospitals providing excellent care for a premium to chaotic, under-staffed and under-equipped government services that do not have the will and resources to provide adequate healthcare.