Asserts that North American medical education favors an explicit commitment to traditional values of doctoring--empathy, compassion, and altruism--but a tacit commitment to behaviors grounded in an ethic of detachment, self-interest, and objectivity. Explores differing ways (conflation, deflation, and maintaining of values) that students respond to this conflict, and how medical education can encourage "immunity" to non-altruistic values. (EV)