Between the reorganization of medicine during the French Revolution and the Vichy regime, the professionalization of French medicine did not involve a reliable, written body of ethical guidance. The state licensed doctors but provided little legal protection against irregular medical competition. Doctors were obliged to organize informally to protect their interests and reputations, which they did in medical societies and in medical unions until the formation of an Ordre des Médecins under Vichy. An informal deontology of medical etiquette emerged that applied to the intra-professional needs of medical practice and only indirectly defended the rights of patients and the human subject.