Abstract
A case study is presented in which an obstetrician who performs fewer cesarean sections than his colleagues is asked by a hospital administrator to reconsider his pattern of practice. The administrator points out that, because the hospital is reimbursed on the basis of "diagnosis related groups" (DRGs), it loses money on normal deliveries. Three commentators debate the ethics of the administrator's request, the obligations of physicians to consider costs when making medical decisions, and the courses of action open to both parties. (KIE abstract)
