Sin boldly: ethical issues of DRGs

The current system of diagnostic related groups poses a series of ethical concerns for patients, practitioners, and hospital administrators. In addition to reducing access to health care by those groups most in need, the system results in diminished quality, health care rationing based on cost/benefit projections, and en eventual two-tiered method of health care delivery. Most important, the author suggests that a radical change is occurring in the image of health care from service/mission to production/business with concomitant attitudinal changes in staff and administration. Capitulation to the business ethic results in the devaluation of "patients as products." Guidelines are offered to continue prudent fiscal management with service-oriented delivery to recover the historical mission of health care provision in hospitals.