Moral dilemmas and economic realities.

Administrators of teaching hospitals confront a variety of ethical issues. Some of these arise because of the peculiar character of the teaching hospital, while others are more generic. This paper provides a framework for addressing and resolving such ethical issues as the treatment of indigent patients, discontinuing treatment from patients with a poor prognosis and inability to pay for care, the involvement of students and professionals-in-training in patient care, and the soaring costs of high-technology and research-oriented medical care. The paper closes with a consideration of the hospital administrator's role in shaping the moral character of his or her institution.