DRGs and the ethical reallocation of resources.

To allocate resources ethically under DRGs, we need an expanded medical ethics. Appealing to traditional patient-centered principles such as individual beneficence and autonomy will not be sufficient. We also need to take into account the social principles of full beneficence and justice. If marginal benefits must be eliminated, clinicians should not participate in deciding who should get less care but should remain committed to their patients' interests.