The New York City Landmarks Preservation Commission this week denied the request made by St. Vincent’s Hospital and Rudin Management to demolish eight buildings in the Greenwich Village Historic District so that they could be replaced by a condominium complex with a 265-foot-high tower, and a 330-foot-high hospital building. The buildings proposed for demolition form the campus of St. Vincent’s, the historic, 159-year-old Roman Catholic hospital. St. Vincent’s, teetering on the edge of financial ruin, says that such a joint operation with a major developer is the hospital’s only way to survive.

With the commission’s ruling, St. Vincent’s and Rudin have three options: They can radically alter their plan so as to win commission approval; they can file for a hardship exemption to the commission’s ruling, or they can drop the plan altogether. The smart money is on a hardship appeal.

At the same time, many preservationists are incensed at New York University’s proposal to demolish the Provincetown Playhouse on MacDougal Street. The two cases call into question the role of preservation in a dynamic, innovating city.

Last February, the Museum of the City of New York hosted a conference built around Anthony Wood’s book “Preserving New York: Winning the Right to Protect a City’s Landmarks” (Routledge); there, the historian Kenneth Jackson bravely addressed the audience, which consisted overwhelmingly of dyed-in-the-wool preservationists, on why he thought there may be more landmarking in New York than is good for us. His arguments — partly echoing those of economists such as Harvard’s Edward Glaeser, who has written on the subject for The New York Sun — maintained that the cost-benefit ratio of rampant landmarking puts undue value on the preservation of sometimes obscure cultural relics over a global city’s pressing economic needs. Mr. Jackson cited St. Vincent’s Hospital and its rebuilding plans. Hospitals, Mr. Jackson said, rank high among the innovatory institutions that cities exist to foster, as much as — perhaps even more than — they serve as repositories of tangible touchstones of collective memory.

So might it be said of universities, the potential of which as economic engines for the city has barely been tapped, yet which find themselves in one land-use imbroglio after another. New York University and its Greenwich Village neighbors are at loggerheads each and every time the university needs to build something.

The Provincetown Players moved into a converted stable at 133 MacDougal St. in 1918. In 1940, the former stable was merged with adjoining structures and given a new façade with discreet, almost invisible, classical detailing and a simple, dignified new entrance to the theater eliminating all traces of its former life as a stable. A widely circulated letter written by Andrew Berman, executive director of the Greenwich Village Society for Historic Preservation, to Alicia Hurley, NYU’s vice president for governmental affairs and community relations, notes the university’s disingenuousness in claiming that the playhouse lost its historical integrity when it was renovated in 1940. According to Mr. Berman, internal arrangements changed very little and, besides, the post-1940 history of the playhouse is quite as important as the pre-1940 history. (A building must be at least 30 years old to be eligible for landmark designation.)

In both the St. Vincent’s and NYU cases, claims of landmark quality may plausibly be made. The Provincetown Playhouse, even in its 1940 version, ranks high among the important sites of American theater history.

The most important building in the St. Vincent’s complex is the former National Maritime Union building, designed by Albert Ledner and built in 1964. Ledner used nautical forms, suggestive of an ocean liner, in a way that was as radical as the building’s contemporary, Edward Durell Stone’s 2 Columbus Circle. Here were Modern architects trying to forge something new at a time when orthodox Modernism had clearly run its course. And their continued presence could serve as object lessons for young architects.

In St. Vincent’s and Rudin’s rejected plan, seven hospital buildings that abut one another to the east of Seventh Avenue between 11th and 12th streets would yield to the condominium complex. The proceeds from the sale would allow St. Vincent’s to tear down the Maritime building, which the hospital owns and has operated as the O’Toole Building. On the site, St. Vincent’s would build a brand-new, state-of-the-art hospital. At first glance, it looked like a win-win: The Village gets badly needed new housing, and the hospital gets a new lease on life.

But it was not to be. Supporters of St. Vincent’s plan forget or don’t care that, until fairly recently, the decks were so stacked against preservationists that the rapidly mounting losses at last tipped the public into its widespread embrace of landmarking. Among other things, landmarking seemed the only logical reaction when, as the philosopher Roger Scruton has put it, the rule- and custom-based urban morphology of the preceding two millennia or so was cast asunder in the mid-20th century by Modernist architects and planners. As for detractors of St. Vincent’s, they don’t seem to know or care a jot about economics. Apparently, some of them feel they need only say it’s all “about money” to cast doubt on the sincerity of St. Vincent’s. Or to say, “There are plenty of other ways that the hospital could upgrade its facilities.” Really? And do the detractors even care?

One day, I dearly hope, the two sides will stop talking past each other.