Deborah Jones, NP and Daniel King, PharmD, are working in a privately owned primary care clinic. This clinic serves mostly Medicaid-eligible families. Although Medicaid pays generously for most diagnoses and procedures, it often denies payment for wellness services. In order for the clinic to make a profit, it has become an unwritten policy to give every patient a diagnosis even if no problem actually exists. Deborah Jones and Daniel King are reluctant to do this because they consider this fraud. Their supervisor assures that everyone else at the clinic invents diagnoses, not only is it common practice across the country, it is a necessary practice to ensure that the clinic will stay open. The supervisor says that Medicaid policy is outdated, and that inventing a diagnosis is the logical solution. She also implies that Deborah Jones and Daniel King could jeopardize their jobs if they refuse to participate in this practice. The other employees in the clinic tell them that the supervisor is right- everyone has been doing this for years; it has never caused any problem. Deborah and Daniel are worried that if they refuse to follow the supervisor’s request, they may lose their jobs. They also believe Medicaid really should be paying for the visits and that the clinic is a vital community service.
Your group is assigned to argue “AGAINST” Deborah and Daniel complying with the practice of making up patients diagnoses. Use the questions below to guide your discussions and the Position Statement Worksheet to articulate the best options for your assigned position.
1. Is this an ethical dilemma, a legal problem, or both?
2. What principles are involved?
3. What are the legal implications for Deborah and Daniel?
4. What are the legal versus the ethical implications of this situation?
5. How do you think Deborah and Daniel should handle the situation?

Position Statement Worksheet.docx :
Interprofessional Education IPE in Bioethics
Position Statement Worksheet
Case Study #1: Deborah Jones, NP and Daniel King, PharmD comply with the practice of making up patients’ diagnoses.

Case Study #2: Jane should quit her job for the sake of her safety.

Position: For Against