08 Oct Deborah is a nurse practitioner working in a privately owned primary care clinic. This clinic serves mostly Medicaid-eligible families.

Ethics In Nursing

Deborah is a nurse practitioner 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 is reluctant to do this because she considers this fraud. Her supervisor assures her that everyone else at the clinic invents diagnoses, and not only is it common practice across the country, but it is a necessary practice to ensure that the clinic will stay open.

 The supervisor says that Medicaid’s policy is outdated, and that inventing a diagnosis is the logical solution. She also implies that Deborah jeopardizes her job if she refuses to participate in this practice. The nurses in the clinic tell Deborah that the supervisor is right—everyone has been doing this for years; it has never caused any problems. Deborah worries that if she refuses to follow the supervisor’s request, she may lose her job. She also believes Medicaid really should be paying for the visits and that the clinic is a vital community service.

Is this an ethical dilemma, a legal problem, or both?

What principles are involved?

What are the legal implications for Deborah?

What are the legal versus the ethical implications of this situation?

How do you think Deborah should handle the situation?

Response to be posted to correct Assignment folder.  Items placed in wrong folder will not be graded.  Please follow guidelines as outlined in the course syllabus.  Be sure to address all questions and use your critical thinking skills and your new framework for decision-making skills to aid in your exploration of these issues.

 Whether gods exist or not, there is no way to get absolute certainty about ethics.

 Without absolute certainty, what do we do?  We do the best we can.”

 ~ Richard Stallman

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