Q. I carry out medical tests in a clinic. The clinic routinely falsifies the test results in order to get reimbursed from government programs or insurers for unnecessary treatment. Do I have to quit?
A. Jewish law recognizes different levels of complicity in wrongdoing. Depending on what your role is in your clinic, you could be at any of them or none of them. Let's examine the various levels.
PERPETRATOR: If you are actually falsifying test results yourself, you are an actual perpetrator of wrongdoing, not merely an accomplice. Falsifying test results that are used for monetary claims is itself a serious transgression. It doesn't matter that you personally oppose this policy and that you are doing so only because of pressure from your boss. The fact that someone is ordering you to transgress doesn't reduce your responsibility; it is your job to remember that "Someone" even more powerful is ordering you not to transgress. The rabbis ask rhetorically, "Given the words of the master [God] and the words of the disciple [your boss], whose words should you heed?!" (1)
And the fact that you are threatened with dismissal is also not an excuse; suffering monetary loss can not justify transgressing a prohibition.
ENABLER: If you are a critical link in the chain, then you may be considered an enabler of fraud. One example: if clinics must hire someone with your qualifications in order to qualify for the payments they receive, then without you they couldn't run their scam – even if you personally don't lie.
However, this consideration will depend on the balance of duties. If your main job is to carry out tests for substantive benefit, but occasionally your results are falsified for purposes of fraud, it is not fair to say that you are hired to promote stealing.
Enabling wrongdoing is less severe than carrying it out, but it is still a serious ethical breach.
PARTICIPANT/ABETTOR: If you are part of the chain, but someone else could easily take your place, then you are a participant but not an enabler. Imagine you are the administrative person who files the forms. On the one hand, you are taking part in the fraud, insofar as this is a necessary step and you are aware it is part of the scam. On the other hand, any person can do this job; if necessary the manager could do it himself.
CONDONER: Even if you take no direct role in the fraud, you could be considered complicit if you are seen as condoning it.
Anyone who has the ability to protest the members of his household but doesn't protest, is held liable for the members of his household. For the residents of his city – he is held liable for the residents of his city. For the entire world – he is liable for the entire world. (2)
Given that you have a responsible position in the clinic, you should make it clear to your employers that you don't approve of the fraud and that you refuse to be party to it.
Even if you manage to arrange your work in such a way that you avoid all these different levels of complicity, I would recommend trying to find a new position. Working in a corrupt workplace has a depressing and demoralizing effect on a person and is likely to ultimately affect his own moral sensitivity as well.
SOURCES: (1) Babylonian Talmud Kiddushin 42b. (2) BT Shabbat 54b
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The Jewish Ethicist presents some general principles of Jewish law. For specific questions and direct application, please consult a qualified Rabbi.