Should Doctors Fudge on Insurance Forms to Help Patients?

A recent study published in JAMA revealed that nearly 40% of physicians reported having manipulated reimbursement rules to obtain health care for their patients. Certain kinds of "gaming" seem plainly indefensible, such as when, for instance, a physician manipulates rules solely for his or her economic benefit or to merely satisfy patient preferences. For example, a patient may desire a cosmetic rhinoplasty, which is not covered by a health plan, and a physician could code the procedure as a correction for a deviated septum, which is covered. However, other situations may involve decisions whereby a patient could suffer serious harm if she does not receive a medical treatment that is not covered by her health plan. Faced with such a dilemma, a physician may be strongly tempted to bend the rules either to avoid serious harm or to provide an important benefit to the patient. Do you think manipulation of reimbursement rules is ethical in these situations?
No, because such behavior constitutes fraud.
No, because such behavior diminishes the trustworthiness of the medical profession.
Yes, if such behavior would avert immediate harm that cannot wait for ordinary channels of utilization review.
Yes, because physicians have an ethical duty to be primary advocates for their patients' health interests, regardless of health plan reimbursement rules.