The following case examines concepts of justice, fidelity, and beneficence, all of which relate to overarching organizational ethics issues encountered in occupational therapy practice. Organizational ethics pertains to the ethical responsibilities attributed to organizations and providers, as business practices continue to influence institutional and professional behavior [8]. Provision of services in the healthcare environment has become much more complex in recent years with the introduction of a more explicit market approach to service delivery [4]. Occupational therapy practitioners are especially prone to encounter organizational ethics based dilemmas as they relate to the delivery of rehabilitation services in today’s complex healthcare environment [7].