1.1 Refuse to sign. As a medical doctor, Nancy must stand up for what she believes is right. Nancy was part of a pharmaceutical team developing a chemical substance called loperamide, a liquid treatment for diarrhoea for people unable to take solid medicine – namely infants, children and the elderly. Loperamide contained 44 times the amount of saccharin allowed in a soft drink, but there were no regulations governing saccharin content in medication.

Nancy was the only medical member of the seven-person project team. The team made a unanimous decision to reduce the saccharin content before marketing loperamide, and so the team initiated a three-month effort for reformulation. In the meantime, management was pressuring the team to allow human testing with the original formula until the new formula became available.

After a heated team debate, all the team members except Nancy voted to begin testing with the current formula.