A nurse presents this situation to an ethicist:
I am a nurse-midwife. Some of my pregnant clients are illegal immigrants from Mexico who are treated under a federally financed migrant-workers' health-care program using their real names. They are sometimes employed under an alias. When they miss work for appointments or their deliveries, I'm asked to write excuses using those aliases. I would ordinarily write such an excuse, but must I refuse unless I can use a real name?
http://www.nytimes.com/2009/06/21/magazine/21FOB-ethicist-t.html?ref=magazine