Abstract: As the sustainability of healthcare fund operations faces challenges, China has progressively implemented novel medical insurance payment models, namely diagnosis-related groups (DRG) and diagnosis-intervention packet (DIP). In the process of reforming medical insurance payment methods, clinical ethical dilemmas have emerged as a critical issue requiring urgent resolution. A systematic analysis of the ethical problems arising from DRG/DIP implementation and the proposal of countermeasures hold significant importance in standardizing medical practices. This article categorizes and analyzes common ethical issues under the DRG/DIP payment system from three dimensions—key elements of medical insurance payment, patient treatment processes, and compliance in healthcare fund utilization—delving into the root causes of clinical ethical challenges. Furthermore, the following strategic recommendations are proposed: (1) optimizing the implementation mechanism of the special-case review system; (2) advancing centralized procurement and national negotiations for pharmaceuticals and medical supplies in a scientific manner; (3) establishing a dynamically adjustable floating mechanism for payment standards; (4) refining differentiated grouping protocols for unilateral and bilateral surgeries; (5) strengthening the supervision system for healthcare funds under the DRG/DIP framework; and (6) developing a rational performance evaluation scheme for medical practices. These measures aim to provide decision-making references and practical guidance for healthcare administrative authorities and medical institutions in addressing the ethical challenges posed by DRG/DIP reforms.