4217.0: Tuesday, November 14, 2000 - 3:15 PM

Abstract #18215

Panel 2: Ethical Issues in the Practice of Occupational Medicine

Tee Guidotti, MD, MPH, Division of Occupational and Environmental Medicine, George Washington University, 2300 K Street, Washington, DC, 202-994-1734, eohtlg@gwumc.edu, Steve Mooser, MPH, Irving J. Seilikoff Center, Mt. Sinai Medical Center, One Gustav Levy Place, New York, NY 10029, 212.241.6173, sbmooser@aol.com, Peter Orris, MD, MPH, Division of Occupational Medicine, Cook County Hospital, 1900 W. Polk, Rm. 500, Chicago, IL 60612, and Glenn Pransky, MD, MPH, Liberty Mutual Center for Disability Research, 71 Frankland Road, Hopkinton, MA 01748.

A consistent ethical framework for occupational environmental medicine is absolutely required. One would like to think that ethics are aligned with law, custom and the expectations of workers, community members and management. However, they are not. Our efforts to adhere to our own ethical framework are sometimes undermined by forces and interests outside the speciality. This may occur due to shifting fashions in management philosophy, the responsibilities assigned to human resources,legal interpretation, liability, legislation, and, in North America,managed care. This does not absolve us of responsibility; it makes our task all the more challenging. We exert little control except over our own behavior. Occupational medicine operates on the margins of clinical practice, business and labor-relations, with little room to maneuver, in a legally hostile environment in which even physician-patient privilege is not formally recognized. Our ethical framework is built on standards of practice that are normative, not absolute, and that may be reinterpreted over time. The AOEC panel will address several specific issues of ethical conduct in occupational and environmental medicine. These include the "morality" of occupational medicine, exploring the fine line between individual responsibility and paternalistic protectionism; medical record confidentiality, the ethics of epidemiology studies (both occupational and environmental); and the growing trend to use the AMA Disability Guidelines to determine job impairment.

Learning Objectives: 1. Participants will understand the challenges and responsibilities of the ethical framework in the practice of occupational medicine. 2. Participants will be able to describe the specific context for ethical conduct with regard to how results of epidemiology studies are applied, medical records confidentiality, use of the AMA disability guidelines, among others

Keywords: Occupational Health Care, Ethics

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA