Current Developments in Ethics in Occupational Medicine

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Current Developments in Ethics in Occupational
Medicine

• Dr Alison Rimmer

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Or

• A sneak preview of the Facultys new guidance

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Sorry, folks ..

• Dont know what they will say
• Dont know when they will be published

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Oh, well ..

• This new edition has extensive revisions to take
  account of these changing attitudes (in society)
  , changes in the law, scientific and technical
  developments, and the mounting pressures
  challenging the professional accountability of
  doctorsIntroduction Faculty Guidance, 1999

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Drivers for this new revision

• Societal
• Increasing openness
• Autonomy vs Paternalism
• The choice agenda
• Legal
• Data Protection changes
• Freedom of Information Act

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Drivers for this new revision

• Changes in Professional Practice
• GMC Good Medical Practice
• Changes in Business Practice
• More outsourcing and subcontracting

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Have the basic priniciples of ethical practice
changed much ?

• What is ethics anyway ?
• Where does it come from ?

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General Medical Council

• The general standards that the public has a
  right to expect from its doctors

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Faculty

• A Code of Conduct
• Ethical behaviour is largely self imposed by
  each doctor who will make decisions according to
  individual conscience, based on their own
  personal experience and training

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Basic principles underlying ethical practice

• The doctor to consecrate his life to the service
  of humanity
• To make the health of his patient his first
  consideration
• To respect his patients secrets (even after
  death)
• To prevent considerations of religion,
  race,nationality,politics or social standing
  intervening between my duty and my patient
• Source Declaration of Geneva 1948, modified 1968
  and 1983

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In Occupational Health Practice

• Consent
• Confidentiality
• Conflict between duty to individual patient and
  third parties

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Day to Day ethical dilemmas of an Occupational
Physician

• What would you do ?

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Consent

• Implied vs Overt consent
• Health assessment if they come have they
  consented ?
• What to do if they say they dont why theyve
  been referred ?
• Capacity and competence to consent

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Confidentiality

• How far do you go ?

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Conflict between the individual and third parties

• Pre-employment screening
• Health assessment for a third party
• The individual vs the workforce
• The individual vs other third parties eg
  vaccinations in health care workers

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Are there any current developments in Ethics in
Occupational Medicine ?

• Maybe not
• Same basic principles
• New settings and applications
• New dilemmas
• May we live in interesting times !

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