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ISLAMIC MEDICAL EDUCATION RESOURCES-04

0608- ETHICO-LEGAL ISSUES IN AN OCCUPATIONAL SETTING I: PRE-EMPLOYMENT

Background reading material for Year 2 Semester 1 medical student PPSD session on Wednesday 30th August 2006 by Professor Omar Hasan Kasule, Sr.

1.0 PRE-EMPLOYMENT PHYSICAL EXAMINATION

Pre-employment examinations reassure management that the employee is physically fit to perform the work and has no risky communication disease or mental condition. A physician asked to undertake pre-employment examination must ensure that the patient has given free informed consent. Consent should be for specific and relevant history and physical examination. The physician should resist employer demands to collect information on matters that to him do not appear relevant to the work in question. After the examination the prospective employee may instruct the examining doctor not to disclose the medical report to the employer. He cannot ask for selective non-disclosure of specific items in the report because that would constitute deception. The request for non-disclosure should be respected in all circumstances but it has the implication that employment will not be granted. The prospective employee has a right of access to the medical report written about him or her.

 

2.0 PRE-EMPLOYMENT TESTING FOR INFECTIOUS DISEASE

Testing for some infectious diseases like HIV and HBV may be required for some jobs. The prospective employee must give consent after being informed of the purpose of the testing and to whom the results will be disclosed. The prospective employee may require that results be disclosed to him before being disclosed to his prospective employer and he has a right after that to refuse any further disclosures.

 

3.0 PRE-EMPLOYMENT TESTING FOR ADDICTION TO DRUGS AND ALCOHOL

With the informed consent of the prospective employee, testing for addictive substances like drugs and alcohol can be undertaken. The results can be communicated to the employer only with permission of the prospective employee. No results can be communicated to law enforcement agencies without informed consent. Counseling about drug addiction is a duty that the examining doctor must undertake and it does not require informed consent because it is part of the public duty of enjoining good and forbidding evil. It however must be carried out in private.

 

4.0 PRE-EMPLOYMENT PSYCHOLOGICAL TESTING

Pre-employment psychological testing with informed consent can be carried out to assess employee aptitude for certain work tasks or to discover psychological vulnerabilities that will put him or others at risk in the course of performing the work.

 

5.0 PRE EMPLOYMENT GENETIC SCREENING

Pre-employment genetic screening is allowed on the basis that workers with genetic predisposition should not be exposed to certain workplace hazards. Such testing can be carried out only after informed consent. Genetic screening cannot be carried out routinely. There must be a rationale related to the job or to the medical history of the prospective employee necessitating genetic screening. If this condition is not fulfilled such screening could be considered as possibly discriminative. Also care must be taken to ensure that genetic data is interpreted by an expert to avoid a biased view.

Professor Omar Hasan Kasule, Sr. August 2006