Throughout history, the relationship between employers and workers has been subject to the equilibrium of power, to legislative norms, to ethical considerations, and more recently to scientific knowledge. The authors examine the ethical conflicts that arise from the application of scientific knowledge to preventive health policies in the workplace. In particular, they discuss the ethical conflicts in the application of screening practices, in the setting of “allowable limits” of harmful work exposures, and in the right of workers to be informed about work hazards. Ethical problems are also created by conflicting interests in the protection of the environment, the health of the general public, and the health of the working population, and by conflicting interests among workers, and even within the individual worker, as in the case of “fetal protection” policies. The authors emphasize the positive use of scientific information and respect for human dignity in resolving these conflicts.
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References
1.
RossiG.Si invoca l'etica quando è in crisi il diritto. Corriere delia Sera, May 26, 1987.
2.
International Labour Office. World Labour Report 1993, pp. 1–2, 9–18. Geneva, 1993.
3.
BerlinguerG.Bioetica quotidiana e bioetica di frontiera. In Questioni di vita: Etica, scienza e salute, pp. 3–236. Einaudi, Turin, 1991.
4.
FriedmanM.The social responsibility of business to increase its profits. New York Times Magazine, September 13, 1970, p. 32.
5.
LeeP. W. R.Some ethical problems of hazardous substances in the working environment. Br. J. Ind. Med.34: 274–280, 1977.
6.
RodotàS.Test genetici per lavorare. La Repubblica, July 18, 1992.
7.
HarrisJ.Le biotecnologie nel 2000: Wonderwoman e Superman. Bioetica1: 32, 1992.
8.
National Opinion Research Center. Survey of the Use of Genetic Testing in the Workplace. Conducted for the Office of Technology Assessment. Washington, D.C., 1982.
9.
RighiM. L.Le lotte per l'ambiente di lavoro dal dopoquerra ad oggi. Studi storici2–3: 619–652, 1992.
10.
BerlinguerG.La salute nelle fabbriche, expanded edition. De Donato, Bari, 1977 [1969].
11.
BerlinguerG.BioccaM.Recent developments in occupational health policy in Italy. Int. J. Health Serv. 17(3): 455–474, 1987.
12.
AllegranteJ. P.SloanR. P.Ethical dilemmas in workplace health promotion. Prev. Med.15: 313–320, 1986.
13.
MinklerM.Ethical issues in community organization. Cited in reference 12, p. 315.
14.
CurranW. S.BodenL. I.Occupational health values in the Supreme Court: Cost-benefit analysis. Am. J. Public Health71(11): 1264–1265, 1981.
15.
Royal Commission on Environmental Pollution. Sixth Report. HMSO, London, 1976.
16.
VineisP.L'osservazione medica: Dalla diagnosi precoce alle cause ambientali delle malattie: I nuovi temi della medicina, p. 102. Garzanti, Milan, 1991.
17.
NavarroV.An International Study on Ethics and Values in Occupational Medicine. Personal communication, March 1982.
18.
AxelsonO.Etica, politica e interpretazione dell'evidenza scientifica dei rischi per la salute dovuti a esposizioni ambientali e professionali. Epidemiologia e Prevenzione42: 8–11, 1990.
19.
LilienfeldD. E.EnginM. S.The silence: The asbestos industry and early occupational research—A case study. Am. J. Public Health81(6): 791–800, 1991.
20.
Brandt-RaufR.Ethical conflict in the practice of occupational medicine. Br. J. Occup. Med.46: 63–66, 1989.
21.
HornsbyJ. L.Risk of bladder cancer: Psychological impact of notification. JAMA253(13): 1899–1902, 1985.
22.
Pereira-DiasH.Bioethics: Implications for medical practice and deontological and legal standards in Brazil. In Bioethics: Issues and Perspectives, edited by ConnorS. ScholleFuenzalida-PuelmaH. L., p. 138. Pan-American Health Organization, Washington, D.C., 1990.
23.
New Scientist, November 7, 1985, p. 66.
24.
EpelmanM.Sindicalismo y medio ambiente en Argentina. Unpublished paper. January 1992.
25.
Figà-TalamancaI.Zone industriali libere a adolescenti sfruttate. Salute umana, 1990, p. 107.
26.
CombaP.Il rischio ambientale e la salvaguardia della vita umana: Aspetti etici. ProtestantesimoXLVI(4): 287–300, 1991.
27.
MercierM.Chemicals and the third world: Problems and perspectives. In Proceedings of an International Symposium on Health and Environment in Developing Countries, pp. 1–7. Heikko, Finland, August 27–30, 1986.
28.
TomatisL.Perspectives for cancer in developing countries. In Proceedings of an International Symposium on Health and Environment in Developing Countries, pp. 8–13. Heikko, Finland, August 27–30, 1986.
29.
JonasH.Il principio di responsabilità: Un'etica per la civiltà tecnologica. Einaudi, Turin, 1990.
30.
BassiR.NeriA.VoltaM. CristinaHandicap e lavoro. La Nuova Italia Scientifica, Florence, 1984.
31.
Figà-TalamancaI.BerlinguerG.Problemi bioetici in medicina del lavoro. Report to the Congress of Occupational Medicine, Turin, 1992.
32.
Figà-TalamancaI.Tossici ambientali e lavorativi e la riproduzione umana: Metodologia, epidemiologia, tossicologia e prevenzione. Piccin, Padua, 1994.
33.
LavineM. P.Industrial screening programs for workers. Environment24(5): 26–33, 1982.
34.
BeckerM. E.Can employers exclude women to protect children?JAMA246(16): 2113–2117, 1990.
35.
Figà-TalamancaI.PaganoR.Disoccupazione e salute, che cosa dicono le statistsiche italiane. Epidemiologia e Prevenzione, 1987.
36.
Figà-TalamancaI.Maternità infanzia e lavoro della donna. In Proceedings of the Meeting on Health and Sickness in the Culture of the Lower Classes in the South of Italy, pp. 207–227. Naples, April 8–10, 1987.
37.
UzychL.Genetic testing and exclusionary practices in the workplace. J. Public Health Policy, Spring 1986, pp. 37–57.
38.
CurranJ. W.Danger for pregnant women in the work place. N. Engl. J. Med., January 17, 1985, pp. 164–165.
39.
SgrecciaE.Manuale di bioetica. Vol. II.E. Vita e pensiero, Milan, 1991.
