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THE HYPOCRITICAL OATH by Kathleen Davis

posted 22 Aug 2013, 14:41 by Gerry Kangalee   [ updated 22 Aug 2013, 14:43 ]
 
Kathleen Davis is the National Health and Safety Officer of the National Workers Union. A trade unionist with over thirty years experience in the struggle, she is retired from the National Union of Government and Federated Workers (NUGFW). She is currently a part-time Lecturer with the Cipriani College of Labour and Co-operative Studies.
 
Comrade Davis is the holder of a Certificate, Diploma and Associate of Science Degree (ASc) in Occupational Safety and Health from the Cipriani College of Labour and Co-operative Studies (CCLC). She also holds Bachelor of Science (BSc[Hons]) in Occupational Safety, Health and Environment from the University of Greenwich, London. In addition, she has completed courses in Disaster Preparedness, Shelter Management and Community Emergency Response Team (CERT) as a Trainer.
 
Comrade Davis has successfully completed training programmes for HIV/AIDS Focal Point in the Workplace, hosted by the International Labour Organisation (ILO). She is a member of the Local Tripartite Council of Trinidad and Tobago (LTCTT), which is the Trinidad and Tobago element of the Pan Caribbean Partnership (PANCAP) against HIV/AIDS.
 
Training in this field also addressed issues such as law, ethics and human rights, as it relates to HIV and AIDS as a workplace issue. She has also undertaken a series of regional training seminars in this field of HIV/AIDS Policy Development. She believes that some of the issues to be addressed in the world of work as it relates to HIV/AIDS would be confidentiality, job security, workplace support systems, productivity, and health and safety.
 

Comrade Davis is a member and Chair of Trinidad and Tobago Volunteer Emergency Response Team (TTVERT) which brings disaster preparedness and readiness training to communities.

 
She is also a member of the Pesticides and Toxic Chemical Control Board and is a Board member of the Labour Advisory Bureau. 
Trade unionists need to be ever vigilant with some doctors who are paid by employers to examine workers. Some of the instances when employers will pay for medical services on behalf of their staff are: medical surveillance in compliance with the OSH Act; where they think there is excessive absenteeism by the workers; employers looking for a second medical opinion for whatever reason. Although these could be legitimate reasons, they can have far reaching consequences for the worker.

There seems to be a growing trend where the workers to be examined are not given a copy of the letter being sent to the medical practitioner detailing the type of complaint or what the doctor should be looking for. The other side of this, and what I consider to be the most important aspect of this situation, is that a number of doctors do not give the workers a copy of the medical report, even when they request it.

As a trade union activist, I have had to deal with this sorry business with employers: after all the union’s recognition certificate did not extend to me having an argument with the doctors. Recently, my concern with this was reawakened when a friend came to me for advice on this subject. The worker fell ill, recovered and returned to work. While ill, no get-well card was given, again following the return to work no welcome-back card came.

Irony of all ironies, now, almost one year later, this caring employer, out of an abundance of concern for the worker, issued a letter for the worker to see a doctor about an “existing or imminent condition”. Let me add, the worker did not get a copy of the letter sent to the doctor, but based on questions being asked by the doctor, the worker wanted to know why those questions, and was told of some things in the letter.

Following the examination, my friend asked for a copy of the report and was told by the doctor she (the doctor) could not do that, as it had created problems for her in the past. My friend was very concerned about not getting a copy of this report going to the employer, as it could be used negatively in the “suited for continued employment” scenario.

The Hippocratic Oath taken by all doctors expressed certain behaviours that should be followed by medical professionals. In 1964, Louis Lasagna, Academic Dean of the
Sackler School of Graduate Biomedical Sciences, wrote in relation to the oath: “I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick”.

However, these oaths and all they encompass seem to escape the consciousness of some of these medical professionals once they have become successful. Remember, new physicians are required to and have sworn “to practice medicine honestly and uphold a number of professional ethical standards”, which is to last them for the duration of their careers. These standards are not necessarily to the persons paying the fees, because the fee payers are not necessarily the patients who need the medical care.

Doctors must also bear in mind that workplaces are never physically examined, as they do not get ill in the same way as humans. They need to note, notwithstanding the fees they receive, or may be due to collect from an employer, the persons to be examined are workers. While they are workers, they are first and foremost human-beings, who happen to also be patients. These are the ones they owe their professional and ethical commitment and human compassion to.

Another aspect of The Hippocratic Oath brings me to the question of “doctor patient confidentiality”. The Oath requires doctors to “…respect the privacy of my patients, for their problems are not disclosed to me that the world may know... Whatever in connection with my professional practice or not in connection with it I may see or hear in the lives of my patients which ought not be spoken abroad, I will not divulge, reckoning that all such should be kept secret”.

So if, because of the employment relationship, it becomes necessary for disclosure to take place, it does not matter who pays for the medical examination. The worker must, by all ethical reasoning, be the first to know the outcome of their own examination. In other words, disclosure of patients’ medical information, does not nullify the doctors’ responsibility to that patient.

Clearly, the trade union movement needs to do some more work in this area. To know what exists under national laws, especially as it relates to who has the right to release; how much information can be released; the need for the patient signature on the release form; whether the patient can authorise other individuals to release on their behalf and the time period for which each release remains valid.
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