Abstract
In the field of occupational medicine and health services, occupational physicians often face ethical dilemmas or conflicts concerning their independence and the privacy of employees' health information. It is stated that, by law in Japan, employers must assume full responsibility for the safety and health of their employees at work. However, the independence of occupational physicians is not clearly regulated by the law. Therefore, an executive director has an obligation to administer the health data of workers and he may require an occupational physician to disclose the medical information of employees. The actual ethical dilemmas of occupational physicians are as follows: 1) company loyalty vs. medical ethics (e.g. disclosure vs. confidentiality of medical information), 2) workers right to know or to work vs. company managerial policy (e.g. do employers inform workers the health effects of chemicals in the workplace accurately, assessment of fitness for work, return to work, restructure of work system), 3) environmental ethics vs. bioethics (e.g. occupational physicians must have the responsibility for not only employees but also the community as well as the company). In order to dissolve these dilemmas, occupational physicians need to have three ethical opposing standpoints, namely, bioethics, environmental ethics and utilitarianism. This is the ethical peculiarity of occupational professionals in comparison with clinical doctors and it is not easy to exercise ethical judgment for employees and the company as specialists of occupational medicine. Therefore, the establishment of ethical codes or guidelines for occupational physicians are required in Japan as well as the UK.
