The Company That Cared Too Much
Lynda is a chemist who works for Brock Plastics, a large company
in New York. Brock Plastics has a reputation for treating its
employees extremely well. In addition to offering generous benefits
and bonuses, the company has an on-site occupational health and
fitness center that is staffed by a team of company doctors,
nurses, nutritionists and fitness experts. This team is responsible
for providing free health care, health promotion programs and
fitness programs for Brock's employees.
Last year Lynda scheduled an appointment for an annual physical
exam with Mary Wolf, the company's occupational health nurse The
exam includes a thorough assessment of the employee's health in the
prior year. During the exam Lynda informed Wolf that she has been
going through a difficult time with her mother, who has been
diagnosed with severe depression but has benefited little from her
current treatment. Lynda, who is an extremely private person,
rarely discusses her personal problems with her co-workers.
However, she was relieved to be able to share with Wolf her
feelings about the stress of handling her mother's condition. Wolf
lent an empathetic ear and provided sound advice for possible
psychotherapy and pharmacological treatments for Lynda's
mother.
A few weeks after Lynda had her health exam she began receiving
pamphlets, through intra-office mail, about a workshop that the
company was offering on the current treatments of depression. Lynda
shares a large cubicle with two other workers who love to gossip.
She was concerned that her co-workers would see the pamphlets and
ask questions. As a result, Lynda made an appointment with Wolf to
discuss the intra-office mailings.
When Lynda met with Wolf, she expressed her discomfort about
receiving personal health information through the company's
intra-office mail. Wolf explained that the occupational health
department conducts targeted mailings according to health problems
that that employees mention about themselves or family members
during health exams. When the company decided to offer a class on
the latest treatments for depression, Lynda was tagged as an
employee to receive the information.
Wolf decided to take this issue back to the team of health care
specialists in her department. Some team members reported that
other employees had expressed similar concerns. However, they knew
how effective the mailings were for recruiting employees into
beneficial programs. Furthermore, employees more typically thanked
them for remembering that they had a particular health problem that
needed attention.
After thoughtful consideration, the team decided to ask
employees during their health exams if they would be interested in
receiving health information through company mail. If the employees
said no, they were tagged in the computer tracking system as
ineligible to receive mailings. After one year of the new process,
approximately 35 percent of all employees asked during an exam
declined having personal health information sent to them through
intra-office mail.
Discussion Questions:
- Did the company nurse violate confidentiality by sending
unsolicited health promotion information to Lynda through
intra-office mail?
- What steps did Mary and the rest of the occupational health
team take to ensure that they were ethical in their health care
delivery and research practices?
- Did the occupational health department deceive employees by not
informing them that they would be sent unsolicited health promotion
information through intra-office mail?
- Should employees be informed when their personal health
information is being used to determine which health promotion
classes should offered by the company?
- Should employees be informed of the occupational health
department's confidentiality policies and procedures?
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Commentary: The Company That Cared Too Much
Commentary on the professional responsibilities of health professionals, particularly their obligation to safeguard the confidentiality of medical and health information.
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Additional Commentary: The Company That Cared Too Much
Brian Schrag's commentary on the professional responsibilities of health professionals, particularly their obligation to safeguard the confidentiality of medical and health information, than about issues in research ethics.