Public Health Law Map - Beta 5 - Medical and Public Health Law Site

problems. The Court also reiterated the popular misconception that workplace toxins
pose the same reproductive risks to men as to women. This ignores the issue that
most of the known risks are due to in utero exposure.
Companies who employ women in positions that might endanger a fetus must warn
women of the risk and provide alternative employment opportunities if the woman
becomes pregnant. A physician who believes that a patient might be endangering her
fetus by the work she does has the responsibility to warn her. This belief must be
based on scientific evidence. Physicians who care for women in their childbearing
years should realize that not all chemicals are dangerous to a fetus. The current
tendency to worry pregnant women with potential but minimal risks has the effect of
discrediting warnings of serious risks such as smoking. Although there are
occupational exposures that endanger a fetus, the more common risk is to the mother
because of her reduced agility and shifting center of gravity.
A woman may be put on leave or alternative duties if the pregnancy makes her
physically unable to fulfill her regular duties or if the work might endanger her
health or the public safety. An airline was allowed to limit flights by pregnant
women because their condition impaired their ability to function effectively in an
emergency. Such decisions must be made on sound medical and workplace safety
grounds. In the rare circumstances where such restrictions would be appropriate,
employers should find alternative employment when possible. A pregnant telephone
company employee may not be able to climb poles safely by the time she is 15 weeks
pregnant, but she can do indoor installations safely until she goes into labor.
Physicians involved in obstetric care of women in the work force should make a
clear distinction between social issues and medical decisions. A healthy woman with
an uncomplicated pregnancy may want a maternity leave that extends for three
months after the baby is born. Her company may offer a six-week leave. It is
generally accepted that the normal physical disability associated with pregnancy and
delivery should resolve by six weeks. It would not be legitimate to give this woman a
medical excuse from work for the second six weeks postpartum unless she had a
specific medical indication for such leave. No matter how strongly a physician feels
about issues like bonding and breast- feeding, these are social issues that do not bear
on the woman’s physical fitness for work.
K. Disability Insurance Evaluations
Disability evaluation and qualification for various public and private disability
programs is becoming increasingly important in general medical practice. Evaluation
of impairments is no longer limited to neurologists, orthopedists, and physical
medicine physicians. The laws have expanded and so have the types of problems that
are considered disabilities. Every medical care practitioner must deal with patients who
are considered disabled under the Americans with Diabilities Act (ADA) and most will
have patients who qualify, or want to qualify, for disability compensation under Social
Security or private insurance.
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