Ethical Perspectives in Work Disability Prevention and Return to Work: Toward a Common Vocabulary for Analyzing Stakeholders’ Actions and Interactions

Abstract

Many studies have emphasized the importance of medical, insurance and workplace systems treating individuals fairly in work disability prevention (WDP) and return-to-work (RTW). However, ethical theories and perspectives from these different systems are rarely discussed in relation to each other, even though in practice these systems constantly interact. This paper explores ethical theories and perspectives that may apply to the WDP-RTW field, and discusses these in relation to perspectives attributed to dominant stakeholders in this field, and to potential differences in different jurisdictional contexts.Literature was sought primarily in biomedical ethics, business ethics, and public administration ethics. In biomedical ethics, four ethical principles are dominant: autonomy, beneficence, nonmalevolence and justice. Business ethics involve theories on Corporate Social Responsibility (CSR), social contracts and organizational justice. Public administration ethics focus on constitutional theory, citizenship, social equity, virtue and public interest. Several concepts were identified as relevant for ethical analyses in the WDP-RTW field, including justice; individual autonomy; nonmalevolence; economic and social responsibility; and social contracts. These concepts provide a vocabulary that may be used to analyze stakeholders' actions and interactions in RTW processes. It was also noted how the power balance between stakeholders will influence which ethical perspectives will influence RTW. Jurisdictional differences that influence RTW processes with regard to stakeholder responsibilities were identified, as well as varying beliefs as to who is the client in different compensation systems. A social contractual approach may inform an analysis of cultural and legal differences.3

Vállalati felelősségvállalás és fogyatékossággal élő személyek foglalkoztatása: külön múlt – közös jövő? – 2. rész: A fogyatékossággal élő személyek foglalkoztatása a CSR-szakirodalomban és a gyakorlatban

“…Ennek egyik folyományaként mérési pontként és mérőszámként is megjelenik a fogyatékossággal élő személyek foglalkoztatása, de miközben tudatosan figyelik a költségeket, mégsem csupán a "business case" logika vezeti magát a foglalkoztatást, hanem erősen megjelennek az etikai érvek is (Reed, 2003;Stahl et al, 2013). Mindkét szervezetre jellemző a CSR, a felelősség komplex értelmezése: nem kom-munikációs, PR-célokat követnek, hanem társadalmi (különösen a belső érintettekre, a munkavállalókra vonatkozó) szemléletformálás és változtatás a kimondott cél.…”

A broad ethics model for mental health practice

“…In 2014, Ståhl et al [26] noted that ethics involves models about what are ''good'' actions and also the criteria related to identifying them. Helmchen, in 2015 [27], noted that contemporary psychiatric ethics deals with reflection on the manner in which moral norms of a general nature are applied to psychiatric situations that are specific.…”

Claiming Justice in Injury Law

“…So once I got home some of the letters and things became less clear as time went on; I also didn't have the support services to explain what they were actually asking. (Male, [30][31][32][33][34][35][36][37][38][39] Several claimants suggested that it would have been useful to have the services of a non-legal advocate or consultant to manage their claim, arrange transport to appointments and explain entitlements in the early stages:…”

“…To me it was pretty obvious that I had something go wrong, I wasn't a fake. (Male, [30][31][32][33][34][35][36][37][38][39] Some claimants perceived the CO's suspicion of wrongdoing as an attack on their personal integrity, that served only to compound stigma they already felt was associated with having a claim:…”

“…They want you back at work and not costing them a cent as soon as possible … Obviously once you're back at work, they're sort of yep, boom, big tick on that, you're out of the system, you're gone sort of thing. (Male, [30][31][32][33][34][35][36][37][38][39] Talking to one of the case managers, who was trying to do the right thing and felt bad because of the stonewalling every step of the way, she said: 'You know, they've got all these graphs and bits and you're just one big blot on their graph that they're simply saying get rid of'. (Male, 40-49)…”