Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context

Abstract

BackgroundInternational codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process.DiscussionFirstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address workplace hazards demand that actions for occupational health extend beyond just the workplace.SummaryA stronger articulation of occupational health practice with advocacy for prevention should be an ethical norm. Ethical codes should ideally harmonize and balance individual and community needs so as to provide stronger moral authority guidelines. There is a need to consider an African Charter on Bioethics as complementary and strengthening of existing codes for the region.

Ethics in occupational health and safety: case studies from Gujarat

“…Table1 shows that a significant number of persons employed in the mines may be suffering from occupational diseases. Studies show that in countries without strong notification and identification systems, the prevalence of occupational hazards is far greater than that reported, because in most cases they are not notified (33). Thus, the existing data hardly give a complete picture of the occupational health status of Indian workers.…”

“…As the ethical aspects of this area have not been fully formulated, there is limited scope for enforcement, especially in low-and middleincome countries (LMICs), which have weak regulatory frameworks. In such cases, international guidelines are the only parameters for dealing with ethical challenges and measuring the gaps in the practice of OHS (33). In the absence of strong legal systems of enforcement, the development and institutionalisation of ethical codes and guidelines would effectively enhance ethical practice (33).…”

“…In such cases, international guidelines are the only parameters for dealing with ethical challenges and measuring the gaps in the practice of OHS (33). In the absence of strong legal systems of enforcement, the development and institutionalisation of ethical codes and guidelines would effectively enhance ethical practice (33). This necessitates an examination of the ground realities through the lens of such codes or guidelines.…”

Neurotoxicology and development: Human, environmental and social impacts

“…Two preconference workshops were held, the first led by Dr. Leslie London on ethical issues in occupational health practice as part of a process of input by an Africa workgroup to revisions of the ICOH Ethical Code (London et al, 2014). The workshop deliberations clarified a series of key ethical challenges for occupational health practitioners specific to the African context and came up with a series of high-level recommendations for ethical codes to better recognize the specific social, economic and cultural factors to ensure international ethical codes speak directly to local context (London et al, 2014).…”

“…The workshop deliberations clarified a series of key ethical challenges for occupational health practitioners specific to the African context and came up with a series of high-level recommendations for ethical codes to better recognize the specific social, economic and cultural factors to ensure international ethical codes speak directly to local context (London et al, 2014). The second workshop led by Dr. Kent Anger reviewed progress on the WHO Neurobehavioral core test battery (NCTB) and is reported in more detail in this edition.…”