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Ethics and confidentiality in occupational medicine
The occupational physician serves the worker's health even when the employer pays – so he keeps confidentiality, gives the employer only a functional conclusion with the worker's consent, keeps professional independence and works to prevent the hazard at the workplace rather than only to screen workers.
Why it matters in the exam
Items on this topic pose "dual role" dilemmas: an employer asks for the diagnosis of an absent worker, a manager asks for the test results of all workers, a worker asks to hide an illness that endangers others, or an employer wants genetic testing before hiring. The principles under the code of ethics of the International Commission on Occupational Health (ICOH): the worker's health is central; the employer receives only a conclusion – fit, fit with adjustments, temporarily unfit or unfit – and not a diagnosis; information is passed with the worker's consent, except where the law requires it or there is real danger to others; group results are presented in a non-identifying way; and the physician informs the worker of his results and their meaning. In Israel the Genetic Information Law forbids an employer to require or perform a genetic test on a worker or candidate, and the Patient's Rights Act protects medical confidentiality. Further items deal with drug and alcohol testing – justified mainly in safety-critical jobs and under clear rules – and with the physician's duty to report to a competent authority when a worker in a safety-critical job, such as a driver, is unfit and refuses to stop. Remember that the occupational physician is also committed to improving working conditions, not only to deciding individual fitness.
Key points
- The occupational physician serves the worker's health.
- The employer receives only a functional conclusion, with the worker's consent.
- Confidentiality is breached only under a legal duty or real danger to others.
- In Israel an employer may not require a genetic test.
- Group results are presented in a non-identifying way and used to improve working conditions.
Summary table
| Principle | Meaning | Example |
|---|---|---|
| The worker's health is central | The physician serves the worker's health even when the employer pays | Recommending a task change rather than only exclusion |
| Confidentiality | The employer receives only a functional conclusion | "Fit with a lifting restriction" – without a diagnosis |
| Consent | Information passes with the worker's consent, except a legal duty or real danger | A driver who is unfit and refuses to stop driving |
| Professional independence | Medical judgement without pressure from employer or worker | Refusing to change a finding on request |
| Genetic information | An employer may not require a genetic test | The Genetic Information Law (2000) |
| Group information | Presenting group results in a non-identifying way | An annual medical surveillance report to the employer |
A free exam question
שני רדיולוגים עברו קורס קוראים מוסמכים לצילומי חזה לאבק מזיק .בבדיקה טרם הקורס הסכימו ביניהם על מחצית מן הבדיקות ולאחר הקורס הסכימו ביניהם על 75% מן הבדיקות. מה משמעות ערך ה- Kappa שהתקבל בנוגע להסכמה בין הבודקים? (the question as examined, in Hebrew)
- א. הסכמה חלשה
- ב. הסכמה בינונית עד טובה
- ג. הסכמה טובה מאד
- ד. הסכמה חלשה מאד
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Sources
- International Commission on Occupational Health (ICOH), International Code of Ethics for Occupational Health Professionals, 3rd ed., 2014 — Duties and obligations; Confidentiality
- Faculty of Occupational Medicine, Ethics Guidance for Occupational Health Practice, 2018 — Consent and disclosure to employers
- Israel, Genetic Information Law (חוק מידע גנטי) and Patient's Rights Act, 2000 and 1996 — Ban on genetic testing by employers; Medical confidentiality
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-06. The text may contain errors; when in doubt, check the source.