Interdisciplinair werken bij arbeid en gezondheid: ethische fricties

Objective

To investigate which ethical considerations play a role in the assessment of absenteeism due to sickness and of disability, and how these are dealt with.

Design

Qualitative, exploratory study.

Method

We conducted interviews with 32 individual professional practitioners: 8 occupational health physicians, 8 insurance company physicians, 8 general practitioners, and 8 psychologists, with the aid of a semi-structured questionnaire. During the interview we differentiated between 4 clusters of questions referring to the ethical, legal, interdisciplinary, and professional context, respectively. The study revealed only the spectrum of ethical considerations that played a role, and not the representativeness. For this reason the results did not allow for quantitative conclusions.

Results

Differences in the manner of thinking and behaving between health-care providers stem from differences in ethical considerations and in background beliefs. These differences hinder effective cooperation within the occupational health sector.

Conclusion

To improve professional performance and to achieve more responsible decision-making those involved need to be aware of their ethical considerations and background beliefs and to make them explicit, possibly with the aid of a checklist.

Conflict of interest and financial support: the investigation was financed by the Netherlands Organisation for Health Research and Development (ZonMw), within the programme ‘Policy for quality in the curative care sector’ and related to a sub-study within the project ‘Ethics in guidelines for work and health’ on which the Erasmus MC, Rotterdam, the Netherlands, the Netherlands Society of Occupational Medicine (NVAB), and the Netherlands Association for Insurance Medicine (NVVG) cooperated.