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Method: While acknowledging the wide cultural variations in each region, the presenter noted some general features of human relationships in Asia, including paternalism, nonverbal communication, and rapid change with advancing Westernization. The presenter articulated contemporary ethical issues arising from occupational health practices in Japan, where remnants of the traditional Asian social order persist in the world of labor.
Results: (1) Legislation requires employers to perform health exams, retain health records, and solicit the views of occupational physicians on measures to maintain employee health. These practices can come into conflict with the principle of worker autonomy. For example, in the case of an employee with a progressive condition who wishes to continue working and is reluctant to reveal his or her actual condition to the employer, an occupational physician faces a dilemma. (2) Growing numbers of cases seek compensation under workers’ compensation insurance for psychiatric ailments attributable to heavy work stress. The recent expansion in healthcare businesses has encouraged companies to contract with independent providers specializing in mental health. Occupational physicians often find themselves isolated, perplexed, and challenged by the difficulty of maintaining fairness. (3) Occupational physicians are ideally positioned to detect the first health effects caused by exposure to new compounds. However, the companies are often reluctant to acknowledge and publicize these detrimental effects. On the other side, modern research ethics require authors to disclose all potential conflicts of interest, even if such disclosure may seriously damage an author’s authority.
Conclusion: Amid an increasingly complex network of human obligations, occupational physicians in Asia are challenged to reconcile the different values of multiple stakeholders. The ICOH Code of Ethics is expected to shed light on best practices in this area.