Abstract:
While ethical codes have been established for practitioners, there is a possibility that dual loyalty affects occupational medical practitioners’ (OMPs) decisions in determining fitness status of employees. Literature indicates dual loyalty of OMPs leads to ethical dilemmas. The study’s main objective is to determine if dual loyalty participates in OMPs’ decisions and influences OMPs to breach medical ethics required in their profession, resulting in employees unfairly losing their jobs.
The study interrogates literature review on dual loyalty and adopts a multi-layered approach focussing on the Constitution; relevant Acts and guidelines; case law and ethical principles. Case studies from the Medical Inspector’s archives are interrogated to determine the influence dual loyalty has on OMPs’ decision-making.
Case law indicates that conflict of interest is the source of dual loyalty. Occupational medical practitioners have fiduciary duties and need to serve the best interests of the employees. From case studies discussed, the study shows that OMPs are affected by dual loyalty and tend to disregard medical ethics. They may be conflicted when making decisions concerning employees’ fitness to work, especially when individualised assessments are not conducted.
A guideline addressing ethical obligations and human rights should be drafted for OMPs, guiding them on dealing with dual loyalty. Employers will need awareness training in various institutions so that OMPs are supported and encouraged to have sound medical ethics. This will promote best practice in doctor-patient relationships, avoiding dual loyalty dilemmas.
