Law, Ethics and Health and Work
What this domain tests
This domain covers the legal framework around health and work and the ethical duties of the occupational physician. Know the principles of consent and confidentiality, the duty of care to worker and employer, statutory reporting of occupational disease, and the role of the occupational physician as an independent adviser. Understand the difference between the clinical duty to the patient and the contractual duty to the employer, and how to reconcile them.
Concepts to hold
Consent must be informed and voluntary; a worker can decline surveillance, and you must explain consequences without coercion. Confidentiality is the default: medical information stays clinical, and reports to employers contain fitness conclusions and restrictions only, with consent. Know the four ethical principles (beneficence, non-maleficence, autonomy, justice) and how they apply to fitness decisions, disclosure and conflicts of interest. Be aware of statutory duties to report certain occupational diseases and of record-keeping obligations.
Traps
Questions frequently test whether you would disclose a diagnosis to a manager: the answer is almost always no without consent, and even then only the minimum necessary. Another trap is the 'dual obligation' framing that suggests the employer's interest trumps the worker's; independence and the worker's health come first. Watch for scenarios where a worker lacks capacity or where a third party requests information: apply the same consent and necessity tests.
Worked rule of thumb
Before disclosing anything, ask: is there consent, is it necessary, and is it the minimum required? If any answer is no, do not disclose.
Example
A manager asks for a worker's diagnosis after a sickness absence: offer a fitness opinion and adjustments, decline the diagnosis without consent.