This case illustrates how healthcare ethics not only is limited to clinical ethics, but also encompasses organizational ethical issues such as occupational hazards and safety concerns, human resource policies, environmental health, and other issues affecting the work place, as well as the complexity of the relationship between law and ethics in general. It was a 1990 U.S. Supreme Court case, in which it was argued that women could not be discriminated against in the workplace on the grounds that they might become pregnant. Among many other items, Johnson Controls manufactures batteries, a principal component of which is lead. Johnson Controls had developed a fetal protections plan in an attempt to balance the adverse health effects of lead exposure against developments in civil rights law. Prior to the Civil Rights Act of 1964, Johnson Controls employed no women in the manufacture of batteries. Thereafter, the employer adopted a program to notify female employees of the dangers involved, and to obtain written acknowledgement of that warning. Despite these warnings, over the next several years, eight employees became pregnant while exhibiting significant blood-lead levels. The company responded by excluding any woman who could not medically prove her infertility from positions in which lead was present. The restrictions further excluded all women from any job which might result in transfer or promotion into an exposed position.
In 1987, displaced employees alleged that the battery manufacturer’s fetal protection plan constituted gender discrimination in violation of Title VII as amended by the Pregnancy Discrimination Act of 1978. The trial court granted summary judgment for the employer, finding that the plaintiffs had failed to prove essential elements of their claim. An eleven-member panel of the Seventh Court of Appeals concurred, finding that airborne lead within the battery plants represented a significant fetal health hazard. The court described previous appellate decisions allowing such policies under the business necessity defense, and agreed that this theory should control. In finding for the employer, the circuit court never addressed the impact of the Pregnancy Discrimination Act, nor stated whether it was adjudicating a case of overt discrimination or disparate impact; it simply chose which defense would control.
In a unanimous decision, the U.S. Supreme Court reversed the Seventh Circuit Court Decision, finding policies which represent such overt gender discrimination unlawful under traditional Title VII analysis unless the plan meets a narrow "bona fide occupational qualification" (BFOQ) defense. A majority of the court found that Johnson Controls’ plan could not be maintained, since that defense could not be stretched to encompass the company’s concerns for fetal safety. [Source: Rutgers Law Review 1992; 44: 479-529. No. 89-1215, 499 U.S. 187 (1991).]
Principles & Concepts: beneficence, autonomy, nonmalificence, justice, paternalism.
