Introduction to occupational medical ethics.

Most bioethical advice has focused on the individual physician-patient relationship. But the ethical dilemmas confronting occupational medicine are more complex, because of the influence of institutional and organizational structure. For example, consider conflicts of interest in managed care: Concerns about costs to employers are not just economic, to be outweighed by commitments to employee health, but also legitimate ethical concerns about fair allocation of resources among all employees. Furthermore, in occupational health research, rather than thinking of employees as a "vulnerable population" it may be more useful to regard them as a distinct community and apply the 23 specified protections of communities.