Was the Settlement at BNR Fair - Report Example

Was the settlement at BNR fair? The first court action made by the U. S. Equal Employment Opportunity Commission (EEOC) against genetic testing resulted in a voluntary settlement – just 3 days later. The EEOC filed a court action challenging genetic testing at Burlington Northern Santa Fe Railroad. On February 12 the railroad announced that it would put an end genetic testing of employees who have filed claims for work-related injuries based on carpal tunnel syndrome (Girion, 2001). The area of genetic testing is new, and the EEOC moved quickly to make an aggressive statement. Labor experts advise that companies move slowly in this area. In particular, they should make sure they have a valid business purpose for such testing. If the testing interferes with rights under ADA, that would also be a matter of concern. It is agreed with the EEOCs interpretation of the Americans with Disabilities Act, which holds that discrimination based on an employees genetic information is a violation of the ADA (Girion, 2001). The EEOCs position remains legally untested, leaving many uncertain as to whether the courts would, in fact, uphold the EEOCs position. This leaves employers in somewhat murky waters as to how current law applies to the issue of genetics in the workplace. Until a more definitive answer is reached, Owens said that it may be advisable for employers to develop a workplace policy on this issue, or include genetic information in their current non-discrimination policies, despite the fact that statistics show that employers are not conducting genetic tests (Stutts, & Kasdan, 1993). In an attempt to demonstrate that CTS was not solely a work-related injury, Burlington Northern began genetic testing to screen workers for the presence of this marker. According to Dr. Phillip Chance, the discoverer of the genetic marker, it was actually associated with a condition known as "hereditary neuropathy with liability to pressure-sensitive peripheral palsies" or (HNPP), not specifically to CTS. In the Times article, Chance states that testing for the marker would have little or no value in screening workers for CTS. Nevertheless, Burlington Northern plunged ahead with their program of testing ( Sambrook, 1999). A railroad worker in Nebraska began to experience numbness in the tips of his fingers and ultimately had carpal tunnel release surgery. In the follow-up period, the company instructed the worker to report to a doctor for additional, objective medical information to determine whether or not the condition is work-related. The employees wife, a registered nurse, became suspicious about the type of tests that would be performed and objected. In a case comparable to that of Erin Brockovich, the worker and his wife hired an attorney and filed suit against the railroad for EEOC violations. To make a long story short, the railroad has since dropped its practice of genetic screening for CTS (Sambrook, 1999). In an attempt to determine the extent of genetic influences on disc degeneration, the many authors compared MRI features of degenerative disc disease in the cervical and lumbar spine of 172 monozygotic and 154 dizygotic twins. An overall score for disc degeneration was calculated, and the results were then adjusted for age, weight, height, smoking, occupational manual work, and exercise. Disc height and bulge were shown to be highly heritable in both the cervical and lumbar sites, and osteophytes were heritable in the lumbar spine (Matsui et al, 1998). Furthermore, the authors suggest an important genetic influence on variation in intervertebral disc degeneration. However, they also state that variation in disc signal is largely influenced by environmental factors shared by twins. In a similar study using magnetic resonance imaging and plain film radiography, Matsui, et al. (1998) investigated whether a family history of lumbar disc herniation is a risk factor for disc degeneration. According to the authors, the study provided evidence that a family history of operated lumbar disc herniation has a significant implication in lumbar degenerative disc disease. They state that there may be a genetic factor in the development of lumbar disc herniation as an expression of disc degeneration (Matsui et al, 1998). Other studies have also attempted to identify a link between heredity and back pain. Postacchini, et al. (1988) surveyed the parents, siblings and children of patients complaining of discogenic lowback pain (Group I); patients that had undergone surgery for lumbar disc herniation (Group II); and those that had never complained of lowback pain (Group III). Of the families in Group I and Group II, 35 and 37 percent, respectively, had at least one member with a history of discogenic back pain, and five and 10 percent, respectively, had one or two members who had undergone disc surgery. Of the asymptomatic subjects in Group III, only 12 percent had at least one or more affected relatives, and one percent had a relative who had undergone disc surgery (Postacchini, 1988). Of the affected families, 41 percent had two or more members with a history of back pain. As one might expect, the proportion of symptomatic relatives in the affected families was higher among sedentary workers and motor vehicle drivers than among heavy or light manual workers. Nevertheless, the authors conclude that there is a strong familial predisposition to discogenic low-back pain, and suggest that the aetiology of degenerative disc disease is related to genetic and environmental factors (Richardson et al, 1997). Richardson, et al (1997) performed a retrospective case-control study to test the hypothesis that there is a familial predisposition to lumbar disc pain and injury. In this study, the immediate relatives of patients who had surgically proven lumbar disc herniations or repetitive upper-extremity overuse syndromes were given a questionnaire that had been tested previously and found to reliably identify discogenic lower back pain. The authors state that analysis identified familial grouping and a history of lifting as the only variables associated with a positive response on the questionnaire. They conclude there is a familial predisposition toward lumbar disc pain and injury (Richardson et al, 1997). While these studies appear to indicate that there is a familial link to the presence of disc degeneration and resulting back pain, they do not demonstrate that this familial predisposition is genetic. Some contend that it is both environmental and psychosocial. In one interesting study, a previously disabled family member is presented as a psychosocial determinant in the subsequent disability of the patient. Eighty-three disabled patients presented for an independent medical examination. All were seeking a workers compensation settlement or continued workers compensation benefits. Forty-four of the 83 had at least one disabled family member. These authors suggest a significant correlation between the "disabled" support system and subsequent disability of the patient (Stutts and Kasdan, 1993). In other words, the "pattern" of familial disability appeared to have a psychosocial origin rather than a genetic one. However, given the recent interest in genetics, one could also argue that there was a predisposition to disability in these individuals. It is not implied that genetic factors are not important in the development of a number of diseases. Obviously, there are conditions such as sickle cell anaemia where genetic factors are the primary consideration. In others, genetic factors may be important, but they may play only a complicating role. Still others, additional factors that are genetically based, such as anthropometry (e.g., wrist size and structure), may contribute to the development of disorders such as CTS. However, it is well established that individuals that take control of their conditions typically do better than those who relinquish control. The idea that the problems that we face are genetically linked may provide some individuals with a feeling of helplessness and further contribute to the idea that they are victims of circumstances. It is important to remember that most of the conditions that we see in practice, and in the workplace, are caused by the interaction of a variety of factors. For most conditions, genetics is probably not the "magic bullet" that some are seeking making the settlement fair on the behalf of the employees (Stutts & Kasdan, 1993). Works Cited Girion L, February 25, 2001. Nurse derails genetic testing, Los Angeles Times, W1. Sambrook P.N. et al. 1999. Genetic influences on cervical and lumbar disc degeneration: a magnetic resonance imaging study in twins. Arthritis Rheum. Matsui H et al. 1998. Familial predisposition for lumbar degenerative disc disease. A case-control study. Spine. Postacchini F. 1988. Familial predisposition to discogenic low-back pain. An epidemiologic and immunogenetic study. Spine. Richardson J.K. et al. 1997. A familial predisposition toward lumbar disc injury. Spine. Stutts J.T & Kasdan M.L. 1993. Disability: a new psychosocial perspective. J Occup Med. Read More