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April 2003, Vol 93, No. 4 | American Journal of Public Health 545-548
© 2003 American Public Health Association

HEALTH POLICY AND ETHICS FORUM

Chevron v Echazabal: Protection, Opportunity, and Paternalism

Norman Daniels, PhD

The author is with the Harvard School of Public Health, Boston, Mass.

Correspondence: Requests for reprints should be sent to Norman Daniels, PhD, Harvard School of Public Health, Bldg 1, Room 1104C, 655 Huntington Ave, Boston, MA 02115 (e-mail: ndaniels{at}hsph.harvard.edu).

The Supreme Court, in Chevron v Echazabal, ruled that risks to a disabled worker, if established by an individualized medical assessment, can disqualify the worker from protections offered by the Americans with Disabilities Act (ADA). This decision rejected the antipaternalist position of ADA advocates that workers with disabilities should be able to determine, through their own consent, the risks they will take.

Such strong antipaternalism may not be compatible with the underlying justification for the protection of workers against health hazards. Stringent regulation of workplace hazards involves restricting the scope of consent to risk.

Resolution of this conflict will depend on more careful examination of the degree to which individualized medical assessments avoid stereotyping and bias.




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