Legal and Ethical issues Regarding Crohn's disease

 

Legal and Ethical Concerns

    When a patient is being taken care of their physicians can often take on responsibilities beyond their medical care. (Tremaine & Camilleri, 2007) They serve as the patients advocates to nonmedical entities and individuals, including insurance companies, schools, employers, companions, and family members. These responsibilities taken on by the physician create a complex relationship between the patient and their IBD physician. These responsibilities can create ethical concerns for the physician who could also be in clinical treatment trials for IBD. (Tremaine & Camilleri, 2007) Other ethical issues that could appear would be therapeutic misconception, clinical equipoise, and financial and nonfinancial conflicts of interest. There needs to be boundaries and separation between the patients and physician, especially when it comes to treatment trials. The ethical treatment of patients needs to be number one priority, even if that means the physician steps away from a clinical trial. (Tremaine & Camilleri, 2007) Crohn's disease is considered a disability by the Social Security Administration, and individuals can collect benefits. They can only claim benefits if they cannot work, but this has to be supported by evidence. Some individuals who have Crohn's disease are bale to work because their case of Crohn's disease is not severe like others. There are a few laws that help individuals who are able to work to help make it easier, we will talk more about this in the next section. (Veazey, 2021) 

Is Meeting the Letter of the Law Sufficient

Crohn's disease can have a huge impact on an individuals ability to work depending on the symptoms and severity of the disease. Individuals with the disease understand the fluctuating and unpredictable course of the disease but others may not. This can lead to anxiety which can lead to trigger additional flare-ups. This then results in a negative performance in the workplace because of the symptoms. (Katzmann, 2020) Some individuals will turn down promotions in their career because they are scared they will not be able to meet the demands of a new position, or they cannot perform the new duties because of their disease. (Katzman, 2020) The ADA protects these individuals from job discrimination. Crohn's disease is a disability that meets the ADA's definition of physical or mental disability because of the physical impairment that affects your digestive system. Under the ADA those with Crohn's disease can request reasonable accommodation from their employer, this can also be requested in school. This allows for individuals with Crohn's to may request like sitting near a restroom while at work, or if the job is suitable to work at home. Each case is different because every situation is different. (Katzmann, 2020) If it was a child in school they may ask to take school work home or test to make up things they have missed due to Crohn's disease. The ADA is made for individuals with a disability in order to help them feel comfortable and "fit in" with other workers. 

Discuss and Illustrate the Spirit of the Law

    As an employer it is ethical to make sure all employees feel safe and comfortable while at work. Some individuals may need extra accommodations. If these accommodations are doable and necessary it would be ethical to accommodate them. If they meet the definition for ADA then it is ethical and legal tat you make those accommodations. Employers who fail to comply with ADA guidelines can be sued by the United States Department of Justice in federal court. First time offenders face civil penalties up to $75,000. They can also face $110,000 for subsequent violations. (Katzmann, 2020) 

Potential Issues Impact on the Individual

    Below is a video that describes how a child is impacted by Crohn's disease in school. The parents sit with the school staff and help them understand what is happening due to the Crohn's disease and how the school can help her be comfortable and be successful in school. Before students knew about the disease they made up rumors about the young girl but once she told the students they understood and were supportive. 

    https://youtu.be/8YUkKIQyAI0

Impact on Family/Friend Environment, and Society

    Having a family member or friend who has Crohn's disease can effect your life as well if you are helping take care of them. Especially for parents who are helping their children. There are many doctors appointments and sometimes hospital visits depending on what is going on with the patient. This can effect the parents work if they have to keep taking time off. If a child is hospitalized or a close family member some jobs have Family and medical Leave Act. This act allows up to 12 weeks of excused unpaid absence each year if you or a family member has a serious health condition. Only companies with over 50 employees have to comply with FMLA, and they can also decide if they provide pay or benefits while you are gone. The benefit part could also add a stressor to the family, because what if that is who the families insurance is through.( Katzmann, 2020) Crohn's disease can be tough on everyone around and involved not just the individual who has it. The Crohn's and Colitis foundation does there best to provide support and help in the ways they are ale for individuals who have Crohn's disease and their families. below is their link to their website, on there they provide information on everything related to Crohn's disease and Colitis. 

    https://www.crohnscolitisfoundation.org/

Reference:

    William J. Tremaine & Michael Camilleri, (2007). Ethical Issues concerning therapeutic studies in inflammatory bowel disease, https://pubmed.ncbi.nlm.nih.gov/17352385/

Karen Veazey, (2021). What to know about claiming disability due to Crohn's disease, https://www.medicalnewstoday.com/articles/crohns-disease-disability

Pat Katzmann, (2020). Crohn's and Your Rights: Is Crohn's Covered Under the Americans with Disabilities Act? https://www.healthline.com/health/crohns-disease/americans-with-disabilities-act