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Volume 4 Number 1
January 6, 2006 |
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The ethics of 'Presenteeism' Is it unethical to go to work when you're sick? Now that the cold and flu season is upon us, it seems like a good time to talk about the ethics of going to work -- or staying home -- when you're sick. This has been a moot point for me until now, because I was a telecommuter for over a decade and telecommuters, unless they're unconscious, tend to work under all sorts of conditions. I've recently been consigned to "cubicle hell" and have come face to face with co-workers who are snuffling, sneezing, coughing, hacking, and regaling the office with tales of how sick everyone in the household is. "Why the heck don't they just stay home?" I silently scream. "Are they trying to make me sick, too?" So, I joined a school of thought that says sick employees should stay home. First, it would help them recover faster. And second, coming in to work only exposes other workers to the illness and could result in a major loss of productivity, if the whole office comes down with whatever they have -- and other people do decide to stay home. In reading up on some of the discussion surrounding the issue, I came across a new word that someone has coined: "Presenteeism." Intended as the opposite of "absenteeism," it refers to the tendency of people to come to work when they really shouldn't and, as the argument goes, putting the operation at jeopardy by exposing everyone in the office to a disease. The reasons people come in to work when sick are rather numerous. For some people, especially hourly workers with no benefits, it's as simple as "no work - no pay." When you're already living at a subsistence level, taking three days off for a cold can put you behind the eight ball economically. For people at the upper levels of management, there is the feeling that the company can't survive without their presence, which may or may not be true. Middle managers may be able to take the time off, but they know that in today's "lean and mean" work environments, no one on the already stretched staff will do their work. So, every day they're out means the in-box will be piled that much higher when they return. Worse still, the boss may discover the operation works pretty well without them, which won't bode well when the next inevitable round of layoffs comes. Even workers with liberal sick leave policies don't want to waste their sick days on such frivolities as a bad cold in February, when they could hoard them for "mental health" days at the beach in the warm, sunny weather. Then, there are the people who just refuse to be "sick," even if they're at death's door. Call them stoics. Call them crazy. Who knows? Just for the record, there are the other people, usually found among that rapidly shrinking group of workers whose employers have liberal sick leave policies, who will stay out of work on the flimsiest of excuses. They usually do throw the office into a turmoil, as few places today have enough "depth" in the staff to take up the slack for a missing worker. But that's a different issue altogether. The question on the table is: Do you have an ethical obligation to stay home from work when sick and to avoid exposing your fellow workers to illness? You could make several arguments about this. One would be that you, in fact, do have an obligation to keep from knowingly infecting other people when you're sick. You could also propose a corollary argument that you have an obligation to the company to minimize the disruption from your illness, and that infecting other people is not in the best interests of the organization. We do have some feelings about an ethical requirement to protect the health of other people. Many states have passed laws imposing draconian penalties on HIV-positive people who have unprotected sex with others. Some places do feel no compunction about ensuring that TB patients are either medicated or confined. I'm not going to argue these situations, even though there are problems with them both. Granted the common cold or the flu isn't necessarily fatal, although in some cases it can be, but that only means that the obligation, assuming it exists, isn't as strong as it would be for something inevitably fatal. An obligation would still be there. The problem with this argument is that if everyone stayed home with the onset of the sniffles, many offices would be vacant most of the winter months, and the organization would really suffer. It would also impose an economic hardship on many people, because latter-day sick-leave policies are pretty paltry. You could take the opposite approach, a more libertarian view, and say that whether you should come into work is your own decision. Anyone who is worried about contracting an illness from you should just stay home. This is along the lines of the pro-tobacco people who say that smokers should be free to light up whenever and wherever they please. Those who fear the immediate and long-term effects of second-hand smoke can just stay home. The counter argument in both cases is the same. The infected person and the smoker are the ones who are changing the background conditions, making things worse for other people. So, it is those people who incur the any obligation, assuming one exists, to ensure that their activities don't adversely affect others. The obligation that causes inconvenience or economic hardship shouldn't fall on those who are simply minding their own business. The answer, as always, lies somewhere in the middle -- and was brought home to me when I started developing the symptoms of a good, old-fashioned cold. What to do? Stay home -- or go to work? The ante was raised by the fact that I haven't been at my new job long enough to accumulate any worthwhile time off, and I would prefer to save it in case I get really sick. I was well enough to do my job very well, but otherwise feeling miserable. My initial knee-jerk line of reasoning -- and one of which I'm not proud -- was that because co-workers had come in sick over the previous month of so, I probably caught the cold from them. Why should I feel some obligation to protect them when they infected me? And besides, they were probably already immune to whatever disease they gave me. And they have more sick time than I do, anyway. I dismissed that as being petty and looked for a more principled approach. What I decided was that while the person in the next cubicle might be exposing you to a cold, that person isn't your only source of exposure. Like it or not -- and unless you're some Howard Hughes-type recluse -- we all live in a sea of microbes. You get up in the morning and embrace your spouse, who may or may not be carrying a germ or two. You hug and kiss your kids before sending them off to those little germ factories we call "school" or "day care." You carpool with people carrying heaven-knows-what illnesses -- either knowingly or unknowingly -- or, God forbid, you take public transportation, grabbing the subway strap that been grabbed by a hundred grimy paws before you just this morning. In between all this, you try to rub the sleep from your eyes, making sure that all the germs you've picked up on your hands are transferred to the most receptive spot on your face. Then, you stop into BigBucks Coffee Emporium for your double-shot half-caf skim-milk latte. Running into a group of colleagues, you shake hands all around. Then you get your coffee drink and sip it through the plastic lid that's been sitting out for two days and has been handled by at least 20 different people, and sneezed on a couple of times. The coffee-shop clerk dutifully wore a plastic glove, but handled your muffin and your money with the same gloved hand. Then, without even realizing you're doing it, you rub your eyes again. And you haven't even gotten to your cubicle yet. And, I'm not even going to talk about what you encounter at the gym after work. I'm not trying to gross anyone out, but merely to show that the person in the next cubicle who may have a cold, isn't your only source of exposure, and may, in fact, add extremely little to the sum total of exposure you experience all day long. So, the question becomes whether your office mate with a head cold, especially during cold season, adds anything significant to your chances of getting a cold. And the answer is, "probably not," especially since most cold and flu germs are passed in hand-to-hand contact and not by an airborne route. And since the person doesn't add anything significant to your exposure, it's hard to see how that creates a significant obligation on that person to "protect" you, especially when that protection might impose significant hardship on the other person. It's important to note that here I'm talking about such things as the common cold, which are prevalent and whose outcome is, while annoying, not necessarily serious. The equation changes if you are suffering from something that potentially has a more drastic outcome, something that is easily spread through an airborne route, or something that isn't prevalent in the general population. So, showing up to work with a case of active TB would be out of the question. The lack of an obligation to stay home doesn't relieve the sick person from taking prudent measures to avoid infecting others. This would include liberal washing of hands, using hand sanitizers, containing coughs and sneezes, and simply declining to shake hands with people. By the way, if you really want to freak people out, decline to shake their hand. Even if you explain that you have a cold, they're not sure how to deal with it. Hand-shaking has become such a part of our business ritual that it really throws people off-stride when you won't do it. Like so many other things, common sense plays a big role. If you have a fever, you're sicker than you may think and you should stay home, both for your own sake and everyone else's. If you come to work carrying a blanket (I have seen this with my own eyes), you need to be at home. If someone at home is seriously ill with a communicable illness that has serious effects, you need to consider whether you may be carrying it, whether or not you have active symptoms. There's also an argument to be made that illnesses aren't simply physical. Even the mildest of illnesses can shift our thinking out of focus, fatigue can make us careless, and our own symptoms can be distractions. You need to question whether you are performing at your best, and, depending on your job, how much a careless or distracted effort can harm the organization. It's not always the case that your illness causes you to work at 80 percent. Tiny mistakes from that missing 20 percent may have serious outcomes later on. No one likes to think that the organization can chug along smoothly without them, but if your performance is a drag on the operation, and your illness-induced slip-ups cause others to work harder down the road, you're not doing any one any favors. So, the bottom line is that if you're sick from a mild illness to which everyone is repeatedly exposed in a normal daily life, something that's "going around," then your obligation to "protect" them from your illness is very weak. However, as your proportionate contribution to their exposure increases, so does your obligation to keep your germs to yourself -- and that is magnified by the severity of the potential outcome. That's my story, and I'm sticking to it. |
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© Copyright 2006 Carlton Vogt |