Kevin, M.D. - Medical Weblog

Slippery slope to ...what?

Employers having the right to hire and fire at will? Cheezit crackers, that's only been the way it works for x-hundred years of English common law.

Nobody has to hire you if they don't like your nasty habits.

The few factors employers can't consider (race, sex, religion) and the ones they must make allowances for (disability which can be reasonably accomodated) don't include picking your nose or smoking or dirty hair or ugly shoes.
 

Mixed feeling on the issue. I hate smoking, but I'd imagine the slippery slope is the employers being able to dictate what people do in the privacy of their homes.

Slightly off-topic, but found this old story by accident and couldn't resist: In some professions they can fire you for being "too fat".
 

If the Clevveland Clinic is footing the health benefits bills for their employees, then they have a right. I have no problem with it.
 

Does anyone worry about the health reasoning though? I can understand banning things from the workplace, but banning an activity outside of the work setting seems inappropriate. I know work pays for their health insurance, but why couldn't they decide in the future using that reasoning that you can't consume trans fats, or require you to be a certain weight, or exercise, or watch less tv. This is why health insurance should never have been linked to work in the first place. If we bought it ourselves, like car insurance, then employers wouldn't have any reason to ban smokers from employment, and they wouldn't because there'd be no real cost incentive.
 

I think this is a great idea! The times I have been a patient in the hospital I have hated more than ever to have a nurse come in, lean over me, and reek of cigarette smoke. It's downright nauseating, and I'm glad CCF is taking a stand on it. People who work at a hospital should set examples for healthy habits. Now let's start in on the cafeteria menu... Oh, and ps, have I mentioned I want to work there?
 

I think the slippery slope is the definition of "nasty habits." Another comment mentioned the ballerina fired for being too fat, but shouldn't that also be taken into consideration by these hiring authorities? There are compelling health and economic impacts of obesity documented by the CDC.

OK, we don't have to hire the overweight and the smokers.

What about people who ride motorcycles? Certainly no employer should be forced to provide insurance for someone who so recklessly risks his/her life, right? Those who ride motorcycles, go sky-diving, bungee-jumping, sailing, etc. shouldn't be hired. Their risky hobbies place an unreasonable (potential) burden on employers.

And what about people who enjoy international travel? Or are clinically depressed? Or are atheists? Or are single?

That's the slippery slope I see. I agree, it makes some sense for a health care entity to promote healthy lifestyles. But how intrusive should our employers become in our non-work lives? Where does that line get drawn, and who gets to draw it? What is out of bounds, and why?

RJ
 

What are they going to do with all the hundreds of employees they have who already smoke? Are they going to fire them all? I have been there many times. In front of the main entrance is a large circle garden area with benches all around this hugh garden. Most days you could not even find one spot to sit because of all the employees who would sit there to have a smoke break.

Im not talking just hourly employees but the professionals. I would think to fire them would be cutting off their own nose.

Where does it end? Why not fire all the diabetics who eat a candy bar or the heart pt. employees, who frequent "their" McDonalds for lunch? Or why not the obese employees (they have many) who stand in line on the first floor and many other areas, waiting for that latte, at all the starbucks that are inside that hospital.

Why not fire all their employees (including drs.) who drink a bit to much alcohol?

I understand if they have made their hospital smoke free. That is all well and good and employees need to abide by that, but when they tell them what they can do in their own homes, after work hours, well that is a problem.
 

"If we bought [health insurance] ourselves, like car insurance, then employers wouldn't have any reason to ban smokers from employment ..."

Most patients strongly desire not to have an open sewer breathing on them, and for those with asthma, migraine, allergies, and so forth it poses a real health threat.
 

An unhealthy personal habit pursued in the privacy of ones own home . . . sounds like anal intercourse. Think they will have the guts to refuse to hire practicing male homosexuals? Is that legal in Ohio or are smokers and fat people the only fair game for puritanical moralizing?
 

I had a co-worker who took up flying small airplanes like Cessna's. He was told that the company's life insurance program would no longer cover him. So he had to give up flying, since he had a family to take care of. He also found that he couldn't get private life insurance for the same reason.

Employers have a lot of latitude in deciding what benefits they will provide and for who, under what circumstances. And since it's employment-at-will, they can choose who they will and won't hire, as long as it doesn't involve race, sex, age, etc.

It may not be fair or moral, but it is legal.
 

Is it legal when you already have a hospital full of employees who already smoke, to not hire qualified employees, based on smoking habit alone. How is it not discrimination?

There is no way they would fire all the employees who already smoke and no way EVERYONE of them is giving up the habit, so to me it sounds discriminatory.

Smoking is not an illegal activity. It is a very unhealthy decision to smoke, but it is still legal. If employers can begin to dictate what LEAGL activities we can and cannot participate in, then where will it end? I don't smoke and haven't for a lot of years, but as far as I know it is still legal for those who chose to do so.

As for CCF, they have a mountain of problems that they might better spend time and energy correcting.
 

Cathy, read the first post in this thread. There is legal discrimination, to be distiguished from illegal discrimination, and employers may excercise it at their pleasure.

The at-will employment doctrine is and always has been the default. Smokers are not in a protected class, and employers have a right not to hire them.

There are rational reasons ad nauseum why an employer might wish to refuse employment to a smoker or all smokers. However, in matter of fact, they have a right to be irrational about it.

No one is obligated to hire a smoker, a nose=picker, and ugly-shoe wearer, a sky-diver, or a person with a disturbing laugh...and they can fire you because it is a Tuesday. Contract employees may have special rights, Unions may negotiate special rules or rights, but the default is you have no special rights to be hired or retained as an employee so long as the discrimination used by the employer is legal.
 

OK, so smokers are not a protected class. but, disabled people are. You and I both know they are doing this for some financial incentive. Probably lower costs through their health care ins. Which implies, that smokers indeed have more physical disabilities than non-smokers. So if they are REALLY not hiring them because of the disabilities they may or may not have, then I think they are violating Ohio Employment Laws.

But, my issue isn't even with the smoking. It is wondering what will be next? Do we want to allow our employers to dictate what rules we must abide by in our own homes? Personally, I cannot stand being around smoke. I think all workplaces should become smoke free. And all employees made to abide by it. But, that is where it needs to stop.

Why not test people for alcoholism and not hire them? or if this actually happens, all the obese employees better watch out, becuase they might be next.
 

I have to agree to disagree with the Cleveland Clinic's decision to not hire smokers. I am just glad to have FINALLY found somewhere to say my opinion. I live in Dayton, OH so I have no clue about the clinic's current employees, but I have to admit I find it very scary that employers are beginning to control our private life. I agree that smoking is a nasty habit (I am a smoker) and I have watched too many family members die from emphazyma (so why do I still smoke??). I also agree that the smell of smoke is disgusting (again, why do I smoke??). It's an addiction--I think it's great that the clinic is offering free 'stop-smoking' seminars, but there are free seminars everywhere, so is this really a benefit that the current employees should be jumping with joy about?

Kind of going off topic--what is wrong with employers today? What happened to if you did your job right and worked hard you were set for life (or at least retirement)? It's sad to see how far we have drifted from honoring our hard working Americans---instead now we are refusing to offer jobs just because we don't agree with their private life-style. To say the least, I'm not angry at the situation, I'm just sad that America has come to this--which makes me wonder, why do we have so many immigrants still fighting to come to America for freedom?
 

the road to hell is filled with good intentions
 

Smoking isn't really something you can keep "private." It stays on you, even hours later, and can trigger asthma attacks and even headaches in others around you. I think it's great that the Cleveland Clinic is putting pressure on negative habits. I think trans fats should be illegal and so should smoking. Maybe the steps by the Cleveland Clinic will help trigger some legislation in these areas.

Would you want a healthcare worker who was under the influence of pot working on you? Would you want a healthcare worker who was a smoker working on you if you were a diabetic? Would you want a healthcare worker who was unable to lift you try to lift you anyway? (Healthcare workers are usually tested for ability to lift a certain amount of weight.)

Healthcare workers are often required to uphold a certain standard of morality, ethics, and way of life because they are healthcare workers. If they fail to do so, they place their job at risk as well as their licenses, etc.

With all the negative health impacts of smoking and eating a poor diet it makes sense that healthcare workers should set an example.
 

To the folks that ask about testing for alcoholism...employers do. I am going to be tested for substance abuse and also receive a physical to ensure that I have the physical ability to lift a certain amount, etc. I have to pass all these tests before I can even begin work. The prospective employer is a hospital in Arizona. This practice is not unique.

Smokers at some hospitals around here must pay higher insurance premiums. I have known smokers who said that they lied about this to get a cheaper premium. I have also known smokers who were hospitalized for cardiac disease that was related to their smoking.
Guess who is supporting the smokers who lie about their habit---the nonsmokers who must pay higher premiums overall.
I'd like to see a drug test for smoking included in all prehire drug tests.