- Ronald Bayer: Mailman School of Public Health, Columbia University, New York, NY 10032, USA. rb8@columbia.edu
On June 10, 2002, a unanimous US Supreme Court rejected the claim by Mario Echazabal that he had been denied his rights under the Americans with Disabilities Act when Chevron USA had refused to employ him because he had hepatitis C. Chevron believed that Echazabal's exposure to hepatotoxic chemicals in its refinery would pose a grave risk to his health. This case poses critical questions about the ethics of public health: When, if ever, is paternalism justified? Must choice always trump other values? What ought to be the balance between welfare and liberty? Strikingly, the groups that came to Echazabal's defense adopted an antipaternalistic posture fundamentally at odds with the ethical foundations of occupational health and safety policy.