Is it better to be poor and unemployed or rich and work in a hazardous environment?

Macdonald, E. B. and Sanati, K. A. (2014) Is it better to be poor and unemployed or rich and work in a hazardous environment? British Medical Journal, 349, g5788. (doi: 10.1136/bmj.g5788)

Abstract

Largent discusses the occupational hazards faced by Sherpas on Everest, and the ethics of hiring people from poor communities to do dangerous work.<p></p> Sherpas are one ethnic group among many who undertake high altitude mountain guiding in Nepal and elsewhere. They usually start their climbing career by working as porters who are lowly paid, are poorly equipped, and carry loads of excessive size and weight.2 If successful they will progress up through a hierarchy of assistant cook, cook, junior guide, and senior guide, and some may employ others and organise expeditions and trekking.<p></p> For all, health and safety and occupational health are comparatively poorly developed, as is generally the case in Nepal,3 where access to primary and secondary healthcare is also limited in remote communities.<p></p> As Largent states,1 high altitude climbing Sherpas are an elite whose dangerous work can provide them and their families with good living standards, schooling, and access to healthcare, and many move their families to Kathmandu for that reason. However, the many other Nepalese who are much less prosperous are likely to face higher overall mortality because of their socioeconomic circumstances.4 Therefore the real ethical question is—“is it better to be poor, unemployed, and die young, or rich and work in a hazardous environment?”<p></p> Throughout human history, workers have been rewarded for undertaking skilled and hazardous work—for example, deep sea divers, coal miners, oil rig workers, and special forces in the military. It is not unethical to offer greater rewards to workers in hazardous industries, particularly if appropriate steps are taken to optimise occupational health and safety, and that is what is needed for Sherpas5 and all other occupational groups.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: MacDonald, Professor Ewan
• Authors: Macdonald, E. B., and Sanati, K. A.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: British Medical Journal
• Publisher: BMJ Publishing Group
• ISSN: 0959-535X
• ISSN (Online): 1756-1833