From Principles to Practice, Part 2 An International Dilemma in Confined Space Entry
Authors’ note: The eight-step framework discussed in this article was developed by Nancy Kass, Holly Taylor, and Joseph Ali of the Berman Institute of Bioethics at Johns Hopkins University, together with Anant Bhan, a researcher at Yenepoya University in Pune, India.

Part 1 of this article, which appeared in the June/July 2016 Synergist, presented a case study illustrating some of the ethical complexities of practicing industrial hygiene in an international setting. That case study involved a hypothetical United States-based company whose factories in Germany, the U.K., and the U.S. use a production process involving spray application of methylene chloride (Dichloromethane). Since each country has a different exposure limit for methylene chloride, the company needed to decide which exposure limit it should adopt for its facilities.

Like all ethical dilemmas, this situation requires industrial hygienists to look for guidance from familiar sources: the American Board for Industrial Hygiene’s Code of Ethics, cultural norms, legal and regulatory requirements, and human rights. For international practice, we must also consider universal ethical principles such as non-maleficence (the avoidance of harmful acts), beneficence (making the most of potential benefits), respect for individuals and communities, and justice.
The article explored the ethical considerations in the case study through the lens of an eight-step ethical decision-making framework:
  1. determine the ethics principle(s) involved
  2. gather facts
  3. review the standards for ethical industrial hygiene practice
  4. articulate the ethical concern(s)
  5. determine whether any principles are in tension with each other
  6. determine options, including analysis of pros and cons
  7. solicit feedback, including local stakeholders
  8. decide on an approach
By following these steps, the company in our case study ultimately determined to apply the “most restrictive doctrine.” According to this doctrine, fair and ethical treatment for all of the company’s employees required application of the most restrictive regulation so that all would have the same risk of disease.
In this article, we present a second case study that explores different legal definitions of a permit-required confined space (PRCS).
ROB AGNEW, MS, CIH, CSP, REM, is an assistant professor in the Fire Protection and Safety Engineering Technology Program at Oklahoma State University in Stillwater, Okla. He can be reached at (405) 744-8772 or MARK KATCHEN, CIH, FAIHA, is managing principal at Phylmar Group Inc. in Los Angeles, Calif. He can be reached at (310) 474-3937 or JOSEPH ALI is a research scholar at the Johns Hopkins Berman Institute of Bioethics and associate, Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland. He can be reached at (410) 614-5370 or