Do Physical Exam Standards Discriminate Against Job Seekers with Chronic Illnesses? (AI Translation)
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文｜财新周刊 黄雨馨，马雪迎（实习）
By Caixin Weekly's Huang Yuxin, Ma Xueying (Intern)
应聘厦门市中医院，笔试面试成绩都是第一，却因患有桥本氏甲状腺炎导致体检不合格，最终被拒之门外。这是医学生梁禄暖2023年首次求职时的遭遇。
During her first job application in 2023, medical student Liang Lunuan topped both the written and interview phases for a position at Xiamen Traditional Chinese Medicine Hospital. However, she was ultimately rejected after failing the medical examination due to Hashimoto's thyroiditis.
沟通无果，梁禄暖认为厦门市中医院侵犯其平等就业权，构成就业歧视，遂诉诸法律。2023年底，厦门市湖里区法院一审宣判，驳回梁禄暖的诉讼请求。这起案件主要争议在于厦门市中医院招聘的体检标准是否合理合法，法院认定，厦门市中医院参照《公务员录用体检通用标准（试行）》（下称《体检标准》）《公务员录用体检操作手册（试行）》（下称《操作手册》）等文件进行招聘体检工作并无不当。
After unsuccessful negotiations, Liang Lunuan believed that Xiamen City Traditional Chinese Medicine Hospital had infringed upon his right to equal employment, constituting job discrimination, and consequently took legal action. At the end of 2023, the Huli District Court in Xiamen issued a first-instance verdict, rejecting Liang Lunuan's lawsuit. The main contention in the case was whether the physical examination standards employed by Xiamen City Traditional Chinese Medicine Hospital during recruitment were reasonable and lawful. The court ruled that the hospital's reference to the "General Standards for Physical Examination of Civil Servants (Trial Implementation)" and "Operational Manual for Physical Examination of Civil Servants (Trial Implementation)" in conducting its recruitment physical examinations was appropriate.
《体检标准》第16条规定，三度单纯性甲状腺肿为不合格。《操作手册》解释说，单纯性甲状腺肿较多见于女性，甲状腺肿大、无甲亢毒性症状是其主要特征。如果单纯性甲状腺肿已演变发展为三度肿大有继发甲亢或癌变的可能应及早进行治疗，因此三度单纯甲状腺肿不合格。但《操作手册》进一步扩大了体检不合格范围，将甲亢、甲状腺肿继发甲亢、慢性淋巴细胞性甲状腺炎（又称为“桥本氏甲状腺炎”）、甲状腺癌、高功能性甲状腺腺瘤这几种甲状腺疾病也列为不合格。
Article 16 of the "Physical Examination Standards" stipulates that a third-degree simple goiter is considered disqualifying. The "Operational Manual" explains that simple goiter is more commonly found in women, characterized by an enlarged thyroid without symptoms of thyrotoxicosis. If a simple goiter has progressed to a third-degree enlargement with potential secondary hyperthyroidism or carcinogenic transformation, early treatment should be sought; hence, third-degree simple goiter is disqualified. However, the "Operational Manual" further expands the range of disqualifications to include hyperthyroidism, goiter with secondary hyperthyroidism, chronic lymphocytic thyroiditis (also known as Hashimoto's thyroiditis), thyroid cancer, and hyperfunctioning thyroid adenoma as conditions that also render an individual unfit.
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- Liang Lunuan, a medical student, was rejected for a job at Xiamen City Traditional Chinese Medicine Hospital despite topping both written and interview tests due to her Hashimoto's thyroiditis found during the medical examination.
- Liang sued the hospital for employment discrimination and violation of equal employment rights, but her lawsuit was dismissed by the Huli District Court in Xiamen, which ruled that the hospital's medical examination standards were legal and reasonable as they adhered to national guidelines for civil servant recruitment.
- The case highlights ongoing debates about the fairness and legality of physical examination standards used in public sector recruitment, with many arguing that these standards are outdated and discriminatory against individuals with chronic illnesses like Hashimoto's thyroiditis.
Liang Lunuan, a medical student, applied for a job at Xiamen Traditional Chinese Medicine Hospital in 2023 and excelled in both written and interview phases but was rejected due to Hashimoto's thyroiditis found during her medical examination [para. 1]. Believing this constituted job discrimination, Liang sued the hospital but lost her case at Huli District Court. The court ruled that the hospital's adherence to civil servant physical examination standards was lawful [para. 2].
The "Physical Examination Standards" disqualify individuals with certain conditions including third-degree simple goiter and Hashimoto's thyroiditis, among others. These standards are widely used not only in civil service recruitment but also by public institutions and some private companies [para. 3][para. 4]. This has led to numerous instances where job applicants are rejected after medical examinations despite passing other recruitment stages [para. 5].
Hashimoto's thyroiditis is prevalent in China, affecting about 1.6% of the population, mainly women between 30 and 50 years old. Despite its high prevalence and the fact that many individuals with this condition can function normally without treatment, it remains a disqualifying factor in employment medical checks under current standards [para. 6].
The controversy over these health examination standards is significant, given their impact on employment opportunities for individuals with chronic conditions. These standards have been criticized for being outdated and not reflective of current medical understanding or practices. There have been calls from various sectors for revisions to make them more aligned with actual job requirements and less discriminatory [para. 7][para. 8].
Legal experts argue that these standards should be reevaluated to ensure they do not unfairly discriminate against potential employees with manageable or irrelevant health issues. The ongoing debate highlights the need for a balance between assessing fitness for employment and protecting rights against discrimination based on health status [para. 9].
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