MMHA 6205 Week 5 Clinic Discrimination Case Example

Protective Motive, Unlawful Decision: A Pregnant Radiologic Technologist Moved to the Front Desk at Lower Pay, Analyzed Under Title VII, the Pregnancy Discrimination Act and the Ethics of Paternalism

Student Name

Walden University

MMHA 6205: Health Law and Ethics

Instructor Name

Month Day, Year

Protective Motive, Unlawful Decision: A Pregnant Radiologic Technologist Moved to the Front Desk at Lower Pay, Analyzed Under Title VII, the Pregnancy Discrimination Act and the Ethics of Paternalism

Facts

1. A radiologic technologist at an outpatient imaging clinic tells her manager that she is eight weeks pregnant. She has worked in fluoroscopy and CT for six years.

2. Two days later, the manager reassigns her to front-desk scheduling "for your own safety and the baby's," effective the next Monday.

3. The scheduling position pays $4.10 an hour less than her technologist rate, and the manager applies the lower rate.

4. The technologist objects in writing. She says she wants to keep her job, will wear a fetal dosimeter and has read that her expected exposure is well within federal limits.

5. The manager replies that the decision is final and that she should "be grateful someone is looking out for her." The clinic's radiation safety officer, asked later, says her exposure could be monitored and kept low.

Everyone in the case is invented.

Legal Analysis

Title VII and the Pregnancy Discrimination Act

Title VII bars sex discrimination in employment. The Pregnancy Discrimination Act amended Title VII to define discrimination because of sex to include discrimination because of pregnancy, and to require that pregnant workers be treated like other workers who are similarly able, or unable, to work (42 U.S.C. § 2000e). The central idea is simple: an employer may not make employment decisions based on pregnancy itself. A pregnant employee who can do her job is entitled to be treated like any other employee who can do it.

The facts fit that idea closely. The reassignment was made because of the pregnancy, by the manager's own statement, and over the employee's objection. She was able to perform her job, and the radiation safety officer confirmed that her exposure could be managed. The pay cut makes the change an adverse employment action, not a mere change of duties.

The protective motive

The manager meant well. That does not help the clinic. The Supreme Court addressed a similar claim in a case where a battery manufacturer barred fertile women from jobs involving lead exposure to protect potential fetuses (International Union, UAW v. Johnson Controls, Inc., 1991). The Court held that the policy was sex discrimination under Title VII, notwithstanding its protective purpose, and that decisions about the welfare of future children belong to the parents who conceive and raise them rather than to employers. The clinic's decision is narrower, applied to one employee rather than a class, but the reasoning applies directly.

Federal radiation rules support the employee's position rather than the manager's. Nuclear Regulatory Commission rules set a lower dose limit for the embryo or fetus of a worker who chooses to declare her pregnancy, and make the declaration voluntary (10 C.F.R. § 20.1208). The system assumes that a pregnant worker can keep working with monitoring, and leaves the choice to declare with her.

Retaliation

If the clinic disciplines the technologist for her written objection, it faces a second claim. Title VII separately bars punishing a worker for objecting to conduct the law forbids (42 U.S.C. § 2000e). The Supreme Court has defined retaliation broadly, as any employer action that could deter a reasonable worker from filing or supporting a discrimination charge (Burlington Northern & Santa Fe Railway Co. v. White, 2006). Her objection is protected activity. A cooler schedule, a poor review or further pay loss after it would invite a retaliation claim that could succeed even if the original reassignment did not.

The manager's reply to the objection, telling the technologist to be grateful, also matters. It shows that the decision was made without engaging her reasons, and it is the kind of statement that would be quoted back to the clinic in any charge filed with the Equal Employment Opportunity Commission. Human resources should treat her written objection as a formal complaint, acknowledge it in writing, and take the decision out of the manager's hands while it is reviewed. Doing so protects the employee and also gives the clinic a record that it responded promptly once the problem was raised.

Ethical Analysis

The manager's reasoning is paternalism: overriding a competent person's choice for her own good. Beauchamp and Childress (2019) distinguish weak paternalism, which protects people whose choices are not informed or voluntary, from strong paternalism, which overrides informed and voluntary choices. This is the strong form. The technologist knows her work and its risks better than her manager does, has read the relevant limits and has proposed a monitoring plan. Overriding her treats her as less capable of judging her own and her pregnancy's welfare than an employer is.

There is a second ethical cost. Reassigning pregnant employees against their will tells every woman in the clinic that disclosing a pregnancy may cost her her job and pay. Some will delay telling the employer, which means delaying the monitoring that actually protects them.

Respecting her judgment does not mean ignoring safety. The ethical course is to give her the information and options, including monitoring, a voluntary temporary change of duties at full pay if she wants one, and a route to change her mind, and then to let her decide. If she later chooses a change of duties, the choice will be hers, made with full information and without loss of pay.

Options for the Clinic

The clinic should rescind the reassignment and restore her rate, with back pay for any hours paid at the lower rate. The radiation safety officer should meet with her to explain dosimetry and the voluntary declaration. If she asks for an adjustment, such as fewer fluoroscopy cases, the clinic should consider it as it would any request. Federal law now also requires covered employers to make reasonable accommodations for known limitations related to pregnancy when a worker requests them (Pregnant Workers Fairness Act, 42 U.S.C. § 2000gg-1), which reinforces that the employee's request, not the employer's assumption, starts the process. The manager needs training on pregnancy discrimination and retaliation, and human resources should review any action involving her for the next year to guard against retaliation.

References

Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.

Burlington Northern & Santa Fe Railway Co. v. White, 548 U.S. 53 (2006).

Dose equivalent to an embryo/fetus, 10 C.F.R. § 20.1208 (2024).

International Union, UAW v. Johnson Controls, Inc., 499 U.S. 187 (1991).

Pregnant Workers Fairness Act, 42 U.S.C. §§ 2000gg-2000gg-6 (2023).

Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000e et seq. (2018).