3 Medicolegal News 1 (1975)

handle is hein.journals/medeth3 and id is 1 raw text is: rmedicolegal news
ILv      _      A publication of the American Society
of Law & Medicine, Inc.
continuing medicolegal education

Vol. 3, No. 1

January, 1975

ANNUAL ASLM STUDENT           The Nonprofit Hospital Amendment to the
ESSAY COMPETITION                     National Labor Relations Act
by Barbara F. Katz, J.O.,
Staff Attorney, Center for Low and Health Sciences,
Boston University School of Law

In memorial tribute ot the late Dr. John
P. Rattigan, physician, educator, co-
founder and first Vice President of the
American Society of Law & Medicine,
ASLM has established the Dr. John P.
Rattigan Memorial Student Essay Con-
test. This contest has been funded in
part by the many friends and col-
leagues of the late Dr. Rattigan.
The purpose of the Dr. John P.
Rattigan Memorial Student Essay Con-
test is to encourage students from the
nation's schools ot medicine, law, den-
tistry, pharmacy, social work, nursing,
hospital administration and other allied
fields of study to prepare original
papers on medicolegal subjects of
timely concern and vital interest to the
many professionals involved with the
mounting medicolegal issues of to-
day's health-care delivery and health
Cash awards will be presented for
three best papers submitted each year.
The essays will be evaluated by a
committee of academicians and practi-
tioners under the coordination of
Richard G. Huber, Dean of the Boston
College Law School and director of
ASLM's new Division of Student and
School Programs.
A formal announcement of the Stu-
dent Essay Competition will soon be
sent directly to the deans and li-
brarians of U.S. and Canadian colleges
and universities, and to ASLM student
members. Details may be obtained
from ASLM National Headquarters Of-
lice, 454 Brookline Avenue, Boston,
MA. 02215. To qualify for the 1975
awards, papers must be received by
ASLM no later than August 15, 1975.
Friends and colleagues of Dr. Rat-
tigan and ASLM members who would
like to make a contribution to be used
expressly for the above'purposes may
send their check made out to the order
of the American Society of Law &
Medicine, John P. Rattigan Memorial
Fund. All contributions will be grate-
fully received and are fully tax deduct-

Until the passage of a recent amend-
ment by Congress, nonprofit hospitals
were excluded from coverage by the
National Labor Relations (Wagner) Act
(NLRA), which had established as the
national policy the right of workers in
most industries affecting interstate
commerce to organize themselves into
unions.' Such exclusion from NLRA
jurisdiction primarily affected the un-
skilled nonprofit hospital employees,
such as general aides, orderlies, por-
ters, nursing aides, housekeeping and
maintenance personnel as opposed to
professional and technical hospital
When there were indications that the
nonprofit hospital exemption was
being reevaluated, numerous argu-
ments in favor of its retention were
advanced by its proponents.
First, it has been contended that
unions tend to break down discipline
and that once unionized, employees
may be less willing to give immediate
obedience to orders. In a hospital,
instant obedience is essential. Thus,
public policy should not encourage the
development of unions in industries of
major importance, such as hospitals,
where discipline is a life and death
matter. However, others counter that
professional organizations have repre-
sented their members without any ap-
parent breakdown of discipline. Unions
also exist in many areas o work in
which discipline is required, appar-
ently with little harm to the public or.
breakdown of order. For example,
workers in railroads and public util-
ities, policemen, and firemen are all
Second, it was advanced that non-
profit hospitals are in a peculiar eco-
nomic position. The traditional role of
hospitals as institutions for caring for
the poor, coupled with the present high
cost of hospital care, results in a
situation in.which, because the public
is unwilling to assume the full cost of
hospital care, there are inadequate
financial resources to fund wage in-

creases. Yet, in some cases, this left
the nonprofit hospital workers in the
position of subsidizing hospital care in
the form of low wages and substandard
working conditions.3 In a sense, the
employees are assumed to share the
same charitable intent as their employ-
Third, it was argued that the prevail-
ing personnel policies are adequate.
Thus, nonprofessional employees did
not need unions, since they already
had an adequate grievance procedure
within the hospital by which they could
bring their problems to the attention of
the hospital administration without the
needless intervention of outsiders.
However, it is well documented that
non-professional employees, both by
personality and background, are often
unwilling to speak up or to form orga-
nizations of their own. There are a
large number and variety of skill levels
comprising the hospital work force.
This stratilication tends to intensify
status differences, create sharp lines
between positions, and stimulate indi-
vidualism, creating a characteristic
lack of unity among hospital workers.
The wide social gap between non-
professional employees and higher
management, and the fact that lower
level stall can be easily replaced,
contribute to making them reluctant to
speak out to management by them-
selves, and formal procedures may
actually create a barrier for the un-
skilled, uneducated hospital workers
who are without the assistance of an
experienced union representative.
Ultimately, these issues resulted in a
turning point in hospital labor relations,
and on July 26, 1974, Congress pas-
sed Public Law No. 93-360 by which
the National Labor Relations Act was
amended to extend its jurisdiction to
employees of nonprofit hospitals as
well. Congress realized that hospitals
need certain safeguards, so rather
than merely extend NLRA jurisdiction
to nonprofit hospitals, it also included
Continued on page 8

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