Discusses US use of drug testing in the workplace, screening employees for smoking, AIDS, genetic traits and reproductive hazards. Attributes this to the costs employers face in insurance, litigation and compensation. Points out that the purpose of drug testing is to circumvent management responsibility for: accidents in the workplace, stress, bad management practices, and disregarding health and safety initiatives. Acknowledges that the tests are harmful and indefensible. Reports that 81 per cent of members of the American Management Association in 1996 conducted drug testing. Claims that screening is the alternative to monitoring – that is screening out individuals who are seen as high risk in some way – yet that misses the point – the focus should be on making hazardous working conditions safe. Indicates that companies may use drug testing as a means of deterring drug users from gravitating towards their organization. Mentions that workplace‐induced stress can lead to substance abuse and that, therefore it is management driven, rather than being a problem the worker brings to the workplace. Quotes a number of company physicians who object to policing drug use. Indicates that drug testing has diverted attention away from health and safety issues and hazardous working conditions.

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This response to Tee Guidotti's (2008) critique of Elaine Draper's 'The Company Doctor: Risk, Responsibility, and Corporate Professionalism' (2003) argues that a forthright examination of the conflicts of those working in the field of occupational medicine is essential to maintaining the health of the profession and to promoting constructive policies. Research for 'The Company Doctor' reveals how doctors walk a tightrope of professional demands on them. The author describes how corporate employment affects medicine and science and how professionals working in corporations are subject to the decisions of company managers and to economic and legal imperatives stemming from their status as corporate employees. Analyzing company doctors' role in confronting toxics and responding to liability fears in corporations, the author argues that problems of lost credibility, stigmatization, and tarnished reputation that company doctors describe largely stem from the organizational constraints, economic interests, and other aspects of the social context of their work. These social forces exert powerful pressure on the ethical framework and daily work lives of these professionals as well as on the reputation of their field. The author discusses ways in which the conflicting demands from being both a corporate employee and a physician are a social and structural problem beyond individual ethics.