Due to chronic diseases, the experts suggested that the public examination physical examination standards should be filed for review

On March 16, 2024, at the test center of Luoyang School of Henan Experimental Middle School, students who participated in the civil service provincial examination were reviewing before the exam. (Photo courtesy of People's Vision)

Eight years after the revision, the General Standards for Physical Examination for Civil Servants (Trial) (hereinafter referred to as the "Standards") are once again subject to public scrutiny.

A phenomenon that is becoming increasingly obvious is that in recent years, there have been a number of candidates who have been rejected for admission because they have been found to have chronic diseases such as Hashimoto's thyroiditis and polycystic kidney disease during the physical examination. In addition, the application of standards has been expanded, and some public institutions, state-owned enterprises, and even private enterprises have also used this as a basis to screen job seekers, and related legal proceedings have frequently appeared in the newspapers.

On the afternoon of April 16, 2024, at the "Jimen Decision-making" forum hosted by the Public Decision Research Center of China University of Political Science and Law, Li Hongbo, a professor at China University of Political Science and Law, proposed that the standard will standardize "explicit discrimination", and the scope of influence will gradually expand, from "civil servants to public institutions to enterprises", resulting in institutional discrimination. He suggested that the relevant departments should conduct a record review and judicial review of the standards.

At the forum, a number of medical and legal scholars, including Jiang Rongmeng, vice president of Beijing Ditan Hospital affiliated to Beijing Medical University, believed that the standards were suspected of occupational discrimination and should be revised in a timely manner to take into account whether the disease affects work.

None of the cases were won

The current standards were implemented in 2005 and revised for the first time in 2016, and the relevant authorities issued the 137-page "Manual for the Operation of Physical Examination for Civil Servants (Trial)" (hereinafter referred to as the "Manual").

There are a total of 21 standards, which stipulate blood pressure, vision, hearing, heart rate and other indicators in the physical examination of civil servants.

In addition, the standards are not only applicable in the civil service examination, but also in some public institutions, state-owned enterprises, and private enterprises.

For example, the manual states that patients with Hashimoto's thyroiditis fail the medical examination. In an administrative lawsuit represented by lawyer Zhang Xiaoli, the represented Zhou was the "victim" of this provision.

Zhang Xiaoli told a reporter from Southern Weekend that in June 2022, Zhou applied for the position of a full-time social worker in Gongshu District, Hangzhou. This position is not a civil servant or career establishment, but a "contract worker".

After Zhou passed the written test and interview, he was judged to be unqualified and rejected because he was found to have Hashimoto's thyroiditis.

Hashimoto's thyroiditis is an autoimmune disease that is not contagious. When thyroid function is abnormal, symptoms of hyperthyroidism and hypothyroidism are present, but when the thyroid gland is normal, the patient's life and work are not affected. The disease is relatively common. A paper in Nature showed that the prevalence of Hashimoto's thyroiditis in the female population is more than 10%.

After the application for administrative reconsideration failed, in March 2023, Zhou took the Gongshu District Government and the Gongshu District Civil Affairs Bureau to court.

Zhang Xiaoli believes that the position of community worker applied for by Zhou is not a civil servant position, and the "General Standards for Physical Examination for Civil Servants (Trial)" should not be applied to his physical examination, "In the absence of legal basis, the arbitrary application of other standards will damage the employment rights of others, and unreasonable requirements are a kind of employment discrimination." ”

In the end, Zhou lost the lawsuit. The Hangzhou Shangcheng District Court held that the Gongshu District Civil Affairs Bureau clearly informed the applicable standards for physical examination when recruiting, and Zhou also signed when he signed up to indicate that he knew and obeyed the recruitment arrangement. Therefore, it was not improper for the Gongshu District Civil Affairs Bureau to make an administrative act of not employing the plaintiff based on the conclusion of "failing to pass the physical examination".

Southern Weekend reporters combed through and found that on the judgment document website, there were 28 administrative litigation cases related to the "Physical Examination Standards for Civil Servant Recruitment" (trial), all of which were dismissed, and none of the applicants won the lawsuit.

Most of the reasons given by the court were that the decision of the relevant authorities not to hire the plaintiff because his physical condition did not meet the standard requirements was not improper.

Due to various concerns, there are many more "Zhou" who failed to choose legal means to defend their rights.

Zhang Xiaoli remembered that a girl from Xi'an had gone to consult before. When she applied for a teaching position, she was the first in the written test and interview, but was not hired due to Hashimoto's thyroiditis. But after Zhang Xiaoli wrote the complaint for her, the other party gave up the administrative lawsuit.

The girl explained, "This medical examination was brushed, but it may not be detected in the next public examination physical examination", but once the prosecution is filed, the matter of her illness will be made public and known to others within a certain range.

After representing Zhou's case, Zhang Xiaoli came into contact with more young people who were stopped from the public examination due to illness. She noted that the standards were being abused by an increasing number of employers, and that the employment options of these young people were further shrinking.

Zhang Xiaoli believes that the standard itself "should also be modified with the progress of the times".

涉熱违反上法

In addition to Hashimoto's thyroiditis, hypertension, diabetes, hyperthyroidism, headache, dizziness, insomnia, and significant memory loss in severe neurosis are all unqualified conditions stipulated in the standard physical examination.

The standard also stipulates a catch-all clause: "Other serious diseases that are not included in the physical examination standards and affect the normal performance of duties are not qualified." ”

In practice, there is confusion among the physician community about the application of the criteria.

A doctor from the physical examination center of a tertiary hospital in Sichuan publicly stated that there are some situations that are not specified in the "manual". For example, some people who live at high altitudes for a long time often have red blood cell counts and hemoglobin levels that are higher than the upper limit of the prescribed values. The diagnostic criteria for diabetes should also be further refined.

At the Jimen Decision-making Forum, a number of experts believed that the question that needs to be clearly explored is whether the diseases specified in the standards have an impact on the performance of personal duties and public safety.

Xu Guogang, chief physician of the Second Medical Center of the PLA General Hospital, believes that specific positions such as military work and astronauts do require high standards of physical fitness and health due to the special nature of their duties. At the same time, civil servants are special positions, and it is relatively normal to set up entry thresholds. However, in the diagnosis of the disease, the criteria need to take into account the age factor.

Xu Guogang gave an example: "People in their 50s and people in their 20s are definitely different." If we remove the age and consider this issue again, it will become a universal one, "everyone is talking about this matter, which is tantamount to playing hooligan."

In addition, Xu Guogang believes that the standard for mental illness and infectious diseases should be strictly controlled, and for chronic diseases and non-communicable diseases, they should be classified and analyzed, for example, when diabetes is first diagnosed, it can be intervened through lifestyle and medication, "It does not affect life and work, but if it reaches the complication period, it needs to be controlled."

Jiang Rongmeng also pointed out that with the advancement of technology and the update of treatment methods, some of the diseases listed in the standards no longer affect an individual's ability to work, and will not be transmitted in daily work and life. In the medical community, there is a clear consensus on these issues.

A number of legal scholars have suggested that some of the provisions of the standard are suspected of violating the Constitution, the Employment Promotion Law, the Labor Law and other superior laws.

For example, the Employment Promotion Law stipulates that an employer may not refuse to hire a person on the grounds that he or she is a carrier of an infectious disease. The Law on the Prevention and Treatment of Infectious Diseases also points out that no unit or individual may discriminate against patients with infectious diseases, pathogen carriers, or patients suspected of having infectious diseases. However, Article 18 of the Standard stipulates that AIDS is not eligible.

From the perspective of legal rank, the General Standards for Physical Examination for Civil Servants (Trial) do not belong to the national standards and recommended standards stipulated in the Standardization Law, but are normative documents formulated by administrative organs.

Cheng Xiezhong, a professor at the Law School of China University of Political Science and Law, said that the standard has low legal effect and does not have a wide range of compulsory applicability, and in terms of the correlation between the physical examination standard and the performance of duties, "the court and the reconsideration organ can conduct a legality review of the physical examination standard."

As for the standard itself, Xu Guogang suggested that it should be updated from time to time, linked to the classification and classification of diseases, and at the same time emphasize the assessment of work ability. Most importantly, public education should be strengthened, "which can only be solved by raising public awareness of some chronic diseases and health problems and eliminating misconceptions and prejudices about them".

Southern Weekly reporter Chen Yifan and Southern Weekly intern Dai Ziting

Editor-in-charge: Qian Haoping