OPAC 89-036

IN THE MATTER OF AN ARBITRATION

BETWEEN-

THE METROPOLITAN BOARD OF COMMISSIONERS OF POLICE,

( the "Smployar" ),

. - AND -

THE METROPOLITAN TORONTO POLICE ASSOCIATION UNIT "A",

(the "Association")

AND IN THE MATTER OF THE GRIEVANCE OF BONNIE SCHULLERER

ARBITRATOR Paula Knoof

APPEARANCES

For the Employer Carolyn Kay-Aggio, CounselLen HazelPaula FairmanDr. David Hancock

For the Association Roger Aveling, Counsel

The hearing in this matter was held in Toronto onNovember 28, 1939

A_W_A_R_D

This g r i e v a n c e i n v o l v e s - ' a ' c l a i m for s ick l e a v ^be .ne f i t s den ied to the. g r i e v o r d u r i n g .a period w h a n she- wasabsen t f r o m work in t h e - e a r l y stages of her p r e g n a n c y . TheAssoc ia t ion- c la-ims tha t the g r i e v o r ' s m e d i c a l c o n d i t i o n wassuch that she q u a l i f i e d for s i ck leave , whe reas the Employerasserts . that there was no m e d i c a l c o n d i t i o n p r e s e n t toj u s t i f y the p a y m e n t . The issue is w h e t h e r , in thecircumstances of th is case, the .g r ievor was " i l l " w i t h i n them e a n i n g of .the co l l ec t ive a g r e e m e n t . The co l l ec t ive

. ag r eemen t p rovides :

11.10 Every member on the f i r s t of the monthfo l l owing comple t ion of s ix months ofservice shall be e l ig ib le to receive sickpay , a t f u l l s a l a r y , for any time lost byreason of i.Llness_or_injur_y_ to the f u l le x t e n t of s ick pay c r e d i t s a v a i l a b l e toh i m / h e r , a t the t i m e of each absence , . . .

[ emphas i s added]/

The facts are not in dispute. The grievor is aClass 4 Clerk in the Records Bureau. Her main duties involvetyping with some minimal light carrying of materials for ' •delivery in other areas. She has oeen with the Metro Police.since 1975. Her relevant medical history began in March 1937when she experienced severe bleeding' and 'cramps early in apregancy. Soon thereafter she suffered a miscarriage whichis properly referred to as a "spontaneous abortion". Shebecame pregnant again in 'the spring .of 1937. She experiencedsome "spotting" and- pain and was advised to have bed rest byher .attending gynaecologist because of. har past history ofmiscarriage. -However, she suffered 'another spontaneous

tabortion soon thereafter.

In m-id-Uovember of 1383, -the grievor learned 'she waspregnant again. She was examined by her family physician -andhe advised her to hav/e complete bed :rest :eor" the cirst .• .trimester of the pregnancy. She had not experienced any ofthe cramps or bleeding as in the first two pregnancies, butthe advice was given on what all parties recognized to be aprecautionary basis. Her physician wrote to the Employer onNovember 15 as follows:

To Whom It May Concern:

This is to certify that 3.S. is a patient ofmine. She has just shown a positive pregnancytest. Because of her history of severalmiscarriages in the past, I highly recommend shestay off. her feet and on complete bedrest foraproximately [sic] six weeks. If you have anyquestions please do not hesitate to call me. Thankyou very much. .

.Upon a request for further information, the 'ohys ic ianelabora ted:

To Whom It May Concern:

This is to certify that B.S. is a patient ofmine. She has a history of several miscarriages inthe past. Also, she has been suffering with ahiatus hernia.' She is known to get severe attacksof nausea and vomitting accompanied by excruciatingpains in her stomach. She has tested positive to apregnancy test. In order for her to have a'safepregnancy, she must stay off her feet and havecomplete bedrest for approximately six.weeks atleast. Please feel free to call ma if you have anyfurther questions or concerns. Thank you verymuch.

In fact, the grie'vor completed work che weak ocNovemoer 16 in order to tie up some loos.e »nds.. 'Ie r first -day. off work was Monday Novemoer 21. She slaved 'off workuntil early in the new year .and the completion oc the first

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t r i m e s t e r . Sh-3 .d id as t t i o doc tor o r d e r e d and took c o m p l e t e .bed - r e s t e x c e p t fo r v i s i t s - to her f a m i l y d o c t o r and her •gynaeco log i s t . She then r e t u r n e d to woric and e n j o / o d ar e l a t ive ly t r o u b l a - f r s e p r e g n a n c y r e s u l t i n g in the oirtn of ahea l thy baby g i r l in June of 1989. -

ii ' '

The gynaecologis t who at tended her in 1937 wrote amedica l o p i n i o n , to th i s Board o u t l i n i n g the h i s t o r y of herf i r s t two p r e g n a n c i e s . The o p i n i o n o f f e r s no m e d i c a le x p l a n a t i o n for the two spontaneous abo r t i ons b u t i tconcludes : ' . ' - . '

I t should be no ted t h a t th is p a t i e n t does have ah i g h r i sk of m i s c a r r i a g e . . . .

My fee l ings ( s i c ) t ha t d u r i n g her f i r s t t r imestershe should have -bed res t also recommended by herf a m i l y p h y s i c i a n ( s i c ) . U n f o r t u n a t e f o r her thatshe s t i l l had a. m i s c a r r i a g e . From my p o i n t ofview, bed rest was s t rongly recommended for thispat i .en t . S h e w a s o f f ; w o r k f o l l o w i n g m e d i c a li n s t r u c t i o n s a n d ' no t due to the f a c t t h a t she d i dnot w a n t to go back t o - w o r k . ( s i c ) .

She was a t t ended by another gynaeco log i s t f o r thed u r a t i o n of the s u c c e s s f u l p r e g n a n c y . His r epo r t reads:

I f i r s t saw th is p a t i e n t on November 5, 1933 whenshe was n i n e weeks p r e g n a n t on r e f e r r a l as ahigh r isk p regnancy , oas^d on a oast h is tory of twom i s c a r r i a g e s . In 1987, a t - 13 weeks and in 1937 ' a t10 weeks , she e x p e r i e n c e d m i s c a r r i a g e s .

The p a t i e n t had been advised by he r f a m i l yp n y s i c i a n to o e d r a s t f o r s ix weeks , p r i o r to comingto my o f f i c e . She had cons ide- rab le a n x i e t y a b o u tthe f e a r of lo s ing a n o t h e r p r e g n a n c y . C x c e p c f.ortwo episodes of o I e n d i n g of shor t d u r a t i o n , a t 19and a g a i n a i 33 w o ^ k s , he r ' p r e g n a n c y p r o g r e s s e dunev-en cf u 1 ly , u n t i l > o .we-?!<3 g e s t a t i o n f a l l o w i n gp r e m a t u r e r u o t u r - ? of ch-* m e m b r a n e s and c r e m a t u r el abour , she was d e l i v ^ r o J of a 2330 g rarrn no rma 1f e m a l s .in f a n t on. J u n e 15, L 9 3 9 .

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This course of events clearly confirms thediagnosis ot" high risk pregnancy 'and w i l l influenceher. future prenatal care. , I trust that thisinformation will assist /ou in your deliberationson • he r oehal f..

You.rs sincerely,

"A. Berns te in"Dr. A. Berns te in '

While there was no dispute over the facts of the case,the employer called evidence from its Director of Medical andHealth Services, Dr. David Hancock, to deal with some of themedical questions raised by this case. Dr. Hancock'sevidence was clear, articulate, and very instructive. Thethrust of his evidence was to.stress that pregnancy must berecognized, not as an illness, but, as a "state of health".He examined the medical evidence available to the Employer inNovember 1983 and concluded that the evidence revealed no• -s ta te of .illness and so advised the E m p l o y e r . • He was and isaware of the g r i e v o r ' s med ica l h i s to ry b u t notes t h a t , therewas never any ind i ca t ion of any " s p e c i f i c t rea table problem"w i t h each p r e g n a n c y . Ins tead , he e x p l a i n e d tha t eachpregnancy ought to be considered as " i t s own e n t i t y " and t ha tthe state of m e d i c a l knowledge is s u c h ' t h a t one c a n n o t ,d e t e r m i n e the cause and/or th.e p r e d i c t a b i l i t y of the courseof a new p r e g n a n c y . He a d m i t s there would have been a causefor the two m i s c a r r i a g e s . He e x p l a i n s tha t m e d i c a l sc iencej u s t cannot d e t e r m i n e w h a t those causes are in many cases.He also expla ined tha t there is no known t rea tment to p r e v e n tspontaneous a b o r t i o n s in s i t u a t i o n s where the causes a re no tk n o w n . He d e f i n e d the p r o b l e m in to three c a t e g o r i e s :

( 1 ) T h r e a t e n e d a b o r t i o n - w h e r e t h e r e - r e 3/mo cornsof b . l e e n m g a n 3 p e r h a p s c ramps .

(2) Missed aoo.rt'-on - where the f-itus h^s .liedw i th in the u terus .

(3) Inevitable abortion - where there issignificant olaeding and cramps and nothingcan' be done to prevent the loss of the fetus.

Dr. Hancock believes that if someone is experiencing bleedingand cramps, "ic is only humane" to advise them to lie downuntil the situation is ' resolved-. But he strongly believesthat prolonged bed rest was not an appropriate course oftreatment for the grievor in her condition because it wouldincrease risk of other complications and he could see nosymptoms or signs of a threatened, missed or inevitableabortion. Further, Dr. Hancock advises that there is noliterature which supports the theory that" bed rest will alterthe state.of a pregnancy or reduce the risk on spontaneousabortion. In reviewing all the medical information available

ion the grievor, Dr. Hancock concluded that tnere was noindication of any illness in the grievor and indeed hedescribed the pregnancy "in retrospect" as being "fairlyuneventful and normal". His opinion is that she would havebeen able to. continue at her joo which involved mainly typing

\and some mov ing a round . Ho acknowledges t h a t w h e n thegr ievor ' ' s doctor advised her to .begin complete bed rest itwas reasonable f r o m the g r i e v o r ' s p e r s p e c t i v e to f o l l o w t h a tadvice- . But Dr . , Hancock c a u t i o n s , i t may not: be h a v e been aresonab.le r e c o m m e n d a t i o n . ' However , he concedes t h a t theg r i e v o r ' s d o c t o r ' s a d v i c e o u g h t not to b.-? c o n s i d e r e d as" w r o n g " and t ha t p h y s i c ' i a n s can and 06 d i f f e r on the courseof t r e a t m e n t on - a n y g i v e n se t of f a c e s -

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Tne A s s o c i a t i o n a r g u e s cha t the g r i e v o r ' was t a k i n g

p r e v e n t s cive' ac t ion a g a i n s t the w a l l - f o u n d e d r i s k ofc o m p l i c a t i o n s in he r p r e g n a n c y , g i v e n her p a s t h i s t o r y . I-twas s u b m i t t e d t h a t there is scope f o r hones t d i s a g r e e m e n tbe tween doctors on the m e d i c a l e v i d e n c e and that theg r i e v o r ' s d o c t o r ' s adv i ce ough t to be cons idered as areasonable p r e c a u t i i o n to do e v e r y t h i n g possible to p r e v e n tb leed ing and cramps f r o m b e g i n n i n g a g a i n . We were remindedof the gynacolog ica 1 repor ts i n d i c a t i n g the g r i e / o r was in ah i g h r i s k p r e g n a n c y and the basis of th is was the twop r e v i o u s m i s c a r r i a g e s . G i v e n her pas t h i s t o r y , i t was saidthat there was a t h r e a t to t h i s p r e g n a n c y tha t was d e a l t w i t hby her doctors by a d v i s i n g bed rest and th is m u s t beconsidered as b e i n g a d i s a b l i n g i l lness . It was said tha tthe g r i e v o r d id not "have the l u x u r y of c o n t i n u i n g to work tosee if h i s t o r y would repea t i t s e l f . To expect that wouldhave been unreasonab le . " Thus, she followed her doctor ' sadvice and stayed off work and this ough t to be considered asf a l l i n g w i t h i n the a m b i t oc A r t i c l e 1.1.10. We were r e f e r r e dto t h e . cases of Hostel _Dieu_of_ St._JosepJi_Hq3p_i£al_(_Wj.Qdso£)(1935) 20 L . A . C . ( 3 d ) 299 ( M a c D o w e l U and C l _ i n ton _Publ icHospital ( 1 9 7 9 ) , 22 L . A . C . ( 2 d ) 37 ( B r u n n e r ) .

Counse l f o r the E m p l o y e r a r g u e d tha t b e n e f i t s wereden ied in November oc 1983 on the bas is t h a t the g r i e v o r wasnot s u f f e r i n g f r o m -any i l lness. I t was said tha t pregnancyi tself is not an i l l ne s s or a d i s a b i l i t y because i t isi n s t e a d , a s t a t e 'of h e a l t h . It was ' s u b m i t te ~i t ha t in a l l thecases w n e r e s i ck ' pay has been g r a n t e d t h e r e has e i t h e r '~>e'en ap r e - e x i s t i n g c o n d i t i o n a g g r a v a t e d by p r e g n a n c y or ana o n o r m a i i t y in tne p r e g n a n c y to j u s t i f y the p a y m e n t of s i c k ,b e n e f i t s . S i n c e none of these existed in th i.s case , i t wassaid ' t ha t s i c k b e n 3 n i t s were no t a p p r o p r i a t e . I t was

- 7. -

stressed tha t cho re was no e v i d e n c e o£ a n v o L e a d ing ,s

s p o t t i n g , c r a m p ing , ' . • or ' a n y o t h e r c o m p l i c a t i o n s . i n p r . - j g n a n c / .I was r e f e r r e d to the case on Soard3_oi :__ E d u :.a t ion _q_f _tn 3Gove_rnmen t_o^ ?.ask_ajichewa_n gn j _ tnr? Te ache r3 _q!f Saska tch 'ewan( l ' J 8 3 ) , 12 L . A . C . ( 3 . 4 ) - 309 ( S m i t h ) t o ' s t and fo r thep r o p o s i c i o n that a f e a r o£ h a r m w i t h i n a o r o g n a n c y o u g h t no tto' be cons idered an i l lness . I t was- sa id c h a t there m u s t bea real r i sk suppor ted by ' o b j e c t i v e m e d i c a l e v i d e n c e in o r d e rto q u a l i f y for be ing an i l lness. I t was a r g u e d t ha t i f thec l a i m was a l lowed , i t would be t a n t a m o u n t to p r o v i d i n gb e n e f i t s f o r a c o n d i t i o n tna t was not even p r e s e n t on thefac t s of this case and tha t should not be c o n s t r u e d to be the

• i n t e n t i o n of the par t ies in negot ia t ing thei r co l l ec t ive 'a g r e e m e n t . I t was said that the. e v i d e n c e only ind ica ted . asub jec t ive fear on the par t of the gr ievor and her a t t e n d i n gp h y s i c i a n s that the h i s to ry of m i s c a r r i a g e would repea ti t se l f . I t was said that if the b leed ing had m a n i f e s t e di t s e l f , the f e a r would not be cons ide red s u b j e c t i v e . Ins teadthere would have- been an o 'b ject ive basis to j u s t i f y thep a y m e n t s . H o w e v e r , u n t i l tha t p o i n t was r eached , i t wasa rgued tha t paymen t of b e n e f i t s was i n a p p r o p r i a t e . We werer e f e r r e d to the cases of Ho te l__Oi > eu_o_f__S_t . Josep_h HosQi^alI_LondorO _ and O n t a r i o M u r s e s ' _ Association ( 1 9 7 6 ) , 13 L . A . C .( 2d ) 177 ( O ' S h e a ) , Hote_l 21e?u_Hqsp i ta_L_K i_nQ.^_ton_and _ O n c a r i _ qFli2lic._d£?lZi£e .5.m.Pl2Yi.lf..JJ.rli2Il ( 1978 ) , • 17 L - A . C . ( 2 d ) 358( M c L a r e n ) ,• Cl_a rke_ Ins t^tu te of P s y c h i a t r y a n ^ _ O n t a r i o 'jurses

ia ci_on ( 1 9 7 9 ) , 21 L.A.C. . ( 3 d ) 73 ( 0 ' Shej: ) , Clinton

. £ li°.^2i^^]-_a.n.^_2QSl£Io_yyi.§l§^ _ ^§.?2£i-5.!;:l2n.i LOG a 1 132( 1 9 7 9 ) , 22 L . A . C . • ( 2c ) 37 . ( 3 r u n n e r ) , T racev ...and _ T h e _ C r o w n _ i n .R i g h t_of On tar 10 ^ ( M ir. is try of • Cor rec c lona l '3er / ices ) ( 1931 ) ,

23 L . A . C . ( 3 d . ) 302 ( S w a n ) , Osh_3wa._Gep.e_rai_ _22S2 ii^I_±.Eld 'PQ-^f£L2 ;iy£%3£^ _ ^3§.?? "-.aJzi2.il - ( 1 5 3 4 ) , 15 L . A . C . ( 3 d ) 65 ( S w a n ) ,'i^.^Jiii0!! ?'lvi£ -192:2 iJi£.* l._§.0.;^ '^H t :3£L2 L''-ir2a3l Assoc la t ion( 1 9 3 3 ) , 32 L . A . . C . . ( 3 d ) 2-34 ( 5 a 1 trnan ) • and B a h t w o o d

lQterna_ci_onaJ. _ U n 10 n _ , _ _ Local. _ 2 _ Q 4 _ ( 1938 ) , I L . A . C . ( 4d ) 47O ' S h e a ) . ' .

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Counse l cor the p a r t i e s have o f f e r e d a r e p r e s a n t a t w el i s t oc the a r b i t r a l j u r i s p r u d e n c e .in tn i s a r e a . 'fnesa casesreveal that a r b i t r a t i o n boards have evolved - w i th societa lt rends and f i n a l l y come to r e c o g n i z a the s ta te of p r e g n a n c yto be no t , in i t s e l f , an i l lness . One shudde r s to t h i n k howor why ' tha t ever was a q u e s t i o n , b u t we need n o t ponder t h a t

, now. Thus , it a p p e a r s to bo we l l r ecognized t h a t the n o r m a le f f e c t s of p r e g n a n c y or the v e r y s ta te of b e i n g p r e g n a n twould not q u a l i f y a woman f o r s i ck leave b e n e f i t s . I n d e e d ,she i s ' n o t s i ck or d i s a b l e d s imp ly because . sh'a is p r e g n a n t .B u t , tne cases do r e c o g n i z e t ha t where there is a d i s a b i l i t ydue to the p r e g n a n c y or a p r e - e x i s t i n g a b n o r m a l i t y or

' cond i t ion ' w h i c h is agg r ava ted or t r iggered by . p r e g n a n c y , th ismay be proper ly t reated as an i l l ne s s or a s i cknes s wherethere has been p r e c r i b e d a r e g i m e n of care wni .cn p r e v e n t e dthe woman f r o m a t t e n d i n g w o r k .

Wha.t d i s t i n g u i s h e s the f a c t s of th i s case f r o m thef ac t s of all the o ther cases c i t ed to us whe re b e n e f i t s havebeen allowed is t ha t there is no d iagnos i s of any s p e c i f i cm e d i c a l p rob lem w i t h the g r i e v o r and there were no symptomssuch as b l e e d i n g or cramps to i nd i ca t e any p a r t i c u l a r r isk-sin tn is p r e g n a n c y . In a l l the cases whe re b e n e f i t s have beena l l o w e d , those f a c t s were p resen t . The Limp I D y e r l i k e n s thiscase to the f a c t s in B o a r d s ojf Sduca t ion _and the_ G o v e r n m e n t0£ Saska tchewan , s u o r _ a , w h o r e a h e - a i t h y p r e g n a n t t eachers o u g h t ' s i c k b e n e f i t s w n i l ' j s h e s t ayed away f - o m s t u d e n t sbecause she l a c k e d an i m m u n i t y to r u b e l l a . Tr .e re , the Board .

. o c A r b i t r a t i o n cor c '.. j 1:H 3 c. ->age 312 .

I t c o j l l n o t be s a i d t h a t M r s . S n y d e r w a s ini m p e r f e c t h e a L ' t : i ' - l u r i n g cite t h r e e w e e k s inq u e s t i o n . I t ~ar. only 0.3 sa id t ha t sh-.i l a c k e d ani m f n u n i c / to r u b e l l a and by v i r t u e of sa~e was a t

• r i s k -oi; becoming i l l i f she a t t e n d e d to l i ^ r - n o r m a lemp loymen t.

To a c c e p t the p o s i t i o n o E counse l on o e h i l f octne u n i o n would be to embody in the concep t ofs ickness the concept of r i s k of i l lne.ss orpre ven ta t ive a c t i o n . . '

When i n t e r p r e t i n g t h e . mean ing ot" words i tbehooves us to use the i r normal accepted mean ing aswel l as g i v i n g them a broad i n t e r p r e t a t i o n . E v e nat its broades t I sugges t s ickness could n o t bes t re tched to b r i n g w i t h it p r e v e n t a t i v e a c t i o n .

B u t r i sk of s ickness is a concept tha t has beenaccepted as C a l l i n g . w i t h i n the d e f i n i t i o n of i l lness forthese purposes. In the Ho tel D i e u of St. Joseph Hosp i ta ILw. i.C!ls.2£) case, suojra, A r b i t r a t o r MacDowel l wrote at page305:

Pregnancy , in i t s e l f , may be a n o r m a l , h e a l t h y andeven des i rab le state, b u t by the same token anabnorma l p r e g n a n c y , or one marked by c o m p l i c a t i o n s9_£ .2.2 .E'iO.̂ i'! -L-S1!!1 !̂ 5.: ^ to n io th j r or c h i l d ' m a y beregarded as "an u n h e a l t h y s t a t e " .

[Cmphasis added]

Thus, a Board of A r b i t r a t i o n has recognized tha t p o t e n t i a lthrea ts to a m o t h e r or a f e t u s c a n n o t be cons ide red to.be as ta te of h e a l t h and the mo'ther can then be s a i d to be in astate of i l lness . Su re ly it would be wrong to say a woman .was not d i s a b l e d f r o m w o r k i n g i f c o m p e t e n t m e d i c a l a d v i c epresc r ibed absence f r o m work in o rder to p r o t e c t the . h e a l t hof the m o t h e r or the f e t u s . As summar ize ! in the Hotel Die

°l_§.t'._i9s.e-2il_ii°ri.2k^:5ji_lw_Lnl3.2£l case, §IJ2£5.' 2Qd '-n a t ? a <D3

3 0 5 : - • '

W h i l e there is a g e n e r a l c o n s e n s u s . t ha t a " n o r m a l , -h e a l t h y p r e g n a n c y " c a n n o t b-3 c o n s i d e r e d an" i l l ne s s " , i t is much less c lear how one s h o u l dc n a r a c ta r ize an " a b n o r m a l p r e g n a n c y " w n e r e ' t h ; em o t h e r ' s p h y s i c a l c o n d i t i o n or symptons s u g g e s t thep o s s i o i l i t y on m i s c a r r i a g e a n d / o r p o t e n t i a l d a m a g e

t o tna m o t h e r or c h L L ' J . T h e p r e s e n t a r b i t r a l f i n dis. co r e g a r d such u n h e a l t h y ' or aonorma.J . o o d i l . /c o n d i t i o n s as 'a f o r m oc d i s a b l i n g i l lness, e n t i t l i n gthe c l a i m a n t to s i ck ieav . j b e n e f i t s .

A g a i n , . p o t e n t i a l damage is r e c o g n i z e d as c a l l i n g wi t .v in the

. a m b i t of i l lness .

v • • ' •We m u s t now app ly these concepts to tns f a c t s of th i s

case. We s t a r t by ag ree ing comple te ly w i t h Dr . Hancock t h a tp r e g n a n c y is a stats of h e a l t h . B e i n g p r e g n a n t i t s e l f w i l lnot e n t i t l e one to b e n e f i t s u n d e r A r t i c l e 11.10. B u t , theg r i e v o r here was the v i c t i m of two p r e v i o u s spontaneousabor t ions . Her two a t t end ing . g y n a e c o l o g i s t s descr ibe her ash a v i n g a " h i g h r i sk of m i s c a r r i a g e . " Her f a m i l y phys i c i anand gynaecolog is t adv ised comple te bed rest fo r 'the f i r s ttr imester dur ing the pregnancy in quest ion. They did not andcould not p i n p o i n t the cause of the r i sk or d e f i n e the r i skin their reports. But as Dr. H a n c o c k ' s evidence i l lustrates,there would h a > / e been some cause for trv3 two p rev iousm i s c a r r i a g e s , medica l science j u s t does not know w h a t thecause could be. The g r i e v o r ' s doctors a d v i s e d t n a t sheshould e n d u r e complete bed rest for the f i r s t t r i m e s t e r . Shefo l l owed that adv ice . C l e a r l y , she and her doctors decidedto take this course of ac t ion b e f o r e any symptoms such ascramps or b l eed ing presented themselves . T h e r e f o r e , this isan u n u s u a l f a c t s i t u a t i o n of a p r e g n a n t woman d i s p l a y i n g nosymptoms of i l lness b u t be ing p re sc r ibed comple t e bed rest inorder to gua rd a g a i n s t a p o t e n t i a l r epea t of a m i s c a r r i a g e .Should tha t be c o n s i d e r e d .to be an " i l l n e s s " d i s ab l i ng herf r o m work a n d ' e n t i t l i n g he r t o b e n e f i t s u n d e r t he c o l l e c t i v ea g r e e m e n t ? I c o n c l u d e t h a t i c s h o u l d . . . . . .

The g r i e v o r was d i a g n o s e d by t h r e e d o c t o r s as os ing a t" h i g h r i s k o f m i s c a r r i a g e . " She w a s p r e s c r i b e d b e d restw h i c h oovi-ously m e a n t she could no't w o r k . ' T h e f a c t t ha t aq u a l i f i e d and l e a r n e d doc to r 1-ike D r . H a n c o c k d i s a g r e e s w i t h

the coarse of . t r e a t m e n t is no t suf f ic l en t to remove her f r o m

- 11 -

the b e n e f i t s o c ' t h e c o l l e c t i v e a g r e e m e n t . 'Tie f a c t is tna tt h ree q u a i i - f i e d m e d i c a l doc to r s £5 I t . 11- w as a p p r o p r i a t et r ea tmen t : F a r t h e r , the g r i e v o r ' s u n i q u e his.tory was t h a t 1

once b l e e d i n g a n d - - c r a m p s _ b e g a n in the f i r s t t r i m e s t e r of ap r e g n a n c y , , a m.iscarr iage fo l lowed soon t h e r e a f t e r . H e r e , thep h y s i c i a n s hoped to avoid the- man i £ es ta t ion of these symptomsin order to protect the g rowth of the f e t u s . U n d e r thesec o n d i t i o n s i t i s p e r f e c t l y c o m p a t i b l e w i t h t he c u r r e n t s ta teof j u r i s p r u d e n c e ' and common ^sensc? to accept t h a t she had ac o n d i t i o n of h i g h r i s k p r e g n a n c y , for reasons u n k n o w n to ,m e d i c a l sc ience , bu t w h i c h r e q u i r e d the t r e a t m e n t o f bed res tin the op in ion of q u a l i f i e d med ica l p r ac t i t i one r s . This isnot to say that mere ly - f o l l o w i n g m e d i c a l a d v i c e e n t i t l e s oneto s ick b e n e f i t s or tha t a s imple f e a r o£ m i s c a r r i a g e doesthe same. The g r i e v o r ' s s i t u a t i o n was q u i t e d i f f e r e n t . H e rm e d i c a l h i s to ry is s u c h ' t ha t the m e d i c a l e v i d e n c e con-vincesme tha t she was d i s ab l ed f r o m w o r k i n g d u r i n g che f i r s tt r imes te r due to the p r e - e x i s t i n g m e d i c a l c o n d i t i o n p u t t i n gher a t h igh r isk in her p r e g n a n c / and for w h i c h she wasprescribed oed rest by q u a l i f i e d m e d i c a l p r a c t i o n e r s .

T h e r e f o r e , I dec la re t h a t the Employe r b reached theco l lec t ive ag reemen t in d e n y i n g s i c k b e n e f i t s u n d e r thesep a r t i c u l a r c i rcumstances , . The Employer should make anynecessary a d j u s t m e n t s to records and c o m p e n s a t i o n t ha t may bea p p r o p r i a t e . I' r e m a i n ' s e ized w i t h i m p l e m e n t a t i o n of ' thisaward .should my as s i s t ance be r e q u i r e d f u r t h e r .

DATSD a t Toronto , ' O n t a r i o th is 19th day of D e c e m b e r ,1939.

' Pau la K.-.opcSo la A r o L tr-a tor