Nobody chooses to get catastrophically ill. It just happens. At a large institution like the University of Iowa, this raises a policy question: What will we do when employees get very sick? 

This is a policy question because we can reliably predict that some small but nonzero number of people will get catastrophically ill. So, we need some reliable policy for all workers. UI administrators have recently updated their catastrophic-leave policy for faculty and staff. 

A catastrophic illness is defined as one so severe that it will likely lead to “a loss of 30 or more work days (six weeks) in a 12-month period” — examples include childbirth, especially after a cesarean section, and long-term sicknesses such as cancer.

This system “works” by allowing faculty and staff who are catastrophically sick to receive donated sick and vacation leave from other faculty and staff. Crucially, this system only applies to faculty and staff who already accrue sick and vacation leave — so all faculty and staff who do not accrue paid leave are out, as are graduate workers and undergrads on work-study.

This system, as a policy, has two severe flaws. First, it relies on the good will of others. Good will is powerful force, but it is usually limited, particularly when we feel ourselves at risk of harm. This system ignores this human tendency by forcing faculty and staff — who are already facing catastrophic illness — in the uncomfortable and likely ineffective position of having to beg for paid leave from others who themselves have self-interested reasons to refuse their request.

Second, we all can get sick. Cancer does not care if you accrue leave or not. So, as a policy, catastrophic leave should cover everyone who can get sick, which is everyone who works here.

— Landon Elkind, UI philosophy visiting assistant professor