This article builds on existing feminist literature on obstetric violence in the context of childbirth to argue that there is a continuum of obstetric violence that also includes that perpetuated in relation to pregnancy prevention and termination, as well as antenatal healthcare and birth. This structural violence is highlighted in relation to conscientious objection, the reporting of people suspected of illegal abortions by their healthcare providers, and contraceptive coercion. Recognizing the limitations of criminal and human rights approaches to (...) obstetric violence, this article takes Martha Fineman’s vulnerability theory as the foundation for the transformative structural change of healthcare institutions. (shrink)

Women with opioid use disorder (OUD) face unique challenges meeting their reproductive goals. Because the rate of unintended pregnancy in this population is almost 80 percent, there has been a push to increase the use of contraceptives among reproductive-aged women with OUD.1 The patient-level ethical issues of such initiatives, however, are often overlooked. This review discusses the ethical issues in two realms: obtaining contraception when it is desired and avoiding contraceptive coercion when contraception is not desired. It is (...) important that access to reproductive education and care be improved to ensure autonomous decision making by women with OUD. It is also necessary to be mindful of the history of oppressive and coercive contraception and sterilization policies in the United States. These policies have left a legacy of mistrust and continue to be manifested in the form of more subtly oppressive policies in contemporary medical practice. Such policies point to the ongoing stigmatization of, and implicit biases held against, women with OUD. Based on these ethical issues, solutions are suggested at the clinical, systemic, and societal levels. (shrink)

Reproductive coercion encompasses a collection of pregnancy promoting and pregnancy avoiding behaviours. Coercion may vary in severity and be perpetrated by intimate partners or others. Research is complicated by the inclusion of behaviours that do not necessarily involve an intention to influence reproduction, such as contraceptive sabotage. These behaviours are the most common, but are not always included in survey instruments. This may explain why the prevalence of reproductive coercion varies widely. Prevalence also varies when coerced (...) abortion is included in survey instruments. When it is, it seems roughly comparable in prevalence to coercion intended to impregnate. The extent and nature of coerced abortion can also be derived from studies that explore the reasons why women access abortion, the relationship between abortion and intimate partner violence, and online blogs and forums. This narrative review of reproductive coercion examines the evidence and attempts to comprehend why coerced abortion has been neglected. (shrink)

Pregnant adolescents have a higher risk of poor maternal and fetal outcomes, particularly in the setting of concomitant maternal alcohol and other drug (AOD) use. Despite numerous programmes aimed at reducing overall teen pregnancy rates and the recognition of AOD use as a risk factor for unintended pregnancy in adolescents, interventions targeting this specific group have been sparse. In adult drug-using women, financial incentives for contraception have been provided but are ethically controversial. This article explores whether a trial could ethically (...) employ monetary incentives in adolescents with AOD use to promote the use of long-acting reversible contraception (LARC), with special attention to the relevant distinctions between adults and adolescents. We conclude that a trial of incentives to promote LARC in this patient population is ethically permissible if the incentives are small, are tied to completion of an educational activity to minimise the quick fix temptation and potential for non-attendance to the risks and benefits of LARC and are provided only to the adolescent after an assessment of her reasoning to rule out coercion (eg, by guardians) as motivation. Information about treatment for AOD use and follow-up care in case of problems with the contraceptive or desire for removal should also be provided. Before implementing such a trial, qualitative research with input from providers, potential patients and their parents should be conducted to inform the programme's specific structure. (shrink)

We describe the informed consent procedures in a research clinic in Santiago, Chile, and a qualitative study that evaluated these procedures. The recruitment process involves information, counseling and screening of volunteers, and three or four visits to the clinic. The study explored the decision‐making process of women participating in contraceptive trials through 36 interviews. Women understood the research as experimentation or progress. The decision to participate was facilitated by the information provided; time to consider it and to discuss it (...) with partners or relatives; and perceived benefits such as quality of care, non‐cost provision of methods and medical care. For some women, participation was an opportunity to express altruism. The main obstacles for participation were perceived side effects or risks. The final risk‐benefit balance was strongly influenced by women’s needs. Women perceived that the consent form benefited the clinic, proving that participants had made a free decision, and benefited the volunteers by warranting their right to free medical care. The most important problem detected was occasional misunderstanding of the information given on the form. We concluded that a full decision‐making process enhances women’s ability to exercise their right to choose, and assures research institutions that trials are conducted without coercion and that the participants are committed to the study. Researchers have the responsibility of conducting this process. (shrink)

Studies have shown that religion is an important cultural factor that may determine attitudes and behaviors, influencing many demographic variables such as sexuality, marriage, contraception, fertility, abortion, among others. An important variable that can be influenced by religion is the use of contraception, generating patterns differentiated by religious segment. Religion has several mechanisms of influence in the lives of practitioners of a faith, among them the rules, guidelines, sanctions and coercion. This study aims to identify and analyze possible differences (...) in contraceptive use by religions between sexually active women in the Brazil. We used data from the National Survey of Demography and Health of Children and Women 2006 and binomial logistic regression model. The results suggest that Catholic women used more modern contraception especially hormonal options. Already evangelical women used more traditional contraception and sterilization. Thus, although the Catholic Church is against the use of modern contraception, its rules do not seem to influence the contraceptive behavior of faithful. An other inference is that the low frequency on cults may generate little commitment and lead to doctrinal relativism. (shrink)

We describe the informed consent procedures in a research clinic in Santiago, Chile, and a qualitative study that evaluated these procedures. The recruitment process involves information, counseling and screening of volunteers, and three or four visits to the clinic. The study explored the decision‐making process of women participating in contraceptive trials through 36 interviews. Women understood the research as experimentation or progress. The decision to participate was facilitated by the information provided; time to consider it and to discuss it (...) with partners or relatives; and perceived benefits such as quality of care, non‐cost provision of methods and medical care. For some women, participation was an opportunity to express altruism. The main obstacles for participation were perceived side effects or risks. The final risk‐benefit balance was strongly influenced by women’s needs. Women perceived that the consent form benefited the clinic, proving that participants had made a free decision, and benefited the volunteers by warranting their right to free medical care. The most important problem detected was occasional misunderstanding of the information given on the form. We concluded that a full decision‐making process enhances women’s ability to exercise their right to choose, and assures research institutions that trials are conducted without coercion and that the participants are committed to the study. Researchers have the responsibility of conducting this process. (shrink)

The benefits of family planning for those who desire it, and the possibilities of coercion against those who do not, are well-known aspects of international population policies. Family planning technologies, more than simply a means for preventing conception, are involved as identity artefacts in the construction of bodies and in the reproduction of power relations. As such, modern contraceptives, organized by and implemented through, donor-funded programmes constitute a discursive apparatus through which scattered hegemonies are disseminated. Women's use of family (...) planning, traditional and modern, allows them to counter the expectations of these hegemonies at some times, and to embody them at others. Both service providers and clients, construct identities, referenced through women's bodies, using the discourses of international population control and family planning. This paper uses data collected in Tanzania to understand how notions of modernity in the family planning programme construct Tanzanian female bodies as ‘traditional’ and ‘modern’, how these discursive inequalities reflect and compound material disparities and how these logics come into play in the ways that women construct themselves and each other. (shrink)

Due to a history of coerced sterilization, a federal Medicaid sterilization policy mandates that a specific consent form be signed by a patient at least thirty days prior to when the patient undergoes sterilization. However, in contemporary obstetrical practice, the Medicaid sterilization policy serves as a policy‐level barrier to autonomously desired care. We review the clinical and ethical implications of the current Medicaid sterilization policy. After discussing the utility and impact of waiting periods for other surgical procedures, we explore the (...) psychology of time required for decision‐making and consider scientific understanding of regret. We argue that the current Medicaid sterilization waiting period is clinically and ethically unjustifiable and that the policy ought to be revised in light of the goals, preferences, and concerns of the people most affected by it. While the need for continued protection against coercion remains, the current mandated waiting period does little to enforce the high‐quality shared decision‐making that is desired for sterilization counseling. (shrink)

The idea of coercion is one that has played, and continues to play, at least two importantly distinct moral-theoretic roles in our thinking. One, which has been the focus of a number of recent influential treatments, is a primarily deontic role in which claims of coercion serve to indicate relatively weighty prima facie wrongs and excuses. The other, by contrast, is a primarily axiological or eudaimonic role in which claims of coercion serve to pick out instances of (...) some distinctive kind of pro tanto human bad (such as unfreedom or interpersonal subjection). I argue that this turns out not to be a simple case of one idea put to two different uses, but rather a case of two subtly distinct ideas in need of separate philosophical treatment. Moreover, although often relatively neglected, the primarily eudaimonic idea of coercion is of enduring importance to both liberal-perfectionist and socialist political moralities, as well as to personal ethics. This paper aims to elucidate it and to examine its relationship to its better-theorised deontic cousin. In addition, the paper seeks to show how a better understanding of these aspects of the concept can enable us to resolve certain important and long-standing theoretical disagreements, such as the dispute over whether coercion is an ‘essentially moralised’ concept and the dispute over whether (genuine) offers can be coercive. (shrink)

According to recently influential conceptions of public reasoning, citizens have the right to demand of each other ‘public justifications’ for controversial political action. On this view, only arguments that all reasonable citizens can affirm from within their diverse ethical standpoints can count as legitimate justifications for political action. Both proponents and critics often assume that the case for this expectation derives from the special justificatory burden created by the systematically coercive character of political action. This paper challenges that assumption. While (...) conceding that citizens who propose to deploy the coercive apparatus of the state to enforce controversial legislation owe their fellows a justification that overcomes the strong presumption against coercing agents, it denies that this consideration can explain why public justifications are also required. Having argued that the public justification requirement is not among the justification conditions for public coercion, the paper then proposes an alternative rationale for the expectation that political action be publicly justified. On this alternative, the case for the public justification requirement depends on democratic citizens’ standing as legislative co-authors, and not on considerations having to do with their liability as private individuals to coercion at the hands of the state. (shrink)

Don Marquis’ future-like-ours account argues that abortion is seriously immoral because itdeprives the embryo or fetus of a valuable future much like our own. Marquis was mindful ofcontraception being reductio ad absurdum of his reasoning, and argued that prior tofertilisation, there is not an identifiable subject of harm. Contra Marquis, Tomer Chaffercontends that the ovum is a plausible subject of harm, and therefore contraception deprives theovum of a future-like-ours. In response, I argue that being an identifiable subject of harm is (...) notsufficient for Marquis’ argument to succeed. In addition, we must also share our identity withan ovum. I show that on the account of personal identity utilised by Marquis’ defenders, weare not identical with an ovum. As a result, Chaffer’s reductio fails. (shrink)

The practices of using hostages to obtain concessions and using human shields to deter aggression share an important characteristic which warrants a univocal reference to both sorts of conduct: they both involve manipulating our commitment to morality, as a means to achieving wrongful ends. I call this type of conduct “moral coercion”. In this paper I (a) present an account of moral coercion by linking it to coercion more generally, (b) determine whether and to what degree the (...) coerced agent is liable for the harms resulting from acceding to moral coercion, and (c) investigate factors relevant to determining whether we ought to accede to moral coercion. In so doing, I provide grounds for the intuition that we “allow evil to succeed” when we accede to moral coercion. (shrink)

Coercion in the treatment of persons suffering from mental disorders is one of the major ethical controversies in psychiatry. Despite great efforts to reduce the use of coercive interventions, they are still widespread and differ between European countries regarding the specific type of intervention and the number of patients affected. It is common to justify measures against the present will of patients under the assumption that they promote their well-being, that is, by reference to the ethical principal of beneficence. (...) However, it is indisputable that such measures can also cause severe harm to the patients concerned and that these measures are often experienced as degrading. In which situations can coercive interventions be labeled justifiably as “beneficial”? How can they be reduced to a minimum? This volume addresses these issues from an interdisciplinary and international perspective, combining contributions from, among others, medical ethicists, philosophers, legal scholars, psychologists and psychiatrists from different European countries. Theoretical and conceptual essays are complemented by contributions with a strong relationship to clinical practice. (shrink)

I examine ways in which belief can and cannot be coerced. Belief simply cannot be coerced in a way analogous to central cases of coerced action, for it cannot be coerced by threats which serve as genuine reasons for belief. But there are two other ways in which the concept of coercion can apply to belief. Belief can be indirectly coerced by threats which serve as reasons for acting in ways designed to bring about a belief, and it can (...) be coercively compelled by threats which non-rationally cause belief. The former is often a necessary and epistemically acceptable feature of compulsory education, but the latter produces beliefs which even if true are epistemically problematic. (shrink)

According to recently influential conceptions of public reasoning, citizens have the right to demand of each other ‘public justifications’ for controversial political action. On this view, only arguments that all reasonable citizens can affirm from within their diverse ethical standpoints can count as legitimate justifications for political action. Both proponents and critics often assume that the case for this expectation derives from the special justificatory burden created by the systematically coercive character of political action. This paper challenges that assumption. While (...) conceding that citizens who propose to deploy the coercive apparatus of the state to enforce controversial legislation owe their fellows a justification that overcomes the strong presumption against coercing agents, it denies that this consideration can explain why public justifications are also required. Having argued that the public justification requirement is not among the justification conditions for public coercion, the paper then proposes an alternative rationale for the expectation that political action be publicly justified. On this alternative, the case for the public justification requirement depends on democratic citizens’ standing as legislative co-authors, and not on considerations having to do with their liability as private individuals to coercion at the hands of the state. (shrink)

Emergency contraceptives may sometimes prevent implantation, thereby causing the death of the embryo. According to some positions contrary to abortion, because the embryo is a human animal, there are usually decisive moral reasons not to use them. In this article, I will show that objecting to the use of emergency contraceptives on those grounds is unjustified. If organisms are real existents, then according to the most plausible conception of what is required for a group of cells to compose one, the (...) embryo cannot qualify as a single organism. On the other hand, if organisms are virtual objects, then whether or not the embryo qualifies as one is morally irrelevant. I conclude that even if those positions are right about the morality of abortion, they are not entitled to oppose the use of emergency contraceptives. (shrink)

The traditional understanding of coercion as exemplified by the use of force and violence to constrain the actions of agents has been challenged by theories that describe coercion instead in terms of the pressure it puts on some agents to act or refrain from acting. Building on earlier work defending the traditional understanding and rejecting the ‘pressure’ accounts of coercion, I argue in this paper that the traditional understanding of coercion, which I dub ‘coercion as (...) enforcement’, provides a helpful analytic tool for identifying coercion in peripheral cases, and thereby supporting the theoretical implications that are supposed to follow from the claim that someone has been coerced. In particular I analyze the coerciveness of the practices of credit-card issuers and institutions of higher education, and the demands by Greece’s creditors that the Greek government institute fiscal austerity, or else leave the European Monetary Union. (shrink)

Are we free? What does "freedom" mean here? In the following, I shall only focus with freedom of action. My main thesis is that there is not just one basic type of free action but more. Philosophers, however, tend to assume that there is just one way to act freely. Hence, a more detailed analysis of free action is being called for. I will distinguish between different kinds of free action and discuss the relations between them. The analysis of different (...) types of coercion will lead to a different view on freedom – a view which stresses the many faces of free action. (shrink)

Emergency contraception — also known as the morning after pill — is marketed and sold, under various brand names, in over one hundred countries around the world. In some countries, customers can purchase the drug without a prescription. In others, a prescription must be presented to a licensed pharmacist. In virtually all of these countries, pharmacists are the last link in the chain of delivery. This article examines and ultimately rejects several standard moves in the bioethics literature on the right (...) of pharmacists conscientiously to refuse to dispense emergency contraception. Its central thesis is that the standard ‘moderate’ solution to this problem is mistaken. Thus, when all publicly relevant interests are given their due, it is not acceptable to allow refusals in the big city, where pharmacies are plentiful, but forbid them in rural settings, where pharmacies are scarce. Rather, there should be strong public policy requiring that all pharmacists dispense emergency contraception to customers who request it, regardless of pharmacists' moral or religious objections. (shrink)

In this dissertation I develop a general theory of coercion that allows one to distinguish cases of interpersonal coercion from cases of persuasion or manipulation, and cases of institutional coercion from cases of oppression. The general theory of coercion that I develop includes as one component a theory of second-order coercion. Second-order coercion takes place whenever one person intentionally impairs the formation of the second-order desires of another person, or constrains them after their formation, (...) in a way that frustrates or eliminates the possibility of the victim fulfilling certain of his or her first-order desires. The concept of second-order coercion is important because it suggests that a person's autonomy may be violated in ways that have not been previously recognized. In this dissertation I argue that the unique feature of all cases of coercion is that the alternatives available to the victim, with regard to the formation of his or her will, are intentionally constrained by another person in a way that violates the victim's autonomy. A general theory of coercion should be able to explain how institutions may be understood as coercive. I argue that if institutions are understood as social practices maintained for the purpose of achieving some end, then they may be properly understood as capable of coercion. ;This theory of coercion allows me to make two arguments concerning moral responsibility. First, I argue that current discussions of moral responsibility are inadequate because they fail to take seriously the claim that a person may be responsible, at least in part, for having the beliefs and desires that make a particular action a case of coercion. Second, I argue that discussions of moral responsibility are inadequate because they fail to recognize that an agent may not be responsible for the state of his or her will because he or she may have been coerced in a way that has not been previously recognized. (shrink)

In several jurisdictions, sex offenders may be offered chemical castration as an alternative to further incarceration. In some, agreement to chemical castration may be made a formal condition of parole or release. In others, refusal to undergo chemical castration can increase the likelihood of further incarceration though no formal link is made between the two. Offering chemical castration as an alternative to further incarceration is often said to be partially coercive, thus rendering the offender’s consent invalid. The dominant response to (...) this objection has been to argue that any coercion present in such cases is compatible with valid consent. In this article, we take a different tack, arguing that, even if consent would not be valid, offering chemical castration will often be supported by the very considerations that underpin concerns about consent: considerations of autonomy. This is because offering chemical castration will often increase the offender’s autonomy, both at the time the offer is made and in the future. (shrink)

This chapter addresses the claim that, as new types of neurointervention get developed allowing us to enhance various aspects of our mental functioning, we should work to prevent the use of such interventions from ever becoming the “new normal,” that is, a practice expected—even if not directly required—by employers. The author’s response to that claim is that, unlike compulsion or most cases of direct coercion, indirect coercion to use such neurointerventions is, per se, no more problematic than the (...) pressure people all find themselves under to use modern technological devices like computers or mobile phones. Few people seem to believe that special protections should be introduced to protect contemporary Neo-Luddites from such pressures. That being said, the author acknowledges that separate factors, when present, can indeed render indirect coercion to enhance problematic. The factors in question include lack of safety, fostering adaptation to oppressive circumstances, and having negative side effects that go beyond health. Nonetheless, the chapter stresses that these factors do not seem to be necessary correlates of neuroenhancement. (shrink)

This paper discusses the puzzle of blackmail, i.e. the way in which the threat of an otherwise legally permissible action can in some cases constitute blackmail. It argues that the key to understanding blackmail is in terms of coercion and threats, and the effect such threats have on the validity of a victim’s consent. The nature of coercion and of coercive threats is considered in detail to support the thesis that threats are prima facie impermissible, though often justified (...) all-things-considered. The puzzle of blackmail arises due to the fact that the law rarely has regard to an agent’s motives in acting, whereas this is the focus of the puzzling cases. (shrink)

Political liberals usually assume the coercion account, which argues that state actions should be publicly justified because they coerce citizens. Recently some critics object this account for it overlooks that some policies are non-coercive but still require public justification. My article argues that, instead of understanding coercion as particular laws or policies, it should be understood as the exercise of collective political power that shapes the basic structure. This revised coercion account explains why those ostensibly non-coercive policies (...) are in fact coercive. Moreover, I argue that the alternative accounts suggested by critics fail, unless they assume the revised coercion account. (shrink)

According to what Douglas calls ‘the consent requirement’, neuro-correctives can only permissibly be provided with the valid consent of the offender who will undergo the intervention. Some of those who endorse the consent requirement have claimed that even though the requirement prohibits the imposition of mandatory neurocorrectives on criminal offenders, it may yet be permissible to offer offenders the opportunity to consent to undergoing such an intervention, in return for a reduction to their penal sentence. I call this the neurocorrective (...) offer. In this chapter I consider the coercion-based objection to the neurocorrective offer, which claims that offenders cannot provide valid consent to undergoing a neurocorrective on the basis of this offer because it is inherently coercive. Having outlined early formulations of this argument, I point out that there are in fact two different versions of this objection, which appeal to different understandings of the concepts of coercion, consent and voluntariness. (shrink)

This book makes a systematic defence of the Coercion Thesis in law, arguing that coercion or enforcement mechanisms are not only a necessary feature of legal systems, but a conceptually necessary feature of legal systems.

In this article, I develop a new account of the liberal view that principles of justice are meant to justify state coercion, and consider its implications for the question of global socioeconomic justice. Although contemporary proponents of this view deny that principles of socioeconomic justice apply globally, on my newly developed account this conclusion is mistaken. I distinguish between two types of coercion, systemic and interactional, and argue that a plausible theory of global justice should contain principles justifying (...) both. The justification of interactional coercion requires principles regulating interstate interference; that of systemic coercion requires principles of global socioeconomic justice. I argue that the proposed view not only helps us make progress in the debate on global justice, but also offers an independently compelling and systematic account of the function and conditions of applicability of justice. -/-. (shrink)

Public reason accounts commonly claim that exercises of coercive political power must be justified by appeal to reasons accessible to all citizens. Such accounts are vulnerable to the objection that they cannot legitimate coercion to protect basic liberal rights against infringement by deeply illiberal people. This paper first elaborates the distinctive interpersonal conception of justification in public reason accounts in contrast to impersonal forms of justification. I then detail a core dissenter-based objection to public reason based on a worrisome (...) example advanced by Jonathan Quong. While we may be able to impersonally justify coercing the illiberal dissenter, public reason liberals must explain how we can interpersonally justify such coercion—meaning justify given the perspective of the dissenter. The two prominent strategies for dealing with dissenters involve idealization of reasoning and requiring liberal values; I show that these strategies do not succeed in a way compatible with the public reason project. That is, the prominent strategies leave public reason theorists with a dilemma between denying the legitimacy of using coercion to protect core freedoms against deeply illiberal people or abandoning the fundamental public reason project. I conclude by proposing a different answer to public reason liberalism’s fundamental question: what requires justification? On my account, it is not that coercion requires interpersonal justification for its permissibility, but that such justification is necessary as a constitutive element of a kind of moral community. (shrink)

Williams argues that impartial moral theories undermine agents’ integrity by making them responsible for allowings as well as doings. I argue that in some cases of allowings, where there is an intervening agent, the agent has been coerced, and so is not fully responsible. I provide an analysis of coercion. Whether an agent is coerced depends on various things (the coercer must provide strong reasons, and the coercer must have a mens rea), and crucially, the coercee’s action is rendered (...) less than fully voluntary by the coercion. The attack on voluntariness is usually explained by limiting coercion to threats rather than offers. I argue that this approach cannot work. Instead I argue that non-voluntariness (and thus coercion) must be understood in terms of the subjective state of the victim. It is a necessary condition of coercion that the coercee actually suffers alienation from her own actions as a result of domination by the coercer. I defend this account and show that it provides an explanation for why agents who are coerced do not act in a fully voluntary way. (shrink)

This paper examines incorrect use of oral contraceptives (OCs) in rural Bangladesh by using data from an OC compliance survey. Of the 1031 current users of OCs interviewed, about 13% took their pills out of sequence, while 17% left incorrect intervals between pill packs. Forty per cent of the women reported missing one active pill during the 6 months prior to the survey, and 74% of them took correct action with the missed pill. Of the women who missed two active (...) pills (16%), only 9% took correct action. Multivariate analyses revealed that women's education and their husbands' support helped protect against taking incorrect action with a missed pill. The fieldworker's contact was found to protect against leaving an incorrect interval between pill packs. Women who had membership of non-government organizations were less likely to interrupt their pill use, and more likely to take their pill out of sequence. The present study underscores the need for providing women with more support in their pill use, and advocates that service providers should be the focal point of efforts. Husbands' support is essential to improve the pill-taking behaviour of Bangladeshi women. (shrink)

Using payment to recruit research subjects is a common practice, but it raises ethical concerns that coercion or undue inducement could potentially compromise participants’ informed consent. This is the first national study to explore the attitudes of IRB members and other human subjects protection professionals concerning whether payment of research participants constitutes coercion or undue influence, and if so, why. The majority of respondents expressed concern that payment of any amount might influence a participant’s decisions or behaviors regarding (...) research participation. Respondents expressed greater acceptance of payment as reimbursement or compensation than as an incentive to participate in research, and most agreed that subjects are coerced if the offer of payment makes them participate when they otherwise would not or when the offer of payment causes them to feel that they have no reasonable alternative but to participate . Views about undue influence were similar. We conclude that human subjects protection professionals hold expansive and inconsistent views about coercion and undue influence that may interfere with the recruitment of research participants and impede valuable research. (shrink)

This paper argues that there are two irreducibly distinct negative concepts of liberty: freedom as non-prevention, and freedom as non-coercion. Contemporary proponents of the negative view, such as Matthew Kramer and Ian Carter, have sought to develop the Hobbesian idea that freedom is essentially a matter of physical non-prevention. Accordingly, they have sought to reduce the freedom-diminishing effect of coercion to that of prevention by arguing that coercive threats function to diminish freedom by preventing people from performing certain (...) combinations of actions. Against this, this paper argues that coercion diminishes people’s freedom in ways that cannot be fully captured in terms of prevention. Focusing on two types of case, those involving coercive threats and those involving coercive preference manipulation, it argues that non-coercion and physical non-prevention are importantly different goods. It concludes that a complete negative account of liberty must draw not only on the (Hobbesian) ‘non-prevention’ strand of the negative tradition but also on its (Hayekian) ‘non-coercion’ strand. (shrink)

There is a ‘catch 22’ situation about applying coercion in psychiatric care. Autonomous choices undeniably are rights of patients. However, emphasizing rights for a mentally-ill patient could jeopardize the chances of the patient receiving care or endanger the public. Conversely, the beneficial effects of coercion are difficult to predict. Thus, applying coercion in psychiatric care requires delicate balancing of individual-rights, individual well-being and public safety, which has not been achieved by current frameworks. Two current frameworks may be (...) distinguished: the civil liberty approach and the Stone model. Both frameworks are restrictive, and not respectful of human dignity. In a civil liberty approach, individuals who are severely mentally-ill but not dangerous would be denied care because they do not meet the dangerousness threshold or because the use of coercion will not lead to rebirthing of autonomy. This is unsatisfactory. Albeit involuntary interventions such as talk therapies, peer-support etc., may not always lead to rebirthing of autonomy or free patients from mental illness; they can however help to maintain the dignity of each mentally ill patient. In place of these frameworks, this study proposes a new ethical framework for applying coercion in psychiatric care that is respectful of human dignity. Specifically, it draws on insights from the African ethico-cultural system by using the Yoruba concept Omo-olu-iwabi to develop this new framework. This way, the study shows that only a more respectful approach for applying coercion in psychiatric care can lead to the careful balancing of the competing interests of individual's rights, individual's well-being and public safety. (shrink)

In Coercion and Responsibility in Islam, Mairaj Syed explores how classical Muslim theologians and jurists from four intellectual traditions argue about the thorny issues that coercion raises about responsibility for one's action. This is done by assessing four ethical problems: whether the absence of coercion or compulsion is a condition for moral agency; how the law ought to define what is coercive; coercion's effect on the legal validity of speech acts; and its effects on moral and (...) legal responsibility in the cases of rape and murder.Through a comparative and historical examination of these ethical problems, the book demonstrates the usefulness of a new model for analyzing ethical thought produced by intellectuals working within traditions in a competitive pluralistic environment. The book compares classical Muslim thought on coercion with that of modern Western thinkers on these issues and finds significant parallels between them. The finding suggests that a fruitful starting point for comparative ethical inquiry, especially inquiry aimed at the discovery of common ground for ethical action, may be found in an examination of how ethicists from different traditions considered concrete problems. (shrink)

Coercion is commonly said to invalidate consent, and that is always true if the source of the coercion is the physician. However, if it is a family member who coerces the patient to consent, the resultant consent may be quite valid and treatment should proceed.

This chapter contains sections titled: Coercion Law References.

Coercion is morally objectionable: it’s bad to be coerced and it’s wrong to coerce people. But why is coercion objectionable? In this paper, I advance an egalitarian account of what’s objectionable about coercion. The account is rooted in the idea that certain relationships, like those of master to slave and lord to peasant, are relationships of subordination or domination. These relationships are morally objectionable. Moreover, such relationships are in part constituted by asymmetries of power. A master subordinates (...) a slave because the master has more power over the slave than vice versa. The account says that coercion is objectionable because it creates such asymmetries of power, and so creates relationships of subordination. I show how this account can address its most serious problems, and how it can illuminate what’s wrong with blackmail, exploitation, withholding aid, and compulsion. (shrink)

: On the grounds that rape is an act of violence, not a natural act of intercourse, Roman Catholic teaching traditionally has permitted women who have been raped to take steps to prevent pregnancy, while consistently prohibiting abortion even in the case of rape. Recent scientific evidence that emergency contraception (EC) works primarily by preventing ovulation, not by preventing implantation or by aborting implanted embryos, has led Church authorities to permit the use of EC drugs in the setting of rape. (...) Doubts about whether an abortifacient effect of EC drugs has been completely disproven have led to controversy within the Church about whether it is sufficient to determine that a woman is not pregnant before using EC drugs or whether one must establish that she has not recently ovulated. This article presents clinical, epidemiological, and ethical arguments why testing for pregnancy should be morally sufficient for a faith community that is strongly opposed to abortion. (shrink)

The Obama administration’s HHS mandate to force Catholic and other religious organizations to provide insurance coverage for morally objectionable practices has been the source of a great deal of controversy. While the religious liberty question has received the most attention, the mandate reveals a yet deeper problem in the mainstream acceptance of contraception and even abortion as a normal part of medical practice. The author argues that these practices constitute a deep corruption of medicine itself, away from its original meaning (...) as a kind of restorative justice grounded in a substantive understanding of the human good and towards a formalist emphasis on preference satisfaction and patient autonomy. (shrink)

In discussing whether legal systems are necessarily coercive, legal philosophers usually appeal to thought experiments involving angels or other morally driven beings who need no coercion to organise their social lives. Such appeals have invited criticism. Critics have not only challenged the relevance of such thought experiments to our understanding of legal systems; they have also argued that, contrary to the intuitions of most legal philosophers, the ‘man on the Clapham Omnibus’ would not hold that there is law in (...) a society of angels because the view that law is necessarily coercive ‘enjoys widespread support among laypersons’. This is obviously an empirical claim. Critics, however, never systematically polled the ‘man on the Clapham Omnibus’. We boarded that bus. This article discusses findings from five empirical studies on the relationship between law and coercion. (shrink)

The 2016 outbreak of the Zika arbovirus was associated with large numbers of cases of the newly-recognised Congenital Zika Syndrome. This novel teratogenic epidemic raises significant ethical and practical issues. Many of these arise from strategies used to avoid cases of CZS, with contraception in particular being one proposed strategy that is atypical in epidemic control. Using contraception to reduce the burden of CZS has an ethical complication: interventions that impact the timing of conception alter which people will exist in (...) the future. This so-called ‘non-identity problem’ potentially has significant social justice implications for evaluating contraception, that may affect our prioritisation of interventions to tackle Zika. This paper combines ethical analysis of the non-identity problem with empirical data from a novel survey about the general public's moral intuitions. The ethical analysis examines different perspectives on the non-identity problem, and their implications for using contraception in response to Zika. The empirical section reports the results of an online survey of 93 members of the US general public exploring their intuitions about the non-identity problem in the context of the Zika epidemic. Respondents indicated a general preference for a person-affecting intervention over an impersonal intervention. However, their responses did not appear to be strongly influenced by the non-identity problem. Despite its potential philosophical significance, we conclude from both theoretical considerations and analysis of the attitudes of the community that the non-identity problem should not affect how we prioritise contraception relative to other interventions to avoid CZS. (shrink)

Commercial surrogacy in India is a booming industry however the raising number of poor illiterate women's participation as commercial surrogate poses serious question of coercion, on the other hand it economically empowers them. In this context, this article analyses the crucial question, can coercion be justified when it benefits the poor by investigating commercial surrogates’ life stories and looking into the various types of coercion discreetly operates. It concludes with few recommendations which can help in empowering poor (...) commercial surrogates who involved in commercial surrogacy industry in India. (shrink)

This paper considers three modes of captivity with an eye to examining the effects of captivity on free agency and whether these modes depend on or constitute coercion. These modes are: physical captivity, psychological captivity, and social/legal captivity. All these modes of captivity may severely impact capacities a person relies on for free agency in different ways. They may also undermine or destroy a person’s identity-constituting cares and values. On a Nozick-style view of coercion, coercion amounts to (...) conditional threats and so many of the processes creating captivity are not coercive. However, this view overlooks the role that barriers to action play in making threats effective. Thus, an enforcement view of coercion is better to understand the coercion that takes place in captivity but the effects of the use of power on a captive’s psychology remains an important area of investigation. (shrink)

Feminist legal scholarship has questioned the usefulness of non-consent as a criterion for rape. Under conditions of generalized sexual oppression, consent may not be an adequate for absence of coercion. I defend this argument and propose that rape law reform can be usefully informed by state protection of workers in the capitalist labor market, where it is assumed that the parties occupy an unequal bargaining position.

Legal coercion seems morally problematic because it is susceptible to the Hegelian objection that it fails to respect individuals in a way that is ‘due to them as men’. But in what sense does legal coercion fail to do so? And what are the grounds for this requirement to respect? This paper is an attempt to answer these questions. It argues that legal coercion fails to respect individuals as reason-responsive agents; and individuals ought to be respected as (...) such in virtue of the fact that they are human beings. Thus it is in this sense that legal coercion fails to treat individuals with the kind of respect ‘due to them as men’. (shrink)