While sexual violence should not be the prerequisite for legal abortion, expanding definitions of abuse to include reproductive coercion can open avenues of access to abortion following the Dobbs decision. Understanding the increased danger and compounding challenges of intimate partner violence can inform legislative initiatives, healthcare responses, and movements for reproductive justice.

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)

Dobbs v. Jackson Women’s Health continues a trajectory of U.S. Supreme Court jurisprudence that undermines the normative foundation of public health — the idea that the state is obligated to provide a robust set of supports for healthcare services and the underlying social determinants of health. Dobbs furthers a longstanding ideology of individual responsibility in public health, neglecting collective responsibility for better health outcomes. Such an ideology on individual responsibility not only enables a shrinking of public health infrastructure for (...) class='Hi'>reproductive health, it facilitates the rise of reproductive coercion and a criminal legal response to pregnancy and abortion. This commentary situates Dobbs in the context of a long historical shift in public health that increasingly places burdens on individuals for their own reproductive health care, moving away from the possibility of a robust state public health infrastructure. (shrink)

This paper critically discusses an argument that is sometimes pressed into service in the ethical debate about the use of assisted reproduction. The argument runs roughly as follows: we should prevent women from using assisted reproduction techniques, because women who want to use the technology have been socially coerced into desiring children - and indeed have thereby been harmed by the patriarchal society in which they live. I call this the argument from coercion. Having clarified this argument, I conclude (...) that although it addresses important issues, it is highly problematic for the following reasons. First, if women are being coerced to desire to use AR, we should eradicate the coercive elements in pro-natalist ideology, not access to AR. Second, the argument seems to have the absurd implication that we should prevent all woman, whether fertile or not, to try to have children. Third, it seems probable that women's welfare will be greater if we let well informed and decision-competent women decide for themselves whether they want to use AR. (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)

A “universalist” policy on brain death holds that brain death is death, and neurologic criteria for death determination are rightly applied to all, without exemptions or opt outs. This essay argues that advocates of a universalist brain death policy defend the same sort of coercive control of end-of-life decision-making as “pro-life” advocates seek to achieve for reproductive decision-making, and both are grounded in an illiberal political philosophy. Those who recognize the serious flaws of this kind of public policy with (...) respect to abortion must apply the same logic to brain death. (shrink)

When discussing genetic prenatal enhancement, we often encounter objections related to “eugenics.” Those who want to defend prenatal enhancement either try to avoid using the term “eugenics” or talk about “liberal eugenics”, implying that what was wrong with the old eugenics was its coercive character, and claiming that while old eugenics went against reproductive freedom, the new liberal eugenics promotes freedom. In this paper we first explore the objection that genetic enhancement is a form of eugenics that limits parental (...) freedom. We then show how the same objection appears in other bioethical debates. Finally, we answer the objection, showing that genetic enhancement does not limit reproductive freedom in any important sense. (shrink)

Commercial surrogacy arrangements now cross borders; this paper aims to reevaluate the traditional moral concerns regarding the practice against the added ethical dimension of global injustice. I begin by considering the claim that global surrogacy serves to satisfy the positive reproductive rights of infertile first-world women. I then go on to consider three powerful challenges to this claim. The first holds that commercial surrogacy involves the commodification of a good that should not be valued in market terms, the second (...) that it involves the exploitation of the labor of disadvantaged women, and the third that it depends on the illegitimate privileging of positive rights over negative rights. I reject the first of these challenges and argue that global surrogacy arrangements are indeed exploitative on the dual basis of what I call intracontractual injustice and intercontractual coercion. The latter, I contend, depends on a preexisting negative rights violation, which cannot be permitted for the sake of satisfying another's positive reproductive entitlement. I conclude not in favor of a global ban but with suggestions on how developing nations that permit commercial surrogacy might better protect the negative reproductive rights of their female citizens, thereby making them less vulnerable to exploitation. (shrink)

Eugenics is often referred to in debates on the ethics of reproductive technologies and practices, in relation to the creation of moral boundaries between acceptable and unacceptable technologies, and acceptable and unacceptable uses of these technologies. Historians have argued that twentieth century eugenics cannot be reduced to a uniform set of practices, and that no simple lessons can be drawn from this complex history. Some authors stress the similarities between past eugenics and present reproductive technologies and practices (what (...) I define throughout the paper as ‘the continuity view’) in order to condemn the latter. Others focus on the differences between past and present practices (what I define throughout the paper as ‘the discontinuity view’) in order to defend contemporary reproductive technologies. In this paper, I explore the meanings of the word ‘eugenics’ and the relationship between its past and present uses in terms of contemporary debates on reproductive technologies and practices. I argue that moral disagreement about present technologies originate in divergent views of condemnable and justifiable features of the past. (shrink)

Evidence shows that during birth women frequently experience unconsented care, coercion, and a loss of autonomy. For many countries, this contradicts both the law and medical ethics guidelines, which emphasize that competent and fully informed women’s autonomy must always be respected. To better understand this discordance, we empirically describe perinatal maternity care providers’ and women’s moral deliberation surrounding coercive measures during birth. Data were obtained from 1-on-1 interviews with providers (N = 15) and women (N = 14), and a (...) survey of women (N = 118). Analyses focused on an in-depth exploration of responses to a question on the permissibility of coercion in birth whose wording was borrowed from a Swiss medical-ethical guideline. Reasons for and against a principle permissibility of coercive measures in birth were grouped into clusters of reasons to build a coherent explanatory framework. Factors considered morally relevant when deliberating on coercion included women’s decisional capacity, beneficence/non-maleficence, authority through knowledge on the part of providers, flaws of the medical system, or the imperative to protect the most vulnerable. Also, we identified various misconceptions, such as the conviction that a pathological birth can justify coercion or that fetal rights can justifiably infringe on women’s autonomy. Information and education on the issue of coercion in birth are urgently needed to enable women to fully exercise their reproductive autonomy, to prevent long-term adverse health outcomes of women and children, and to reconcile the medical vigilance which has lead to a reduction of perinatal morbidity and mortality with women’s enfranchisement in their own care. (shrink)

As a gynecologic surgeon with a focus on infertility, I frequently hold complex discussions with patients, exploring with them the risks and benefits of surgical options. In the past, we physicians may have expected our patients to simply defer to our expertise and choose from the options we presented. In our contemporary era, however, patients frequently request options not favored by their physicians and even some they've found themselves online. In reproductive endocrinology and infertility, the range of options that (...) may be offered or that patients may themselves seek out is continuously widening. Physicians certainly seek to find the option that will result in the best outcome for their patients, but the information to guide us in achieving the best outcome can be vague or conflicting. Add to this the financial and emotional pressures bearing on patients seeking assisted reproduction. In this essay, I explore the extent to which clinicians in reproductive medicine should follow patient requests with which they disagree or instead try to persuade the patient to do something else or simply refuse outright to meet the request. And if persuasion is to be used, what would be legitimate methods? Clearly, coercion is unacceptable, but the line between persuasion and coercion can be elusive. At what point can or should clinicians resist such requests—and to what degree? (shrink)

As the HIV epidemic continues to grow worldwide, women are increasingly and disproportionally affected. With the introduction of anti-retroviral medications that have been found to effectively prevent perinatal transmission of HIV, the approach to HIV testing in pregnant women has grown increasingly more controversial. In recent years, the model of voluntary counseling and testing (VCT) has come into question with opt-out testing now advocated for by the Centers for Disease Control and occurring widely in pregnancy. The benefits of opt-out testing (...) are numerous and may justify its use in replacing the VCT that many have come to see as insufficient. An ethical analysis of opt-out testing suggests it may be at odds with true informed consent and involve a degree of coercion that would not be allowed outside the prenatal setting. If opt-out testing is going to remain the standard of care then the ethical issues it raises must be made transparent. Strategies need to be designed for ensuring that HIV counseling and testing in pregnancy is done in accordance with ethical and reproductive rights principles. (shrink)

Background Preconception Expanded Carrier Screening is a genetic test offered to a general population or to couples who have no known risk of recessive and X-linked genetic diseases and are interested in becoming parents. A test may screen for carrier status of several autosomal recessive diseases at one go. Such a program has been piloted in the Netherlands and may become a reality in more European countries in the future. The ethical rationale for such tests is that they enhance (...) class='Hi'>reproductive autonomy. The dominant conception of autonomy is individual-based. However, at the clinic, people deciding on preconception ECS will be counselled together and are expected to make a joint decision, as a couple. The aim of the present study was to develop an understanding of autonomous decisions made by couples in the context of reproductive technologies in general and of preconception ECS in particular. Further, to shed light on what occurs in reproductive clinics and suggest concrete implications for healthcare professionals. Main text Based on the shift in emphasis from individual autonomy to relational autonomy, a notion of couple autonomy was suggested and some features of this concept were outlined. First, that both partners are individually autonomous and that the decision is reached through a communicative process. In this process each partner should feel free to express his or her concerns and preferences, so no one partner dominates the discussion. Further, there should be adequate time for the couple to negotiate possible differences and conclude that the decision is right for them. The final decision should be reached through consensus of both partners without coercion, manipulation or miscommunication. Through concrete examples, the suggested notion of couple autonomy was applied to diverse clinical situations. Conclusions A notion of couple autonomy can be fruitful for healthcare professionals by structuring their attention to and support of a couple who is required to make an autonomous joint decision concerning preconception ECS. A normative implication for healthcare staff is to allow the necessary time for decision-making and to promote a dialogue that can increase the power of the weaker part in a relationship. (shrink)

Assisted reproductive technologies and abortion prompt serious questions about how we should understand the complex relationship between money, markets, choice, and the care relationship. This essay defines “patient” and “consumer,” and then describes how they are less important than their attributes. Then it describes theories of commodification and consumption in reproductive contexts and their consequences, from compliance and coercion to resistance and creativity. It also examines whether ART and abortion are “markets.” Finally, this essay explores how the (...) attributes which comprise the patient/consumer roles can be incorporated into health care reform, and the implications of health care reform models on ART and abortion. (shrink)

Rape culture is reportedly prevalent in sub-Saharan Africa. Culture, patriarchy, poverty and religion continue to sustain rape culture. The notions of the objectification of women’s bodies amongst the Shona people are causatives for rape culture within diverse cultural institutions. Africans reasonably uphold marriage with high esteem; unfortunately, the marriage institution is also susceptible to becoming a source of abuse, coercion, and is often used as a tool for controlling women. Some of the entrenched marital rituals embody diverse detrimental and (...) contentious practices, which deprive girls and women their autonomous rights, particularly their sexual and reproductive rights. This research article interrogates numerous aspects within the Shona indigenous religion and culture, which precipitate the construction of rape culture. The study uses African feminism as a theoretical framework. It utilises African feminist cultural hermeneutics to interrogate rape culture amongst the Shona people. The research study is qualitative with a conceptual analysis paradigm. It concludes by proposing the need for tapping into some life-giving and gender inclusive principles within the Shona indigenous religion and culture to be utilised as tools for eradicating rape culture.Contribution: Utilising the African feminist cultural hermeneutical framework, the article interrogated several factors precipitating rape culture amongst the Shona people. It foregrounded that women bear the brunt of burden of rape culture. It concludes by proposing the need for tapping into some positive Shona indigenous traditions as tools for curbing rape culture. (shrink)

The application of genetic technologies in China, especially in the area of prenatal genetic testing, is rapidly increasing in China. In the wealthy regions of China, prenatal genetic testing is already very widely adopted. We argue that the government should actively promote prenatal genetic testing to the poor areas of the country. In fact, the government should prioritize resources first to make prenatal genetic testing a standard routine care with an opt-out model in these area. Healthcare professions would be required (...) to inform pregnant women about the availability of genetic testing and provide free testing on a routine basis unless the parents choose not to do so. We argue that this proposal will allow parents to make a more informed decision about their reproductive choices. Secondarily, this proposal will attract more healthcare professionals and other healthcare resources to improve the healthcare infrastructures in the less-developed regions of the country. This will help to reduce the inequity of accessing healthcare services between in different regions of China. We further argue that this policy proposal is not practicing eugenics. (shrink)

I explore Jason Stanley’s notion of ideology. After preliminary remarks on ideology and coercion in social reproduction, I offer a restatement of Stanley’s position on ideology, examining his notion of epistemic harm. I then examine the role of emotion in his thinking as that which binds beliefs to agents, and conclude with an argument for a notion I call “affective ideology” that enables us to connect ideology with the use of force in “coercive social reproduction.”Examino la noción de ideología (...) debida a Jason Stanley. Tras algunas observaciones preliminares sobre ideología y coerción en la reproducción social, ofrezco una reformulación de la posición de Stanley sobre la ideología, examinando su noción de daño epistémico. Examino a continuación el rol de las emociones en su pensamiento, en tanto que son las que vinculan las creencias a los agentes, y concluyo con un argumento a favor de lo que llamo “ideología afectiva”, la cual nos capacita para conectar la idelogía con el uso de la fuerza en la “reproducción social coercitiva”. (shrink)

In this article, I discuss cross-border egg provision by young South African women as a form of traveling biolabor that is critically about embodiment, and aspirations for mobility and cosmopolitanism. The frame of biolabor challenges the frames of altruism/commodification, and choice/coercion, and instead highlights the desires of egg providers, fundamental to the creation and maintenance of the global fertility market. When biolabor crosses borders as traveling biolabor, the analysis can focus on the specificities of inequalities embedded within such (...) class='Hi'>reproductive mobility. Traveling or mobility is often a privileged decision and connotes freedom and cultural capital. Yet, when applied to young white egg providers from South Africa, this traveling biolabor relies on a particular kind of biopolitics wherein the reproductive potential of ova/egg is fundamental in facilitating women’s cross-border mobility. I divide the findings sections into three key themes—“cosmopolitan competency,” “alternatives to maternity,” and “productive pain”—to argue that, on the one hand, from recruitment of traveling egg providers to their management, this biolabor is built on the young women’s aspirations for cosmopolitanism. Traveling biolabor becomes a way to escape the normative expectations of their families and the national project of the volksmoeder. On the other hand, the pursuit of these aspirations is critically contingent on management successfully reframing the embodied pain of egg provision as well as the biolaborer’s own maternity. Laborers’ desires and management disciplining tactics converge to sustain the global fertility market. (shrink)

ABSTRACT In social evolution theory, biological individuals are often represented on the model of rational agents, that is, as if they were ‘seeking’ to maximize their own reproductive success. In the 1990s, important criticisms of this mode of thinking were made by Brian Skyrms and Elliott Sober, who both argued that ‘rational agent’ models can lead to incorrect predictions when there are positive correlations between individuals’ phenotypes. In this article, I argue that one model of rational choice—namely, Savage’s model (...) —can actually be vindicated in evolutionary biology, provided that the pay-offs are computed in inclusive fitness terms. I also show that the use of this model is better avoided when pay-offs are non-additive, or when certain causal influences affect the outcome of natural selection. The result is a partial rehabilitation of this mode of thinking, conditional on both the additivity of the pay-off structure and the absence of any form of manipulation or coercion. _1_ Introduction _2_ When Natural Selection and Rational Deliberation Part Ways _3_ A Simple Solution: Redefining the Pay-offs in Inclusive Fitness Terms _4_ Sober on Inclusive Fitness Maximization _5_ Inclusive Fitness with Non-additive Pay-offs _6_ Causal Influences and the Savage– Hamilton Model _6.1_ Reciprocity and partner choice _6.2_ Coercion and manipulation _7_ Conclusion Appendix. (shrink)

There is nothing new about evil; it has been with us since time immemorial. But there is something new about the kind of evil that characterizes our contemporary liquid-modern world. The evil that characterized earlier forms of solid modernity was concentrated in the hands of states claiming monopolies on the means of coercion and using the means at their disposal to pursue their ends ends that were at times horrifically brutal and barbaric. In our contemporary liquid-modern societies, by contrast, (...) evil has become altogether more pervasive and at the same time less visible. Liquid evil hides in the seams of the canvass woven daily by the liquid-modern mode of human interaction and commerce, conceals itself in the very tissue of human cohabitation and in the course of its routine and day-to-day reproduction. Evil lurks in the countless black holes of a thoroughly deregulated and privatized social space in which cutthroat competition and mutual estrangement have replaced cooperation and solidarity, while forceful individualization erodes the adhesive power of inter-human bonds. In its present form evil is hard to spot, unmask and resist. It seduces us by its ordinariness and then jumps out without warning, striking seemingly at random. The result is a social world that is comparable to a minefield: we know it is full of explosives and that explosions will happen sooner or later but we have no idea when and where they will occur. In this new book, the sequel to their acclaimed work Moral Blindness Zygmunt Bauman and Leonidas Donskis guide the reader through this new terrain in which evil has become both more ordinary and more insidious, threatening to strip humanity of its dreams, alternative projects and powers of dissent at the very time when they are needed most. (shrink)

In recent years, there has been renewed interest in the question of when, if ever, the state may use coercion to enforce majority views about what types of conduct are right or wrong, noble or base, decent or indecent. Such interest has been generated by both political and philosophibal pressures. In recent political history, controversies over such issues as abortion, homosexuality, pornography, textbooks in schools, new reproductive technologies such as surrogate parenting and in vitro fertilization, and faith healing (...) have focused attention on the role of the state in supporting or opposing various moral views. In political philosophy, often a theoretical reflection of the political debates of the time, we have seen renewed attempts to provide a satisfactory foundation for traditional liberal views of the legitimate scope of state power. In particular, there has been an emphasis on the neutrality of the liberal state and the right of individuals to be treated as equals by the state. (shrink)

ABSTRACTGlobal demand for human ova in in vitro fertilization has led to its expansion in countries with falling average incomes and rising female unemployment. Paid egg donation in the context of national, regional, and global inequalities has the potential to exploit women who are socioeconomically vulnerable, and indeed there is ample evidence that it does. Structural injustices that render women in middle-income countries – and even some high-income countries – economically vulnerable contribute to a context of ‘omissive coercion’ that (...) is morally troubling. When egg brokers or fertility clinics take advantage of these background structural injustices and prospective ova providers’ vulnerability in order to pay them less than they need to meet their livelihood needs, they engage in exploitation. Analyzing paid egg donation as a form of reproductive labor, however, can direct our attention to reforms that would reduce exploitative instances of this practice. In contrast to those who see... (shrink)

In social evolution theory, biological individuals are often represented on the model of rational agents, that is, as if they were ‘seeking’ to maximize their own (expected) reproductive success. In the 1990s, important criticisms of this mode of thinking were made by Brian Skyrms ([1994], [1996]) and Elliott Sober ([1998]), who both argued that ‘rational agent’ models can lead to incorrect predictions when there are positive correlations between individuals’ phenotypes. In this article, I argue that one model of rational (...) choice—namely, Savage’s model ([1954])—can actually be vindicated in evolutionary biology, provided that the pay-offs are computed in inclusive fitness terms. I also show that the use of this model is better avoided when pay-offs are non-additive, or when certain causal influences (due to manipulative behaviours) affect the outcome of natural selection. The result is a partial rehabilitation of this mode of thinking, conditional on both the additivity of the pay-off structure and the absence of any form of manipulation or coercion. 1 Introduction2 When Natural Selection and Rational Deliberation Part Ways3 A Simple Solution: Redefining the Pay-offs in Inclusive Fitness Terms4 Sober on Inclusive Fitness Maximization5 Inclusive Fitness with Non-additive Pay-offs6 Causal Influences and the Savage– Hamilton Model6.1 Reciprocity and partner choice6.2 Coercion and manipulation7 ConclusionAppendix. (shrink)

We explain libertarian thought about family and children, including controversial issues in need of serious attention. To begin our discussion of marriage, we distinguish between procedural and substantive contractarian approaches to marriage, each endorsed by various libertarians. Advocates of both approaches agree that it is a contract that makes a marriage, not a license, but disagree about whether there are moral limits to the substance of the contract with only advocates of the substantive approach accepting such. Either approach, though, offers (...) advantages over the current licensing system, so we discuss paths from that to a contractarian system. We also discuss the concept of marriage itself, the ages of consent for marriage, sexual activity, and reproduction, as well as how marriages can be dissolved, and coercion that sometimes occurs in marriage. We then turn to children. We first discuss reproductive freedom and then discuss the moral relationship between children and parents, especially considering stewardship, propertarian, and best interests approaches (we also touch on anti-natalism). One of the biggest issues facing parents is how to properly raise and educate children; we discuss this in depth and consider the sort of schooling that should be offered in a free society. Since children lack the requisite ability to consent, they cannot choose their education; how to respond to this is of the utmost importance for libertarians. As we note, the same issue of consent looms large for many forms medical treatment of children. (shrink)

We explain libertarian thought about family and children, including controversial issues in need of serious attention. To begin our discussion of marriage, we distinguish between procedural and substantive contractarian approaches to marriage, each endorsed by various libertarians. Advocates of both approaches agree that it is a contract that makes a marriage, not a license, but disagree about whether there are moral limits to the substance of the contract with only advocates of the substantive approach accepting such. Either approach, though, offers (...) advantages over the current licensing system, so we discuss paths from that to a contractarian system. We also discuss the concept of marriage itself, the ages of consent for marriage, sexual activity, and reproduction, as well as how marriages can be dissolved, and coercion that sometimes occurs in marriage. We then turn to children. We first discuss reproductive freedom and then discuss the moral relationship between children and parents, especially considering stewardship, propertarian, and best interests approaches (we also touch on anti-natalism). One of the biggest issues facing parents is how to properly raise and educate children; we discuss this in depth and consider the sort of schooling that should be offered in a free society. Since children lack the requisite ability to consent, they cannot choose their education; how to respond to this is of the utmost importance for libertarians. As we note, the same issue of consent looms large for many forms medical treatment of children. (shrink)

Carol Pateman has said that the public/private distinction is what feminism is all about. I tend to be sceptical about categorical pronouncements of this sort, but this book is a work of feminist political philosophy and the public/private distinction is what it is all about. It is motivated by the belief that we lack a philosophical conception of privacy suitable for a democracy; that feminism has exposed this lack; and that by combining feminist analysis with recent developments in political philosophy, (...) we can meet the philosophical and political need for a distinctively democratic conception of privacy. This book then, is an effort to sketch and defend such a conception of privacy. It aims to show that while some conceptions of privacy are inconsistent with democracy, others are not. Indeed, the book asserts, the belief that privacy can be valuable and that it can justify basic legal rights, is implicit in a democratic conception of persons as free and equal beings, and a democratic conception of politics as the self-governing, or regulating, activity of such individuals. Just as we can and should reject undemocratic conceptions of the suffrage in favour of democratic ones, so the book maintains, we can and must reject undemocratic conceptions of privacy in favour of ones that reflect the moral equality of men and women, and a commitment to democratic forms of government. Democracy is often described as government by and for the people. On such a view, democracy is a political regime which can be contrasted with monarchies or aristocracies on the one hand, or with theocracies and despotisms on the other. By contrast with the former, it is a form of government that views individuals as citizens and as equal members of the agency which authorizes the use of political power. By contrast with the latter, it is a form of government whose purposes and aims are established by the common interests of individuals, conceived as free and equal citizens. It is my contention that there is a plausible and attractive conception of privacy implicit in this view of democracy. Hence, I show that individuals have fundamental interests in privacy because privacy enables them to participate in politics freely and as the equal of others and, beyond that, to lead lives that they can each affirm to be reasonable, valuable and right. As I think that the ideal of democratic government is properly associated with this latter and broader goal, as well as with the former one, I call my account of privacy a democratic conception of privacy to signal its connection to a particular ideal of politics, and to the conception of persons that makes this ideal a convincing and inspiring one. As this is a work of political philosophy, however, no effort is made to address the legal merits of competing accounts of the right to privacy, or to resolve legal dispute about the content and justification of particular constitutional rights in the United States. Thus, while I use Supreme Court decisions and works of legal theory to illustrate and support my arguments, my use of these materials is governed by philosophical concerns and my conclusions, therefore, are strictly of a philosophical, not a legal, nature. The book is divided into four chapters, moving from feminist criticisms of privacy to an engagement with the philosophical literature on privacy and an account of the right to privacy in a democratic society. It proceeds as follows. In Chapter 1, I examine feminist concerns about privacy, through a close reading of the work of Catherine MacKinnon. I argue that MacKinnon persuasively shows that protection for privacy has frequently licensed the coercion and subjection of women, and that her arguments are supported both by feminist scholarship, key Supreme Court decisions, and by familiar conceptions of privacy and equality. However, I argue, these criticisms do not imply that privacy, like slavery, can never be democratic, because wholly inconsistent with the equality of individuals. Rather, feminist criticisms of privacy suggest that privacy, like the suffrage, can be necessary to the equality of women and can have a legitimate and important place in a democratic society. In Chapter 2, I examine the philosophical literature on privacy in light of the need to distinguish democratic from undemocratic accounts of its nature and value. This literature, I show, can help us to provide an account of privacy that is sensitive both to its inegalitarian aspects and to its importance for a democratic commitment to the freedom and equality of women. However, I argue, we cannot embrace current philosophical accounts of privacy uncritically, because to a striking extent they are, themselves, indifferent to the ways that privacy has licensed sexual inequality. Thus, in Chapter 2, I set about interpreting privacy as a moral and political value, in light of the strengths and weaknesses of the philosophical literature on privacy. Their strength is that they show that there are many reasons for caring about privacy, or many ways in which we might define it as a democratic value. Their weakness is that they tend to assume that we must choose amongst these different conceptions of privacy, in order to provide a philosophically cogent account of privacy. This, I show, is a mistake and one that can be remedied by remembering that a commitment to the equality of individuals requires us to acknowledge the reasonable differences in value and interest that may characterize their relations in a democracy. When we do so, I show, it is possible to define privacy in terms of its protection for self-definition, intimacy and confidentiality, without having to choose between the three of them. For individuals may legitimately disagree about the differences between privacy and other values, even while holding that privacy is a distinctive and important democratic good; and they may also disagree about the importance of privacy compared to other goods, such as equality, without denying that self-definition, intimacy and confidentiality can be morally and politically desirable in a democracy. In Chapter 2, therefore, I show that we can provide a philosophically adequate account of what privacy is and why it is valuable without supposing that privacy is always sexually egalitarian, or denying that it has a distinctive place in a democratic conception of value. Chapter 3 then extends this account of privacy, by considering the justification for a legal right to privacy. Just as we cannot provide a democratic conception of privacy without attending to the different, though equally valid, concerns that individuals may have so, I show, we cannot provide a democratic account of privacy rights if we forget that individuals can, quite reasonably, differ in the importance that they attach to privacy. The result, I argue, is that we can distinguish two main reasons for protecting privacy by right in a democracy, the one personal and the other political. Whereas the former emphasizes the importance of self-definition, intimacy and confidentiality to the personal freedom and equality of individuals, the latter emphasizes their importance to their prospects for voluntary and equal participation in the processes of collective choice and deliberation that define a democratic government. These two justifications of privacy rights reflect the fact that in a democracy the personal can be political, as feminists have insisted, but need not be in order to merit protection by right. Indeed, I argue, we can distinguish democratic from undemocratic accounts of the right to privacy in this way: for whilst the former acknowledge the variety of individuals’ interests in personal and collective choice, the latter either collapse the political into the personal, or assume that the legitimate claims of individuals are merely a function of collective needs, interests and values. Neither of these is consistent with familiar assumptions about the nature and justification of democratic institutions and rights, nor can they be reconciled with a commitment to sexual equality. Thus, I conclude, though the fact that there are different justifications for privacy rights in a democracy means that individuals may legitimately disagree over the content and justification of basic rights, it is wrong to confuse democratic debate with moral or conceptual confusion and so, arbitrarily, to truncate our accounts of privacy, equality and democracy. Finally, in Chapter 4, I test and develop these claims by examining the justification for abortion rights in a democracy. I argue that women have legitimate interests in abortion, as well as in bearing children, because they have fundamental, and legitimate, interests in privacy and equality. Although safe and legal abortion is necessary to sexual equality, as feminists claim, I show that we can provide a convincing and democratic account of women’s claims to abortion only if we recognize women’s interests in self-definition, intimacy and confidentiality. This is because women have both personal and political interests in abortion and we will be unable adequately to identify these if we overlook their interests in privacy. Indeed, I show, the difference between democratic and undemocratic solutions to conflict over abortion lies precisely in this: that whereas the former acknowledge the importance of privacy to the personal and political equality of women, the latter overlook or deny this. As a result, the latter license both mandated abortions, although women have legitimate interests in bearing and raising children, and prohibitions on abortion that cannot be reconciled with the freedom and equality of women. That is not to say that abortion is not a politically significant matter, or that we can resolve moral conflict over abortion simply by giving women a legal right to abortion. Neither is the case. However, the chapter shows, in a democracy individuals are entitled to make morally and politically controversial decisions for themselves not simply because this is expedient or useful, but because this is right. To overlook this feature of democracy, I argue, is to make moral and political conflict utterly intractable by democratic means. Thus, while controversy over abortion has been held to show that privacy is an incoherent and undemocratic right, this chapter argues that it shows the reverse: for controversy over abortion makes clear that privacy is essential to democracy, and why this should be so. This overview of the book, I hope, makes clear that its concerns are methodological as well as substantive, and moral as well as political. Thus, its central methodological claim is that we cannot reconcile privacy with the equality of individuals unless we make a deliberate effort to do so. Its central moral and political claims are that privacy is compatible with the equality of individuals, and sufficiently important to the latter that, in a democracy, the privacy of individuals merits legal protection by right. However, this summary of the book also exposes its limitations. Chief amongst these, I fear, is that it provides no sustained discussion of the place of property on a democratic conception of privacy, and that the latter, itself, is rather a broad preliminary sketch than a polished and detailed portrait. I regard these limits on the scope and arguments of the book as limitations, albeit ones that I hope to be able to remedy before too long.However, limited though the book clearly is, I believe that it lays out the essential components of a democratic conception of privacy and that, by analysing and synthesizing several diverse bodies of literature, it may help those who are interested in the relations between privacy, equality and democracy. (shrink)

This article seeks to illustrate egg donation's incompletely commodified status through an analysis of two cases of first impression, highlighting the tensions that arise from attempts to reconcile egg donation's reality as a robust commercial industry with the nonmarket norms that traditionally underlie reproduction. Antitrust and taxation litigation may seem unlikely sources for guidance in navigating the tensions in egg donation's uncertain place between the worlds of gift and market exchange. Nonetheless, this litigation forces an explicit consideration of how egg (...) donation is perceived, talked about, and operationalized, and where along the gift-market spectrum it fits. These cases also engage familiar questions of commodification, coercion, and exploitation, which are surprisingly central litigation issues. (shrink)

The main value of carrier detection in the general population is to determine reproductive risks. In this manuscript I examine the practice of providing carrier screening programs in the school setting. While the data show that high school screening programs can achieve high uptake, I argue that this may reflect a lack of full understanding about risks, benefits, and alternatives, and the right not to know. It may also reflect the inherent coercion in group testing, particularly for adolescents (...) who are prone to peer pressure. The problem of carrier screening in the schools is compounded when the condition has a predilection for certain groups based on race, ethnicity or religion. I examine programs around the world that seek to test high school students for Tay Sachs and Cystic Fibrosis carrier status. I argue that carrier programs should be designed so as to minimize stigma and to allow individuals to refuse. The mandatory school environment cannot achieve this. Rather, I conclude that screening programs should be designed to attract young adults and not adolescents to participate in a more voluntary venue. (shrink)

Gangestad & Simpson's model of the evolution of within-sex differences in reproductive strategies requires a degree of female choice that probably did not exist because of male coercion. We argue as well that the tradeoff between current and future reproduction accounts for more of the within-sex differences in reproductive strategies than the “good-genes-good parenting” tradeoff they propose.

If a state with liberal political and justificatory commitments extends benefits of various kinds to persons forming families, what qualifications may such a state place on the right to access to those benefits? I will make two assumptions for the purposes of this paper. The first is the political and justificatory terrain of some form of political or otherwise non-perfectionist liberalism. The assumption is that we are considering the resources and limitations of a community of persons who accept moral pluralism (...) (if not a specific doctrine like the "burdens of judgment"), some priority for individual freedom, and the obligation to justify public coercion and exclusion in terms accessible and fair to all members of morally and culturally diverse society. The second is that it is justified for a liberal state to recognize some forms of domestic partnerships or families in the first place and extend further benefits to them such as tax credits or laws extending (or facilitating the extension of) medical or social insurance. It is, of course, possible to imagine the argument that the liberal state gets out of the marriage business by getting out of it entirely - by extending no recognition or positive rights to families whatsoever beyond negative non-interference rights. I am interested in the dilemma of a society broadly like existing liberal ones which is committed both to subsidizing families and also to justificatory neutrality (expressed in American constitutional legal terms as the requirement of providing a "rational basis" for unequal treatment). Given these assumptions, I believe that the most justifiable policy on liberal grounds is not the institution of "marriage" increasingly open to new constituent relationships but rather a status of "registered domestic partnership" which fulfills the social and moral aims behind subsidizing the family but is entirely neutral not only to the gender or even to the numbers of the partners, but also to the affective and emotional content of domestic life and the purposes behind contracting domestic partnerships. So is there a right to polygamy and incestuous marriage? There is not a specific right to either and thus there is no a priori reason why some restrictions or even prohibitions on them might not be justified, but the same is true for every specific act where a general right to the freedom exists. I argue in this paper, however, that the arguments compatible with public reason for prohibiting them outright, or even for excluding them from the permissible types of legally registered partnerships, are quite weak. I argue that objections to polygamy from (1) female autonomy, (2) damage to children, (3) fairness in the marital market, and (4) the unfair burdening of society are serious and worth refuting, but do not establish a victorious case against multi-member relationships. As to incest, there are two separate questions. The first is whether the new institution of "registered domestic partnerships" should be open to them. The answer to that, given the state's lack of interest in citizens' reasons for forming partnerships and in what they do whilst being registered in one, is clearly "yes." The second is whether, entirely separate from the issue of legal recognition of domestic partnership, the state has a legitimate rational interest in deterring, preventing or punishing consanguineous sexual relations between close blood relations (first-degree incest). Here, the objections to allowing such relations are those from (1) child abuse; (2) unfair burdening of society; and (3) the creation of bad lives. I argue that while rape and other forms of child abuse would be no more legal or tolerated than they are now, the concern about any form of weakening a society's legal and political resources to combat such abuses does indeed register on the justificatory scale, but does not prove that such first-degree incestuous sexual relations are inherently bad enough to warrant intervention. I then argue that the concern about unfairly burdening society with unhealthy persons is not as dangerously totalitarian as we might initially fear, but nor is it strong enough to justify an outright prohibition. Finally, I argue that a concern to dissuade persons from creating certain kinds of lives (children with extreme birth defects) is also not as dangerously totalitarian as we might initially fear, and in fact goes further towards explaining why we might have a legitimate interest in intervening. Nonetheless, I argue that the criminalization of such acts only make sense when they are indicators of other offenses, namely negligence or abuse, and it thus seems that the act of consanguineous reproduction is itself insufficient. (shrink)

Argues that applied bioethics should embrace utilitarian decision analysis, thus avoiding recommendations expected to do more harm than good. -/- Governments, health professionals, patients, research institutions, and research subjects look to bioethicists for guidance in making important decisions about medical treatment and research. And yet, argues Jonathan Baron in Against Bioethics, applied bioethics lacks the authority of a coherent guiding theory and is based largely on intuitive judgments. Baron proposes an alternative, arguing that bioethics could have a coherent theory based (...) on utilitarianism and decision analysis. Utilitarianism holds that the best option is the one that does the most expected good. Decision analysis provides a way of thinking about the risks and trade-offs of specific options. Like economics, utilitarian decision analysis makes predictions of expected good in complex situations, using data when possible, and focusing human judgment on the issues relevant to consequences. With such a guiding theory, bioethics would never yield decisions that clearly go against the expected good of those involved, as some do now. -/- Baron discusses issues in bioethics that can be illuminated by such analysis, including "enhancements" to nature in the form of genetics, drugs, and mind control; reproduction; death and end-of-life issues, including advance directives, euthanasia, and organ donation; coercion and consent; conflict of interest and the reform of internal review boards; and drug research. Although Baron opposes current practice in bioethics, he argues that by combining utilitarianism and decision analysis, bioethics can achieve its aims of providing authoritative guidance in resolving thorny medical and ethical issues. (shrink)

In this article I consider whether there a right to incestuous marriage. I begin by suggesting that the liberal state get out of the "marriage" business by leveling down to a universal civil union or "registered domestic partnership" status. Removing the symbolism of the term "marriage" from political conflict, privatizing it in the same way as religion, would have the advantage of both consistency and political reconciliation. The question is then whether incestuous unions should be both legal and eligible for (...) this status. I argue that the arguments compatible with public reason for prohibiting them outright, or even for excluding them from the permissible types of legally registered partnerships, are quite weak. The objections to allowing such relations are those from (1) child abuse; (2) unfair burdening of society; and (3) the creation of bad lives. I argue that while rape and other forms of child abuse would be no more legal or tolerated than they are now, the concern about any form of weakening a society's legal and political resources to combat such abuses does indeed register on the justificatory scale, but does not prove that such first-degree incestuous sexual relations are inherently bad enough to warrant intervention in their own right. I then argue that the concern about unfairly burdening society with unhealthy persons is not as dangerously totalitarian as we might initially fear, but nor is it strong enough to justify an outright prohibition. Finally, I argue that a concern to dissuade persons from creating certain kinds of lives (children with extreme birth defects) is also not as dangerously totalitarian as we might initially fear, and in fact goes further towards explaining why we might have a legitimate interest in intervening. Nonetheless, I argue that the criminalization of such acts only make sense when they are indicators of other offenses, namely negligence or abuse, and it thus seems that the act of consanguineous reproduction is itself insufficient. One potentially surprising conclusion of this inquiry is that far from creating strong reasons for tolerating these practices, religious or cultural reasons for valuing incest (as well as polygamy) actually seem to count against tolerating them. The reason is that from a liberal perspective, tolerating polygamy and incest involves the assumption that it is possible to disassociate polygamy and incest simpliciter from abusive practices associated with them, including environments where children are raised to devalue their own sexual (and other) autonomy. However, the presence of comprehensive doctrines which include polygyny or incest as part of a good life actually makes it harder to justify disassociating polygamy and incest themselves from the likely abuse and coercion practiced by those who would value polygyny or incest. (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)

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)

The « New’imperialism » : Accumulation by Dispossession. It is possible to distinguish throughout the long history of capitalism at a world scale two principal forms of capital accumulation : that based on expanded reproduction, the extraction of surplus-value by means of purely economic constraint, and that based on forms of extra-economic coercion, on violence, predation, expropriation, which illustrates the moment of « primitive accumulation ». This moment, which is characterised as « accumulation by dispossession » is not simply (...) a passing phase of early capitalism, but is rather a permanent modality by which it seeks to resolve its contradictions and to extend its ascendancy over new terrain on a world scale. The current period, marked by neoliberal hegemony, is precisely one in which accumulation by dispossession once again has the upper hand over expanded reproduction, thereby outlining the contours of a « new imperialism », dominated by US power. (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)

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)

Divergences and controversies are inevitable in the discussion of freedoms and rights, especially in the matter of reproduction. The Chinese first social egg freezing lawsuit raises the question: is the freedom to freeze eggs for social reasons justified because it is an instance of reproductive rights? This paper accepts social egg freezing as desirable reproductive freedom, but following Harel's approach and considering two theories of rights, the choice and interest theories of rights, we argue that social egg freezing (...) is not a reproductive right because one cannot justify a right or an instance of rights via merely describing the function of those instances that have been justified as right, that is, the choice theory lacks justifying normativity. Since reserving fertility and a suspension from reproduction do not serve reproductive ends per se, the sufficient reason for demanding social egg freezing as a right should be found in other ends rather than in right‐to‐reproduce, that is, the interest theory denies the demand as a right‐to‐reproduce. Permitting it on any grounds without guaranteeing adequate and accessible resources, especially in light of cross‐border reproductive care, raises serious questions about reproductive equality and violates the idea of reproductive rights. Therefore, any ground for social egg freezing should be weighed against whether more pressing reproductive needs, specifically those that are justified as rights, have been met. It would be social progress to shoulder these burdens for the vulnerable and then allow social egg freezing—if right‐to‐reproduce were not the only privilege of the few. (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)

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)

The past few years has seen a resurgence in the public interest in space flight and travel. Spurred mainly by the likes of technology billionaires like Elon Musk and Jeff Bezos, the topic poses both unique scientific as well as ethical challenges. This paper looks at the concept of generation ships, conceptual behemoth ships whose goal is to bring a group of human settlers to distant exoplanets. These ships are designed to host multiple generations of people who will be born, (...) live, and die on these ships long before it reaches its destination. This paper takes reproductive ethics as its lens to look at how genetic enhancement interventions can and should be used not only to ensure that future generations of offspring on the ships, and eventual exoplanet colonies, live a minimally good life but that their births are contingent on them living genuinely good and fulfilling lives. The paper makes the further claim that if such a thesis holds, it also does so for human enhancement on Earth. (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)

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)

Manipulation by another person often undermines freedom. To explain this, a distinction is drawn between two forms of manipulation: indoctrination is defined as causing another person to respond to reasons in a pattern that serves the manipulator’s ends; coercion as supplying another person with reasons that, given the pattern in which he responds to reasons, lead him to act in ways that serve the manipulator’s ends. It is argued that both forms of manipulation undermine freedom because manipulators track the (...) compliance of their victims, while neutral causal mechanisms do not. Manipulators see to it that their victims comply even in the face of forces that threaten to derail them from the manipulator’s desired course. It is suggested that this has an impact on freedom because part of what we desire in wanting to be free is the availability of forms of life very different from those we actually enjoy. (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)