The problem I am concerned with is very general: Why do we need a coercive institution in our society to control our behavior? This question is a little different from "Why do we need a government?" in two ways: First, because "coercive institution" is a broader term than "government"; probably not every coercive institution that controlled people's behavior would be called a government, though every government is a coercive institution (that is, an institution exercising coercion as one of its (...) main functions). Second, controlling the behavior of the members of the society in which it exists is perhaps not the only important function of government (it may be, for example, that we need a government to fight people from other societies); I will not consider other possible things we might need a coercive institution to do. I will only consider whether we as a society need such an institution to control our own behavior. (shrink)

(1963). Coercion and cooperation: What are the measures of social coercion necessary to safeguard the technique of effective cooperation? World Futures: Vol. 2, No. sup001, pp. 60-64.

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)

Against the libertarian view, this essay argues that coercion aimed at bringing about a more equal distribution across persons can be morally acceptable. Informal social norms might lead toward equality (or another social justice goal) without coercion. If coercion were unnecessary, it would be morally undesirable. A consequentialist integration of social norms and principles of social justice is proposed. The proposal is provided with a preliminary defense against the non-consequentialist egalitarianism of G.A. Cohen (...) and against liberal criticisms directed against the common ground that Cohen and the proposed consequentialist egalitarianism occupy. Key Words: distributive justice • consequentialism • Lockean rights • prioritarianism • social norms • incentives. (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)

Many recent theories of coercion broaden the scope of the concept coercion by encompassing interactions in which one agent pressures another to act, subject to some further qualifications. I have argued previously that this way of conceptualizing coercion undermines its suitability for theoretical use in politics and ethics. I have also explicated a narrower, more traditional approach—“the enforcement approach to coercion”—and argued for its superiority. In this essay, I consider the prospects for broadening this more traditional (...) approach to cover some cases that don’t seem to fit this approach, but nonetheless seem coercive, such as the demands routinely made on people by credit card companies, demands on students by higher educational institutions, and demands made by European financial institutions on the government of Greece. I analyze the similarities and differences of these compared to more central cases of coercion, discussing what lessons can be drawn from this analysis. (shrink)

El presente trabajo identifica en la obra de Wilfrid Sellars dos tesis relevantes para el debate contemporáneo en ontología social. La primera dice que podemos entender la realidad social como estando compuesta parcialmente por estructuras causales o coercitivas. La segunda, que la realidad social se le presenta a los agentes como estando constituida por estructuras coercitivas. El trabajo defiende estas tesis interpretativas recurriendo a los escritos de filosofía práctica de Sellars, y especialmente a su explicación del funcionamiento (...) de los imperativos hipotéticos y categóricos. A su vez, contrasta esta interpretación de corte causal con las concepciones —de índole normativa— predominantes tanto en la ontología social contemporánea como entre los seguidores de Sellars. (shrink)

This article addresses the theoretical difficulty of justifying the use of penal coercion in circumstances of marked, unjustified social inequality. The intuitive belief behind the text is that in such a context—that of an indecent State—justifying penal coercion becomes very problematic, particularly when directed against the most disfavored members of society.

This work provides a game theoretical analysis of the classical idea of a social contract. According to what we might call the Hobbesian justification of the state, coercion is necessary in order to provide people with basic security and to enable them to successfully engage in mutually beneficial cooperation. The establishment and maintenance of a central coercive power, i.e. a state, can therefore be said to be in everyone's interest. The aim of this essay is to examine and (...) evaluate these claims. It is common to interpret the problem of cooperation in a Hobbesian state of nature as a Prisoner's Dilemma game. In this kind of game, each agent prefers that cooperation is brought about, but each also prefers not to cooperate herself, regardless of what others do. Most studies, however, have focused on the prospects for spontaneous cooperation in the 2-player PD. This work focuses instead on the generalized, n-player version of the same game. Invoking an evolutionary game theoretical model, it is argued that the prospects for spontaneous cooperation to emerge in an n-player PD are much worse than in the 2-player case. In order to analyze how the existence of sanctions might affect the prospects for cooperation, a model of a limited sanction system is developed. It is demonstrated that the game that emerges when an n-player PD is modified by a suitable system of sanctions is an n-player version of what Sen has called an Assurance game. It is also demonstrated that in this game, unlike the n-player PD, general cooperation is evolutionarily stable. It is also discussed whether the establishment and maintenance of such a sanction system does itself constitute an n-player PD. It is argued that it does not. (shrink)

Increasingly, mental health social workers in the United Kingdom and elsewhere in the world are employing coercive interventions with clients. This paper explores this trend in the context of community-based settings, using national and international research literature on this subject. It begins with a discussion about the complex, contested nature of ideas on coercion. The authors then explore debates about how coercion is perceived and applied in practice. They choose two forms of coercion?informal types of leverage, (...) and the legally mandated use of Community Treatment Orders?to highlight the range of ethical problems and dilemmas that confront practitioners in this field. The authors conclude by developing a tentative, explanatory model to explain how and why mental health social workers should consider a more holistic, situated approach to help deal with ethical concerns about the use of coercion. (shrink)

Many recent arguments about the role of coercive sanctions in law suggest that the importance of coercion is underrated. The question has thus been where the lower threshold for coercion might be within a legal system. Very little attention, by contrast, has been paid to whether, at some upper threshold, coerciveness might itself present a problem for law, even on a positivist account. In this article I therefore interrogate the standard positivist picture from this unorthodox direction: Is it (...) true that there is no degree of coerciveness that is incompatible with a system of law? Or, in other words, have we gone far enough in circumscribing the role of coercion in our account of law? I argue that coercion of a certain kind undermines the conditions necessary for the social normative practices that ground legality on social accounts of law. Sufficiently coercive circumstances, I conclude, can diminish the law’s normativity by inhibiting the conditions necessary for the effective transmission of norms. (shrink)

The book is a critical analysis of the work of Max Weber, Emile Durkheim and Karl Marx. It focuses on their separate analyses of the role of law in society, pointing out their faults and errors, and the resultant impact on modern social science. The author takes issue with Weber's work on rationality, with Durkheim's work on repressive and restitutive law, and with Marx's work on social justice and law as part of the super-structure. In each section of (...) the book he shows the implications that flow from a re-assessment and re-interpretation of their work for an understanding of society. The book is multi-disciplinary, making ample reference to law, sociology, anthropology, history, religion, ecology, criminology, philosophy and economics. Its various chapters discuss a wide range of themes, including rationality, tradition, science, political authority, conflict resolution, community, justice and altruism. (shrink)

"The work would be of great value to philosophers engaged in the conceptual analysis of coercion, to political scientists studying the state or other coercive institutions, and to advanced readers interested in the field of peace research."--Choice.

In this article we address the social value of bioethics research and show how a participatory approach can achieve social impact for a wide audience of stakeholders, involving them in a process of joint moral learning. Participatory bioethics recognizes that research co-produced with stakeholders is more likely to have impact on healthcare practice. These approaches aim to engage multiple stakeholders and interested partners throughout the whole research process, including the framing of ideas and research questions, so that outcomes (...) are tailored to the interests and context, and the type of impact stakeholders envisage. There is an emphasis on realizing social change through the conduct of the research, and it is believed that the engagement of stakeholders in the research process will promote their intrinsic motivation to change their practice. Another distinctive feature of participatory bioethics research is that its central normative commitment is to reflection and dialogue, not to a particular substantive ethical approach. In reflection and dialogue there is an emphasis on inclusion and the co-production of knowledge. Furthermore, empirical and normative research are combined, and there is a deliberate attempt to give voice to otherwise marginalized positions. This provides a model of social impact which is relevant not only for bioethics research, but also for other areas of health care research. We will show the merits of a participatory approach to bioethics research with a case example. It concerns the reduction of coercion and in particular seclusion in Dutch mental healthcare. (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)

In today’s America the persistence of crushing poverty in the midst of staggering affluence no longer incites the righteous jeremiads it once did. Resigned acceptance of this paradox is fueled by a sense that poverty lies beyond the moral and technical scope of government remediation. The failure of experts to reach agreement on the causes of poverty merely exacerbates our despair. Are the causes internal to the poor – reflecting their more or less voluntary choices? Or do they emanate from (...) structures beyond their control? If both of these explanations are true, poverty experts will need to shift their focus to a hitherto under-theorized concept: coercion. I defend this claim by appealing to distinct areas of philosophical inquiry: social epistemology and moral theory. Poverty knowledge is directly related to both of these inquiries. The aim of poverty knowledge is clearly moral: to reduce suffering and to empower the weak. While the former aim is grounded in utilitarian thinking, the latter aim is grounded in the social contractarian insight that poverty is unjustly coercive, imposing excessive limits on the opportunities and choices of the poor that render them vulnerable to domination by others. Equally obvious is the social nature of poverty knowledge. All knowledge depends on the reliable testimony of others. Poverty knowledge not only ostensibly offers us the most reliable, scientific beliefs about the causes and effects of poverty, thereby determining how we morally judge the poor and their poverty, but it reciprocally bases its understanding of poverty on what the poor themselves have to say about it. What unites both social epistemology and moral theory – at least the social contract variants I will be examining here – is concern about the limits and possibilities of rational choice. As poverty knowledge came of age in the fifties and sixties, it absorbed the language of rational choice prevalent in economics, especially the Keynesian economics whose moral underpinnings can be found in Rawlsian social contract theory. Echoing a different economic theory supported by a different, more libertarian, brand of social contract theory, poverty expertise in the eighties continued to use an abstract model of rational choice. I submit that, in both early and later epochs of poverty expertise, reliance on rational choice reasoning prevented poverty experts from appreciating the coercive impact of poverty on the poor. Social epistemology explains this failure by demonstrating the poverty of rational choice thinking and its mistaken reliance on inflated commonsense expectations about the capacity of individuals to calculate their long-term interests, free from the distortions of social bias. Social epistemology not only exhibits the dangers of not relying on expert testimony, but it also exhibits the dangers of relying on an unreliable source of expert testimony that has removed itself from its human subject matter. In order for poverty experts to become more reliable educators about poverty’s coercive impact on the poor they must return to their discipline’s social epistemological roots. Only a more descriptive and explanatory sociology can narrate a comprehensive story about how the lived experience of poverty relates to the larger social system. The social contractarian model best suited to underwriting this kind of poverty knowledge, I submit, is the discourse theoretic model that has been championed by Jürgen Habermas. When applied as a pedagogical method of dialog and not as a social contractarian model of rational normative consent, discourse theory highlights the unique epistemological advantages of empathetic understanding that are so essential to dispelling stereotypes about the poor. Dispelling these stereotypes is the first step toward respecting the poor as free agents who are nonetheless forced to make suboptimal choices. My defense of these claims proceeds as follows: Part One argues that poverty expertise rightly deserves the opprobrium critics have heaped on it. The charge – leveled by progressives and conservatives alike - that such expertise is ideological is true to the extent that poverty knowledge has all-too-easily accommodated the political aims of the agency that has funded it: the federal government. The shift from the war on poverty to the war on the poor – and the resulting shift from blaming poverty on economic structures to blaming it on the culture of poverty – would not have been possible without an increased emphasis on data gathering aimed at measuring poverty rather than describing it. Part Two assesses the consequences of turning away from qualitative research to statistical analysis: the coercive nature of poverty becomes invisible beneath the surface of aggregate individual choices. The failure to grasp how voluntary choices, ostensibly based on rational, self-interested calculations, can be coerced by social structures - and thereby lead to sub-optimizing behavior – invites the conclusion that the poor have only themselves to blame for their misery. Part Three suggests that this pathologization of the poor directly controverts the major aim of poverty research: to empower the poor as free and equal parties to the social contract. I argue that the different varieties of social contract theory that have justified poverty expertise over the last forty years – the welfarist model pioneered by Rawls and the market-based model defended by Nozick – embrace the same rational choice models favored by poverty experts and so conspire with the latter in neglecting important dimensions of poverty-related coercion. While the welfarist model conceals the coercive nature of bureaucratically administered entitlement programs and top-down urban renewal policies, the market-based model conceals the coercive nature of economic class structures. The discourse-theoretic alternative proposed by Habermas endorses a populist, democratic response to the overly abstract rational choice assumptions embedded in these other models. Despite this advance over its counterparts, the chief advantage of discourse theory for poverty knowledge, I submit, resides less in its proposed procedure of rational collective choice than in its heuristic as a dialogical method of social learning. I demonstrate this claim in Part Four, where I turn to the social epistemological insights of Allen Buchanan. Social epistemology offers a much needed corrective to theories of knowledge that rely on the reasoning capacities of isolated individuals. By stressing the connection between moral response and social belief, on one hand, and the dependence of social belief on epistemic authorities, on the other, social epistemologists suggest ways in which we can learn to distinguish reliable from unreliable authorities and become aware of our own error-prone cognitive proclivities. Their insights need to be supplemented by moral epistemologists who stress the affective dimension of knowledge, above all, the role that empathy plays in understanding the plight of others. Drawing from victim narratives, Diana Meyers shows that switching between first-person experiences of one's own and third-person reconstructions of others' experiences is essential to appreciating the gravity of human rights violations and the seriousness of human rights claims. It goes without saying that such empathy is just as essential to understanding the plight of the poor. Meyers mainly has in mind empathetic understanding that has been facilitated by third-person observation and literary encounter, but the importance of visceral and corporeal representation suggests that face-to-face dialog may sometimes be a more effective way to facilitate empathetic understanding. (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)

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)

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)

This chapter contains sections titled: Coercion Law References.

In this article I revise and defend a core feature of political liberalism, namely, the idea that principles of political justice should be limited in their scope of application to what John Rawls calls the ‘basic structure of society.’ I refer to this feature as the ‘basic structure restriction’ of political liberalism. According to my account of the basic structure restriction, the basic structure includes all and only those institutions that have a profound effect on the lives of all citizens, (...) and thus those institutions that citizens would want to organize as parts of a fair system of social cooperation. Moreover, maintaining the basic structure as a fair system of social cooperation vis-à-vis all citizens requires the exercise of coercive political power. This account of the basic structure, which I call the ‘legitimacy of coercion account,’ shows that limiting the basic structure to those institutions that are maintained by legally coercive means is not arbitrary, contrary to the claims of critics like G. A. Cohen. Furthermore, by recognizing explicitly that there exist certain institutions – and, in particular, the family – that ought to be regulated partially by coercively maintained principles, my formulation of the basic structure provides a more satisfactory account of the way in which principles of justice should apply to the family than does Rawls’s most considered account. Finally, I explain how my account of the basic structure can incorporate many of S. M. Okin’s proposed policies for promoting gender equality in society. (shrink)

Justifications for state authority are typically directed towards the good of those subject to that authority. But, because of their territorial nature, states exercise coercion not only towards insiders but also towards non-members. Such coercion can take the form of denying outsiders the right to enter a territory or to settle in it permanently, as well as various restraints on trade and association. When coercion is directed at insiders, it often comes packaged with various claims about distributive (...) justice, including claims to the effect that being subject to coercion entitles citizens to certain distributive guarantees (social minimum, difference principle). This paper asks three questions: can states acquire the moral right to coerce non-citizens (including in the form of a denial of the right to traverse or enter territory)? are outsiders ever morally bound to submit to the commands of states along these lines? does the right coercively to exclude outsiders bring with it any distributive obligations similar to those entailed by the state’s subjection of co-citizens? The possibility that a right to exclude must be coupled with a duty of compensation to those excluded will be canvassed. (shrink)

Immanuel Kant’s political philosophy has enjoyed renewed attention as an egalitarian alternative to contemporary inequality since it seems to uncompromisingly reassert the primacy of the state over the economy, enabling it to defend the modern welfare state against encroaching neoliberal markets. However, I argue that, when understood as a free-standing approach to politics, Kant’s doctrine of right shares essential features with the prevailing theories that legitimate really existing economic inequality. Like Friedrich Hayek and Milton Friedman, Kant understands the state’s function (...) as essentially coercive and, in justifying state coercion, he adopts a narrow conception of political freedom that formally preserves the right to choose while denying that the range of choices one actually has can be a matter of justice. As a result, Kant cannot identify various forms of social pressure as potential injustices even as he recognizes their power to create and sustain troubling inequalities. For both Kant and the neoliberals, the result is that economic relations almost never count as unjust forms of coercion, no matter how unequal they are. Views that identify coercion as the trigger for duties of justice are thus particularly ill-suited to orient us to contemporary inequality. (shrink)

Whether intended or not, conceptions of informed consent are often rooted in archetypal notions of the researcher and prospective study participant. The former is assumed problematically to be a disinterested yet humanitarian individual who is well trained to conduct robust science. The latter is often characterized as being motivated by some altruistic notions about the contribution to science and society they are making even as they seek some personal benefit from the research. Cast in a dyad, the researcher has the (...) responsibility to inform the participant thoroughly about the purpose of the research, the risks and benefits of participation, and any alternatives to research available, as well as the .. (shrink)

Background While community engagement is increasingly promoted in global health research to improve ethical research practice, it can sometimes coerce participation and thereby compromise ethical research. This paper seeks to discuss some of the ethical issues arising from community engagement in a low resource setting. Methods A qualitative study design focusing on the engagement activities of three biomedical research projects as ethnographic case studies was used to gain in-depth understanding of community engagement as experienced by multiple stakeholders in Malawi. Data (...) was collected through participant observation, 43 In-depth interviews and 17 focus group discussions with community leaders, research staff, community members and research participants. Thematic analysis was used to analyse and interpret the findings. Results The results showed that structural coercion arose due to an interplay of factors pertaining to social-economic context, study design and power relations among research stakeholders. The involvement of community leaders, government stakeholders, and power inequalities among research stakeholders affected some participants’ ability to make autonomous decisions about research participation. These results have been presented under the themes of perception of research as development, research participants’ motivation to access individual benefits, the power of vernacular translations to influence research participation, and coercive power of leaders. Conclusion The study identified ethical issues in community engagement practices pertaining to structural coercion. We conclude that community engagement alone did not address underlying structural inequalities to ensure adequate protection of communities. These results raise important questions on how to balance between engaging communities to improve research participation and ensure that informed consent is voluntarily given. (shrink)

A grounded theory study of psychiatric nurses’ experiences of administering medication to involuntary psychiatric patients revealed a basic social process of justifying coercion. Although the 17 nurses interviewed all reported success at avoiding the use of coercion, each had an individual approach to using the nurse-patient relationship to do this. However, all the nurses used the same process to reconcile themselves to using coercion when it became necessary. This has three stages: assessment of need; negotiation; and (...) justifying and taking coercive action. Two critical junctures - decision to engage and impasse - determine the progression from one stage to the next. The process of justifying coercion allows a nurse to engage in behavior generally disapproved of while retaining a self-image of a ‘good’ nurse. (shrink)

This essay provides a positive account of coercion that avoids significant difficulties that have confronted most other recent accounts. It enters this territory by noting a dispute over whether coercion has to manipulate the will of the coercee, or whether direct force inhibiting action (such as manhandling or imprisoning) is itself coercive. Though this dispute may at first seem a mere matter of taxonomic categorization, I argue that this dispute reflects an important divergence in thought about the nature (...) of coercion. Though it has rarely been noted, there are two significantly different ways of theorizing coercion found in recent writing on coercion. One focuses on the ability of the coercer to inhibit actions by the coercee through techniques such as force, violence, and like powers, or threats based in such powers. The other approach restricts coercion to cases where coercion manipulates the will of the coercee, though widens it to include any sort of threat that puts pressure on the coercee's will and alters the coercee's intentional choice of action. The former, enforcement approach used to be widely assumed by many political theorists who discussed the place of coercion in law and politics, though it has been largely supplanted by the latter, pressure approach. I show that these approaches are indeed quite distinct, and argue that the enforcement approach is in several ways superior to and more fundamental than the pressure approach for recognizing and understanding coercion in ethics and political and legal philosophy. I also consider and respond to a number of objections to the enforcement approach, showing that it can deal with some puzzle cases such as bluffs, blackmail, inefficacious threats, oblique threats, and economic coercion. (shrink)

Although the individual mandate was upheld and the Commerce Clause may have been cabined, the decision to strike down a significant element of the “Medicaid expansion” may prove to be the most significant aspect of the Supreme Court’s decision in NFIB v. Sebelius. Under the Affordable Care Act (ACA), States were required to extend Medicaid coverage to all individuals under the age of 65 with incomes below 133 percent of the poverty line, a new “essential health benefits” package was required (...) for all new Medicaid recipients, and the increased costs due to the expansion would be entirely covered by the Federal government through 2016, with the Federal payment gradually decreasing to a minimum of 90 percent of the total cost from the expanded coverage. The element found to be unconstitutional was §1396c of the ACA, which permitted the withdrawal of all Federal Medicaid funds from those States that did not comply with the ACA’s requirements for Medicaid expansion. The effect on access to health care may be significant: roughly half of those expected to gain coverage under the ACA were going to gain it through the Medicaid expansion; it is unclear how many States will choose to opt into that expansion in the absence of §1396c.1 Additionally, the argument offered by the Court to strike down that provision might be used to attack other federal programs—concerning transportation, social services, environmental protection, and others—that have a similar structure. This paper will demonstrate that the argument rests on a theoretical mistake concerning the relationships between coercion, compulsion, and political accountability and that, further, this mistake is not one legally forced upon the Court. (shrink)

This essay differentiates two approaches to understanding the concept of coercion, and argues for the relative merits of the one currently out of fashion. The approach currently dominant in the philosophical literature treats threats as essential to coercion, and understands coercion in terms of the way threats alter the costs and benefits of an agent’s actions; I call this the “pressure” approach. It has largely superseded the “enforcement approach,” which focuses on the powers and actions of the (...) coercer rather than the perspective of the coercee. The enforcement approach identifies coercion with certain uses of the kinds of powers that agents need to accumulate and wield in order to be able to make significant, credible threats. Though there is considerable overlap extensionally in the instances of coercion recognized by the two approaches, the enforcement approach encompasses some uses of power to coerce that do not involve threats . It also circumscribes which threats should be counted as coercive, though notably it provides a picture of coercion that is non-moralized in its essentials. While there may be specific purposes for which a pressure account is to be preferred, I argue that the enforcement approach better describes how coercion works, and elucidates factors that are often tacitly assumed by pressure accounts. It also is more useful for explaining the social and political significance of coercion, and why coercion is thought to have the implications commonly associated with it. In particular, I argue that it helps us understand why uses of coercion are in general a matter of ethical significance, why state authority depends on commanding a monopoly on the right to use coercion, and why being coerced may reasonably provide one a defense against being held responsible for actions one is coerced into taking. (shrink)

This essay considers how we are to understand the decision to end one’s life under medical aid-in-dying (MAID) statutes and the role of influencing others. Bioethical concerns about the potential for abuse in MAID have focused predominantly on the risk of coercion and other forms of undue influence. Most bioethical analyses of relational influences in MAID have been made by opponents of MAID, who argue that MAID is unethical, in part, because it cannot cleanly accommodate relational influences. In contrast, (...) proponents of MAID have downplayed the role of relational influences because they may threaten the pillars of autonomy and voluntariness on which the ethics of MAID rest. Drawing on a case study collected as part of an ethnographic study of MAID in Vermont, we show how relations of care are central to MAID decision-making. Such relations may muddle motives for assisted death, exposing the limits of conventional bioethics thinking on MAID and relational influence. Here, we argue that ethical frameworks for MAID should account for the role of relational influences in decision-making, and acknowledge that relational influences may support, as well as undermine, a decision for MAID. We then outline an evaluative framework for determining whether relational influences are undue that identifies six key domains for consideration: mental competence, authenticity, relationship context, having an adequate range options, financial considerations and irremediability. We conclude by suggesting that social relationships may constitute an important source of value in end-of-life decision-making and not only a liability. (shrink)

Claims about coercion play a significant role in some of the most important questions in political philosophy: most ordinary citizens as well as philosophers think that the exercise of power by the state and other political institutions is coercive, and as such requires special justification. Political philosophy, it has been assumed, must assess both the truth of that claim and its relevance for whether or not states, in general, can be justified. Whether the state is always or necessarily coercive (...) is a central question in the philosophy of law. Under what conditions a state exercising coercive power can be justified is the question that informs all major works in the social contract tradition since Thomas Hobbes's Leviathan. (shrink)

I argue that a commitment to liberal neutrality, and an opposition to coercion, means that we ought to support a redistributive state in which wealth, insofar as it is instrumental in allowing us to pursue our ends, is equalised. This is due to the fact that any conception of justice and desert works in favour of some, but against others, and that those who lose out by any particular conception are likely not to consent to it (meaning that its (...) imposition is coercive). As having some understanding of justice and desert is inescapable in a society, coercion is unavoidable. However, those who are harmed by the imposition of a certain conception of justice and desert deserve compensation for their foregone position in the alternate conceptions in which they would be better off. This compensation is owed by those who have benefitted from the existing conception of justice and desert. (shrink)

Justificatory liberalism is liberal in an abstract and foundational sense: it respects each as free and equal, and so insists that coercive laws must be justified to all members of the public. In this essay I consider how this fundamental liberal principle relates to disputes within the liberal tradition on “the extent of the state.” It is widely thought today that this core liberal principle of respect requires that the state regulates the distribution of resources or well-being to conform to (...) principles of fairness, that all citizens be assured of employment and health care, that no one be burdened by mere brute bad luck, and that citizens' economic activities must be regulated to insure that they do not endanger the “fair value” of rights to determine political outcomes. I argue in this essay: a large family of liberal views are consistent with the justificatory liberals project, from classical to egalitarian formulations ; overall, the justificatory project tilts in the direction of classical formulations. (shrink)

Research Articles Christopher W. Morris, Social Philosophy and Policy, FirstView Article.

End-of-life debates in medical ethics often centre around several interrelated issues: improving care, avoiding coercion, and recognising the dignity and rights of the terminally ill. Care ethics advocates relational autonomy and non-abandonment. These commitments, however, face system pressures—economic, social and legal—that can be coercive. This article takes up two related aspects in this domain of ethics. Firstly, that competence and communication are core clinical ethics principles that can sidestep the overplayed dichotomies in end-of-life care. And secondly, it questions (...) the assumption that advance directives are universally benevolent—comparing the provisions of the Council of Europe’s 1999 recommendations on protection of human rights and dignity of the dying within the framework of the Irish context. The article also registers the unintended impacts of changing legal frameworks in relation to euthanasia and assisted suicide in Europe, including recent proposals in the Netherlands. A focus on human dignity can provide a theologically and philosophically shared normative orientation that argues for present directives rather than only advance directives, and a presumption in favour of ‘living up to death’. Dignity approaches not only grant rights but secure them by supporting ongoing initiatives that honour, rather than erode, the ‘longevity dividend’. (shrink)

Across the health sector there is increased recognition of the ethical significance of interventions that constrain or coerce. Much of the recent interest stems from debates in public health over the use of quarantines and active monitoring in response to epidemics, as well as the manipulation of information in the service of health promotion (or ‘nudges’). But perhaps the area in which these issues remain most pressing is mental health, where the spectre of involuntary treatment has always loomed large. Indeed, (...) there are good reasons to think of psychiatry as ethically exceptional given its broader role as social and legal arbiter. This is compounded by the fact that mental health treatment has other special features that can serve as potential entry points for more subtle forms of pressure and influence. These include the relative cognitive and emotional vulnerability of patients, the highly confidential information involved, and the importance of the therapeutic relationship. Thus the field of mental health needs to grapple with a range of closely related issues concerning the ethics of influence. In this chapter I explore several, with a primary focus on clinical concerns, although implications for research ethics are also touched on. Discussion of treatment pressure has traditionally focused on ‘coercion,’ or, very roughly, the use of threats or force to get someone to do something they otherwise would not. Here I follow suit, beginning with discussion of its conceptual standing alongside other categories of influence, including manipulation and persuasion. As it stands, there is nothing close to a consensus on these matters. But a relatively broad understanding of coercion is available and can be useful for ethical deliberation. Or so I suggest here. Interestingly enough, there is also a growing body of empirical literature on coercion in psychiatry, including research on the use of coercive measures such as hospitalization, physical restraint, and forced medication, as well as the construct of ‘perceived coercion,’ which tracks patients’ experiences of treatment pressure. I briefly describe several key findings and their relation to recent recommendations to reduce coercion. Building on all of this, I then take up the normative questions directly, by way of evaluating a recently proposed framework for the ethical analysis of influence. (shrink)

Some libertarians argue that informed consent alone makes transactions in the labour market morally justified. In contrast, some of their critics claim that such an act of consent is no guarantee against coercion. To know whether agreements are voluntary, we need to assess the quality of the offers or the prevailing background conditions. ISCT theorists argue that it is imperative to take social norms into account when evaluating the labour market. We present a novel framework for moral assessment (...) in the labour market, which takes consent, background conditions and norms into account, but which mainly focuses on the offers and demands made. Consent renders a transaction legitimate in the same way we regard a fair election legitimate even if we object to its outcome. For offers to be substantially justified, exploitation must be avoided and offers must give expression to the value of community. Only then they are morally justified. (shrink)

The theory of social-property relations, or political Marxism, has argued that in contradistinction with pre-capitalist forms of exploitation, capitalism is characterised by the separation of the economic and the political, which makes surplus appropriation under this system uniquely driven by economic coercion. In spite of political Marxism’s various strengths, this article argues that the paradigm puts forward an ahistorical and sanitised conception of capitalism typical of bourgeois economics, which is an outcome of its formal-abstractionist approach to the concept (...) of the mode of production and the separation between theory and history that it operates. A more satisfactory solution to political Marxism’s inability to make sense of past and present forms of coercion and violence under capitalism can be found in Jairus Banaji’s emphasis on Marx’s historical – rather than formal – conception of the mode of production. (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)

The prelims comprise: Liberty and Coercion Liberty‐Limiting Principles The Harm Principle The Offense Principle Legal Paternalism Legal Moralism Justice Need Conclusion Bibliography.