Oral Presentation Australasian Association of Bioethics & Health Law and New Zealand Bioethics Conference

An attempt to articulate and apply 'coercion' as a mid-level principle in public health (960)

Diego S. Silva 1
  1. Sydney Health Ethics, University of Sydney, Sydney, NSW, Australia

The aim of this paper is to attempt to articulate, defend, and apply coercion as a mid-level principle in public health. This assumes that coercion can be right or good, which may help us articulate and justify the inherent coercive powers of public health.

Coercion as a mid-level principle denotes a commissive or omissive act by P toward Q to bring about an intended end, x, such that P reduces Q’s range of plausible and reasonable choices beyond x, and by extension, reduces the extent to which we hold Q responsible for x should x actualize. Crucially, the use of coercion means that there exists a choice or set of choices y that Q could make at some cost or penalty that would not exist but for the presence of the coercion itself.

Whether or not a coercive act is justified will rest on:

  1. The argument in favour or against what constitutes ‘plausible and reasonable choices’ (i.e., whether the coercive act is right);
  2. (i) who is the person or persons coercing, and (ii) whether they’re coercing properly (i.e., whether the actors are the right actors to be coercing and whether they’re doing so in a fair manner); and
  3. Whether the power imbalance between the coercer, P, and coercee, Q, is right or fair in the first place.

The treatment of tuberculosis provides cases which will allow us to test the plausibility of using coercion as a mid-level principle (e.g., directly observed therapy, involuntary isolation, etc.).