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Coercive public health policies need context-specific ethical justifications

Abstract:
Public health policies designed to improve individual and population health may involve coercion. These coercive policies require ethical justification, and yet it is unclear in the public health ethics literature which ethical concepts might justify coercion, and what their limitations are in applying across contexts. In this paper, we analyse a number of concepts from Western bioethics, including the harm principle, paternalism, the public interest, and a duty of easy rescue. We find them plausible justifications for coercion in theory, but when applied to case studies, including HIV testing in Malawi, vaccine mandates in South Africa, and prohibitions of antibiotic use in livestock in the EU, their limitations become clear. We argue that the context-specificity of ethical justifications for coercion has been overlooked, and there is more work needed to identify context-relevant ethical justifications for coercive policies in various settings and for various populations, rather than relying on universalising Western bioethical justifications across all contexts.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1007/s40592-024-00218-x

Authors


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Institution:
University of Oxford
Division:
MSD
Department:
Nuffield Department of Population Health
Sub department:
Population Health
Oxford college:
Hertford College
Role:
Author
ORCID:
0000-0003-2071-4302


More from this funder
Funder identifier:
https://ror.org/029chgv08
Grant:
221719/Z/20/Z


Publisher:
Springer
Journal:
Monash Bioethics Review More from this journal
Volume:
43
Issue:
2
Pages:
350-371
Publication date:
2024-10-15
Acceptance date:
2024-09-17
DOI:
EISSN:
1836-6716
ISSN:
1321-2753


Language:
English
Keywords:
Pubs id:
2031312
Local pid:
pubs:2031312
Deposit date:
2024-09-20

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