Coercive measures in health promotion: can they be justified?

Though environmental hazards and lack of medical care continue to threaten the public's health, much recent attention has turned to the role of destructive health-related behavior. If, as Fuchs suggests, changing behavior patterns is the most powerful alternative open to advanced countries in the pursuit of health, the role of the health educator is likely to grow more prominent relative to other health-care professionals. At the same time, that role may change. A campaign to solve the nation's health problems by altering habits of living may require methods which are stronger than the traditional health educator's efforts to facilitate and inform. This paper examines the coercive aspects of some of these possible measures and surveys the moral justifications for a policy of using coercion to bring about the desired changes in health-related behavior. Three such arguments are most plausible: that the coercion is justified by the social benefit; by the benefit to the coerced; and by a right of others in society to prevent the self-destructive individual from placing unfair burdens upon them.