ing on the ability of the state to justify the use of coercion. It is concluded that for some classes of individuals and in some situations, coerced immunotherapy is likely to be legal, subject to the constraints of due process and establishment of the modality’s safety and effectiveness. Assuming a situation in which immunotherapy may be legally coerced, the appendix concludes with some reflections on fairness in implementing coercion policy.

The entire discussion here is necessarily subject to substantial uncertainty. Given the novelty of immunotherapies, no law has been developed pertaining to them, so likely legal authority must be inferred from a set of successively more generalized or analogous areas of law: first, from the very sparse law pertaining to coercion of other modalities of substance abuse treatment; second, from the law pertaining to coercion of substance abuse treatment in general, also sparse; and third, from the law pertaining to coercion of treatment for mental illness, which is more developed but only analogous. While this approach cannot lead to very confident predictions, it may well mirror the thinking of courts as they review precedents to inform their future decisions regarding coercion of immunotherapy.


The law permits the government to enforce addiction treatment under parens patriae and police powers. Although the U.S. Constitution generally confers broad autonomy to individuals, parens patriae and police powers are invoked by the government to limit the actions of individuals when broader societal interests are at stake.

Parens patriae, translated literally from the Latin, means “parent of the country.” This power lies with the states, where it has been broadly interpreted as the right to protect interests such as the health and welfare of the people. For example, all states permit the civil commitment of individuals with mental disorders. The rationale for civil commitment is to provide treatment for mentally disordered individuals as well as to prevent harm to the larger society.

Overlapping parens patriae are police powers. These are derived from the Tenth Amendment to the U.S. Constitution, which reserves to the states any powers not explicitly delegated to the federal government. Under their police powers, states (and by delegation localities) may “adopt such laws and regulations as tend to prevent the commission of fraud and crime, and secure generally the comfort, safety, morals, health and prosperity of its citizens by preserving the public order, preventing a conflict of rights in the common intercourse of citizens, and insuring to

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