Patients in the admissions process who reported that others acted out of concern for them, treated them fairly, in good faith, with respect, and without deception, provided them with an opportunity for voice, and took what they said seriously were much less likely to experience coercion. When these moral norms reflecting patient attitudes about how they should be treated are adhered to, many apparently coercive acts seem to be accepted by the patient as morally legitimate. (Winick, 1997, p. 1159)

While the MacArthur studies did not demonstrate that perceptions of coercion were related to treatment adherence (Rain et al., 2003), care should still be taken to assure fairness and respect in determining who should be required to accept immunotherapy treatments and in administering such treatments.

This appendix does not attempt a broad argument against immunotherapies. These new therapies might have tremendous benefits for society—if they prove safe and effective for all groups of potential recipients and if trust-building measures are taken where coercion is necessary. The importance of those conditions is simply emphasized.


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