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If consent under third-party coercion is voluntary, we should rethink informed consent

Smith and Mackie’s feature article addresses the worry that vaccine mandates—for example, requiring employees to get the COVID-19 vaccine—constitute coercive threats that undermine the voluntariness of informed consent.1 Drawing on Maximilian Kiener’s interpersonal account of voluntary medical consent, they propose that informed consent can be voluntary despite being motivated by third-party coercion, provided that the consent-receiver does not personally coerce or wrong the consent-giver in any way. In most cases, those who administer and obtain informed consent for vaccines play no role in coercing or otherwise wronging consent-givers; thus, it seems consent to mandatory vaccination can be voluntary.

Smith and Mackie’s proposal is interesting, but in this commentary, I will caution against accepting it. My main worry is this: If we accept Smith and Mackie’s account of voluntary consent, we can no longer rely on the process of informed consent to help us fulfil our obligation to respect patient…

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Posted in: Journal Article Abstracts on 01/26/2026 | Link to this post on IFP |
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