Exploitation, coercion and domination – the conceptual tool we have been missing?

David Hunter, Associate Professor of Medical Ethics1

1 Flinders University, Bedford park Campus, Adelaide, South Australia, david.hunter@flinders.edu.au 

Exploitation is a commonly dismissed issue in the bioethics literature. This is because that literature focuses (unfortunately almost exclusively) on autonomy and threats to autonomy. Hence much of the discussion of exploitation has tried to explicate the wrongness of exploitation in terms of coercion. However it has been argued across an array of areas that the kinds of cases in which exploitation is supposed to be problematic involve offers which expand the options available to people – such as payments for kidney donors or research participants. It is argued that these offers cannot be coercive because they increase rather than decrease the options available. Elsewhere I have argued that the mainstream bioethics literature (with the notable exception of some feminist bioethicists) has neglected a significant challenge to the validity of informed consent – that of being in a situation of domination. Someone is dominated where someone can arbitrarily interfere in important matters in our lives, with minimal consequences for them. In this situation we shape our lives and choices to the desires of those who have power over us which invalidates consent. In this paper I explore whether domination provides the conceptual space to explain the wrongness of exploitation in a novel and illuminating fashion.


David Hunter is an Associate Professor of Medical Ethics in the Medical School at Flinders University, originally from New Zealand he has been previous located at University of Birmingham, Keele University, the University of Ulster and Massey University. A political philosopher by background his work focuses on the intersection of medical ethics and political philosophy. Primary areas of interest include, research ethics, resource allocation, public health ethics and the ethics of regulation of new technologies.