When Push Comes to Shove: Social Justice and Involuntary Confinement

Involuntary confinement has a long jurisprudential history. It is most often discussed in the context of either severe mental illness, or contagious diseases. Over the past couple of decades, it has been used in other areas, such as for pregnant women who use drugs, alcohol, or even tobacco. This paper develops a cohesive understanding of the legal requirements for involuntary confinement across the various applications, and also examines the theoretical framework that supports the use of state coercive power in different contexts. For example, one underexplored issue is interplay between restrictions on liberty and impositions on privacy. Alternatives to involuntary commitment (a restriction on liberty), often involve limitations on privacy, such as directly observed therapy. How do we balance protection liberty against protection of privacy? Another important concern is the role of informed consent, and the distinction between forced confinement and forced treatment. How does the right to refuse treatment function in a public health context? Finally, the definitions of “illness”, “risk”, and “harm” vary considerably depending on whether the situation is public safety (mental illness), public health (contagious disease), or procreative liberty (pregnant women). Among other issues, I'll consider the social justice implications of involuntary confinement in a variety of settings, as it has been unevenly applied to different racial and ethnic groups.