Human behaviour and the ethics of coercion.

There is an assumption that legislation against unhealthy behaviour would be unethical, or at best unenforceable and counterproductive. However, the ethics of coercion depend on the manner in which such coercion is introduced, the essential precondition being wide, favourable community consensus. Two recent Australian examples have been the Victorian seat-belt legislation and the Tasmanian hydatid campaign. Hydatid control in Tasmania began with a voluntary campaign in the farming community which led to a popular demand for government intervention. In response to community pressure, the State Department of Agriculture introduced control measures with a stepwise increase in coercion that began with a voluntary dog-testing programme, and proceeded to a compulsory test and later to the quarantine of infected dogs. Ultimately, quarantine was extended to premises with a higher-than-average residual prevalence in sheep. Today, hydatid disease has almost disappeared in livestock. As no new human case of hydatid disease has been diagnosed in a person of under 10 years of age since 1972, or in one of under 20 years of age since 1976, human infection probably ceased by 1972. Legislation today could control the composition of processed food (for example, the salt content), or establish compulsory testing for human immunodeficiency virus antibodies. The necessary consensus could be the specific objective of health education during a voluntary phase.