From Social Justice to Coercive Virtue

Several years ago, I wrote about the confusion that arises when occupational therapy conflates charity with social justice and about the subtle but important shift from the Social Gospel tradition toward a politicized discourse of redistribution and equity 

At the time, some dismissed these concerns as overly semantic. But the receipts are there: once you build “social justice” into the profession's Code of Ethics, you’re no longer talking about voluntary altruism. You’re talking about mandatory redistribution.

And now, as discussion emerges on academic listservs about the decline of student volunteerism, some are discovering that not all students are enthusiastic about forced redistribution. So, what’s the next move?

You start mandating volunteerism.

Think about that for a moment. Mandatory volunteerism.

That phrase itself is a contradiction so sharp it should stop us in our tracks.

  • If the goal is charity, it cannot be compelled because coerced charity is not charity.

  • If the goal is justice, forced gestures like service hours don’t restructure inequitable systems. They just create resentment.

  • If the goal is professional formation, we already have fieldwork and capstones designed for authentic, reciprocal engagement. Adding “mandatory altruism” on top of that confuses the categories and cheapens the outcome.

What’s left is neither charity nor justice. It is a morally bankrupt workaround: coercion dressed up as virtue.

And this is what happens when you push political language into places it doesn’t belong. The profession wanted to look “justice-oriented.” But instead of building consensus or creating structural reforms, it manufactured compliance. The result is a hollow exercise that undermines the values it claims to uphold.

I warned about this ten years ago. The “mandatory volunteerism” conversation now surfacing is exactly the predictable outcome. In 2020 there was a failed RA motion for 'Civility Pledges.' Now there is discussion about 'Mandatory Volunteerism.'

These are all attempts at what I call coercive virtue. On paper they look benign, but they actually become blunt instruments of ideological conformity that attempt to prescribe kindness but in actuality only serve to force an adherence to curated norms.

None of these efforts fosters free generosity. They suppress dissent, throttle dialogue, and manufacture superficial consensus around so-called 'values.'

A profession can't resort to compulsion to salvage a failed moral narrative - or worse - a preferred ideology. History is replete with the impacts of systems that included compulsory service or engagement mandates. We have the Civilian Conservation Corp and the Selective Service.  While these two programs achieved some societal goals, their coercive elements eroded autonomy and led to unintended outcomes. These were well-meaning programs and I am not arguing that the outcomes are equivalent in comparison to the OT example, but the point is that these methods tend to erode autonomy and can lead to unintended systemic outcomes.

In the case of OT, social justice requirements may be responsible for disengagement and pressures for ideological conformity. That leaves us with students checking boxes to meet requirements and stifling what might otherwise be diverse ethical perspectives.

While mandatory volunteerism might expose students to diverse populations, these benefits can be achieved through voluntary fieldwork, and that can be fostered without sacrificing autonomy.

I said this would happen - call it a civility pledge, or call it mandatory volunteerism... it is all the same thing - coercive virtue.

And coercive virtue is not virtue at all.

It used to be that when students were asked in interviews why they wanted to be nurses, OTs, or PTs, the answer was almost quaint in its simplicity: “I want to help people.”

Maybe that answer was trite, but maybe it was also true... and maybe it was better.

When we replace that freely chosen impulse with compulsion models and mandatory altruism, we don’t elevate professional values. We hollow them out. We stop forming health professionals who help because they want to, and instead create graduates who help because they have to.

That shift doesn’t just weaken occupational therapy. It corrodes the moral core of all health professions.

Comments

Post a Comment

Popular posts from this blog

Reflecting on the AOTA Code of Ethics: A 2025 Crossroads

Image
In light of the proposed 2025 revisions to the AOTA Code of Ethics, I feel compelled to respond—not just as a practitioner and educator, but as someone who has been observing and writing about the profession’s ethical evolution for over a decade. This post reflects on concerns raised in the new draft and situates them in a broader historical context drawn from earlier critiques I published in 2011, 2013, 2014, and 2015. When Ethics Become Ideology The proposed 2025 Code of Ethics contains well-meaning language that reflects cultural currents around equity, inclusion, and advocacy. However, the revised document appears to shift the Code away from its core purpose—guiding ethical behavior—and toward promoting a specific ideological framework. It contains language and assumptions that may unintentionally alienate practitioners, obscure clarity in enforcement, and conflate professional conduct with political conformity. A Critical Logic Problem The most serious concern is the...
Read more

On retained primitive reflexes

Each year I receive several emails from colleagues about 'retained primitive reflexes.'  I am also seeing an increased number of reports from local 'health care' providers who are documenting these alleged problems so I thought I would write a summary of my opinion on this topic.   Predatory 'health care' providers including some OTs, PTs, chiropractors, and behavioral optometrists are creating a new 'market' for treating this alleged 'problem.'  Parents should be very wary of these practitioners and other professionals should challenge these practices whenever they are seen. The following is the kind of information that causes concern and was provided to me by a colleague as a sample from a student's IEP: The student continues to demonstrate the following retained primitive reflexes that at times interfere with his ability to demonstrate appropriate adaptive responses: Fear Paralysis Reflex, Moro Reflex, Palmer Reflex, Tonic Labyri...
Read more

The Ant Mill of Occupational Therapy: A Profession Trapped in Its Own Spiral

Image
Being in program development mode has given me both the time and headspace to think more deeply about some of the broader dynamics shaping our profession. The release of AOTA’s newly published Vision Statement and the proposed changes to the Code of Ethics have provided a catalyst for deeper reflection. Ethics in occupational therapy can feel distant or overly academic—something shaped by committees and frameworks rather than day-to-day practice. I’m someone who has worn both hats—a street-level OT who’s spent too much time in academia—and that gives me a particular vantage point for reflecting on where we’ve been and where we might be headed. I’m writing this for the lunch-bucket practitioners out there—the ones grounded in clinical realities—who have sensed that something in our professional dialogue feels increasingly unfamiliar or prescribed. But I think we need to bring these conversations down to earth. We need to pull chairs into a circle, metaphorically speaking, and talk thr...
Read more