Bioethics commentary in an article entitled “Toward Improved Understanding of the Ethical and Clinical Issues Surrounding Mandatory Research Biopsies”, published in the January 1, 2013 issue of the Journal of Clinical Oncology, reinforces the truth that imprecise language muddles the minds and, consequently, the pronouncements of the intelligentsia in every human profession. Though the author of the aforementioned essay presumably believes the contentious issue he — Jeffrey Peppercorn, MD MPH at Duke University Medical Center in Durham, North Carolina — illuminates is the ethical status of mandatory versus optional research biopsies, the actual controversy concerns the use of equivocation by the opponents of mandatory research biopsies. This error, a notorious logical fallacy, is strangely common in non-libertarian and libertarian circles and is the root of much philosophical mischief.

 

What is equivocation? Wikipedia defines equivocation as “the misleading use of a term with more than one meaning or sense (by glossing over which meaning is intended at a particular time)”. The offending passage in this bioethical example of equivocation occurs in the third paragraph of the article:

“Opponents of mandatory research biopsies do not dispute the need for research biopsies in some settings. However, they argue that linking consent to a biopsy to trial participation is at minimum unfair, and at worst coercive. Access to promising, if unproven, experimental therapy within a trial is viewed by many as an important component of quality cancer care. It is clear that patients in some settings feel that they will be harmed, through loss of access to the experimental intervention, if they fail to pursue trial care. This arguably creates a sense of coercion that violates the principle of voluntarily informed consent to the research biopsy.”

 

In this excerpt, the author lists an argument (used by the opponents of mandatory research biopsies) that exhibits equivocation by cleverly equating two different senses of the word coercion. Logical evaluation of this allegation must begin with a precise definition. What does the word coercion mean? Dictionary.com lists the following three definitions of coercion:

  • the act of coercing,
  • use of force or intimidation to obtain compliance, and
  • force or the power to use force in gaining compliance as by a government or police force.

 

With these versions of the definition of the term coercion in mind, do the opponents of mandatory research biopsies engage in equivocation in this instance? The answer is yes. They initially use the word coercion in a context (“linking consent to a biopsy to trial participation is at minimum unfair, and at worst coercive”) consistent with the second portion of the second version of its definition — use of intimidation to obtain compliance — which is not a form of aggression. Then, they use the word coercion in a context (“arguably creates a sense of coercion that violates the principle of voluntarily informed consent to the research biopsy”) consistent with the first portion of the second version of its definition — use of force to obtain compliance — which is a form of aggression. Thus, they link two different versions of the definition of the word coercion, thereby equating non-aggression and aggression, which is a contradiction of absurd proportions.

 

The purpose of this equivocation appears to be an attempt to manipulate the emotions of readers in the hope that they will be persuaded to join the opposition to mandatory research biopsies. This tactic fails. Libertarian readers note the logical fallacy and dismiss any conclusion derived from the false premise.

 

Equivocation and coercion are further discussed by Stephan Kinsella in his 2011 Mises Academy “Libertarian Controversies” course. Other terms prone to equivocation, specifically by libertarians, include government, aggression, state, justice, property, self and scarcity. Precise language is the antidote to equivocation irrespective of the perpetrator’s ideology.

 

In conclusion, all versions of coercion are not equal, irrespective of the assertions of the opponents of mandatory research biopsies. Equivocation, misleading the reader by ambiguously switching back and forth between the different senses of a word with multiple meanings, is a fallacy that should be avoided by all those interested in logical argumentation. This error is particularly harmful when it creeps into the theory and practice of liberty, for its use can lead to support of rather than opposition to aggression.