Complementary Social Sanctions and Enforcement
Social sanctions and enforcement as negative motivations to complement the force of public moral norms
WHAT IS IT?
This principle means that SHG may employ monitoring and sanction mechanisms when actors do not fulfill the responsibilities that they voluntarily committed themselves to. SHG values voluntary commitment, but it does not condone exploitation of health agencies towards short-term narrow self-interest in the homo economicus capacity. The privilege of voluntary cooperation comes with the responsible use of one’s health agency. Once actors commit to the collective endeavor of health capability for all, they may not opt out for illegitimate reasons. For example, organizations cannot idiosyncratically change public health intervention agreed under SHG to a treatment of a specific disease that serves their goals better. SHG retains the use of negative motivations, such as monitoring, sanctions, or punishments if actors neglect what they voluntarily consented to. Free-rider and non-compliance are omnipresent in health and health care. When actors do not fulfill their collectively established responsibility, SHG employs negative motivations to secure compliance.
WHY IS IT IMPORTANT?
Shared values, principles and norms, and common goals in SHG have normative power; backed by substantive and procedural legitimacy, they attach morally obligated actions to each responsible actor. Even though SHG is morally grounded and legitimate for all involved actors, individuals and groups may not cooperate immediately – for example, some people may remain skeptical about whether the endeavor is realistically feasible and hesitate to cooperate. In those cases, external and negative monitoring and sanctions may be helpful.
WHAT DOES IT LOOK LIKE?
SHG envisions various modes of compliance and enforcement. The overarching principle is voluntary compliance rising from common values, shared norms, and substantive and procedural legitimacy. However, as needed, SHG appeals to actors' positive motivation (persuasion, incentives), but also allows negative motivations (monitoring, sanctions, punishments), such as the threat of intervention. For example, the global community may intervene in national affairs if a country does not follow what it has committed to and if the intervention respects the country’s legitimate self-determination and self-governance.
HOW DO WE DO IT?
Sanctions and enforcement play complementary roles to positive, voluntary motivation in SHG. While social sanctions and enforcement are not primary tools for cooperation, they are exerted when more central SHG measures are ineffective. Consequently, sanctions and enforcement presuppose that normative governance and major SHG institutions with legitimate authority have been established. Given such conditions, central institutions may exercise their legitimate authority with enforcement and sanctions.