“Mutual” obligation in Indigenous health: can shared responsibility agreements be truly mutual?

Mutual obligation and Indigenous health: thinking through incentives and obligations

“…I note with interest recent articles by Collard and colleagues 2 and by Kowal, 3 debating “shared responsibility agreements”. The expressions “shared responsibility agreement” 3 and “mutual obligation” are variations of the expression “social contract”.…”

Implications of land rights reform for Indigenous health

“…For example, in 1998 the Jawoyn people withdrew a native claim in exchange for an alcohol rehabilitation centre and two renal dialysis machines 21 . Eight years ago, such agreements were rare, but with the proliferation of shared responsibility agreements, 22 it is possible that in the future Indigenous groups will be forced to choose between access to medical treatment and control over their traditional lands.…”

Mutual obligation and Indigenous health: thinking through incentives and obligations

“…This is the key issue for Collard and colleagues, 3 and others for whom community autonomy and self‐determination are central concerns. They suggest that the Mulan community was not “well placed to judge whether the benefit they will get from a petrol bowser will be worth the ‘price’ they have agreed to pay”, 3 implying an element of exploitation or coercion in the government's approach. The proponents of the agreements, however, argue they enhance community autonomy by allowing the community to deal directly with government, rather than through intermediaries in multiple bureaucracies 9…”

“…The near‐silence of health commentators on this issue was, thankfully, broken last year by Collard and colleagues in this Journal 3 . These authors questioned the morality of the government in placing conditions on the provision of basic rights to Indigenous communities.…”