Sometimes people have to do unpleasant things for the good of others or themselves. Mathilda obviously does not want to be examined by a doctor, and so she has lied to her parents, saying she does not have a sore throat. The doctor, in turn, does not begin the story wanting to force the examination on Mathilda. He repeatedly requests her cooperation, to no avail. However, as a medical professional, he knows the risks of allowing Mathilda’s illness to go untreated, and so he commits himself to doing whatever is necessary to complete the examinations. Even Mathilda’s parents, who obviously do not wish to hurt her, must commit to aiding the examination: if the choice is between forcing their daughter’s mouth open or watching her die of diphtheria, they will do what is necessary to save her life.

The story asks readers to question the consequences of committing a necessary evil. While it would be easy to derive a sense of validation from knowing that the doctor acted on behalf of both Mathilda and the broader public’s well-being, Williams reminds readers that things are rarely so simple. Though the adults ultimately prevail and successfully complete the exam, the doctor experiences a sense of “adult shame,” and Mathilda is left crying and furious in her defeat. The ending is not a victorious moment for anyone involved and is instead a concession to the damages wrought in pursuit of the greater good.

“The Use of Force” can be read as a character study focused on the effects of force from the perspective of the one using it. Over the course of the story, the doctor devolves from a rational, upstanding individual into a primal, violent attacker who takes pleasure in the control he has over a child. He becomes almost animalistic in his fervor, remarking that he “could have torn the child apart” and enjoyed it. The use of force seems to bring out an almost bestial side in the user, overpowering a person’s more logical thought processes in favor of pure, uninhibited instinct.

Mathilda’s actions further support this conclusion. As a child, she has not yet been fully indoctrinated into the world of adult rationality and decorum. It is therefore easier for her to attack the doctor on sight and emit “wild hysterical shrieks,” falling victim to her more animalistic instincts in the face of fear and uncertainty. That the confrontation is figured as a “battle” between the doctor and Mathilda suggests that violence and conflict is humanity’s natural state. Though people pretend otherwise, the primal instinct toward the use of force is always lurking beneath the surface of respectability, and once force is used, such instincts cannot be suppressed until the battle is won.

Informed consent has long been a source of debate, especially in the field of medical ethics. The right of patients to make decisions about their bodies and the treatment they receive is an acknowledgment of individual autonomy. However, in the case of Mathilda, her resistance to receiving treatment is—at least from the rational, adult perspective—at odds with her own well-being. Furthermore, as a child, she is incapable of understanding the broader implications of her illness, both for herself and for those she may come into contact with. Indeed, the doctor remarks that “others must be protected against [Mathilda]” because diphtheria is highly contagious. From his perspective, the danger that Mathilda poses to society and herself is enough to waive her right to consent.

However, the violence with which the doctor conducts the examination calls into question his true motivations....