The coercion of care: Compulsory connectivity in assistive communication

Assistive communication expands autonomy, participation and social life. Under particular conditions, the capacity to communicate becomes a duty to remain available. I describe this configuration as compulsory connectivity. It arises when mediated output functions as evidence of presence, nonresponse attracts an adverse default and refusal threatens care, support or recognition. Advanced amyotrophic lateral sclerosis and locked-in syndrome provide the central case because augmentative and alternative communication may enable speech, environmental control, relationships and access to care. Bringing disability media studies into conversation with deep mediatisation and digital disconnection, the essay identifies three mechanisms: the labour of legibility, recursive interpretation in care and divergence between technical and relational states. Together they make output perform presence and render silence legible as loss. The normative alternative is protected ambient presence: social recognition without continuous communicative production. A two-layer protocol gives that principle operational form: communication status distinguishes engagement from recognised withdrawal, while an independently governed safety channel preserves agreed clinical safeguards. Smartphone messaging isolates availability pressures under weaker dependence; brain–computer interfaces provide a prospective test of the boundary between detectable neural activity, communicative intent and consent. Accessibility becomes emancipatory when control extends beyond how a person communicates to whether communication is owed.