Topics in Moral and Political Philosophy Paternalism

Justifications for restricting liberty Harm Principle: it is permissible to interfere with someone’s liberty in order to prevent harm to someone else. Offense principle: it is permissible to interfere with someone’s liberty in order to prevent offense to others. Paternalism: it is permissible to interfere with someone’s liberty in order to protect her from harm or to make her better off. Moralism: it is permissible to interfere with someone’s liberty in order to ensure that she acts morally.

Paternalism “It is permissible to interfere with X’s liberty, against X’s will, in order to make X better off or protect X from harm.”

Governmental forms Pension system Helmets Drugs Consent to assault Unenforceability of certain contracts Civilly committing people who are a danger to themselves Blood transfusion Euthanasia

Non-governmental forms Should doctors always tell the truth about their patients’ medical conditions? Should physicians always tell the truth about how much someone suffered before dying? May a husband hide the sleeping pills from his depressed wife? May philosophy department require students to take logic courses?

OVERDETERMINATION When these policies are justified solely on the grounds that the person affected would be better off as a result of the policy, but the person in question would prefer not to be subject to them, they constitute a form paternalism.

3 components X acts paternalistically towards Y by doing T when: 1.T interferes with the liberty or autonomy of Y 2.X does T without the consent of Y 3.X does T only because T will improve the welfare (or promote the interests) of Y

Strong vs weak paternalism Strong paternalism: it is legitimate to prevent people from achieving ends that are mistaken or irrational (e.g. preferring the wind rustling through my hair to my safety). Weak paternalist: it is legitimate to interfere with the means agents choose to achieve their ends, if those means are likely to defeat those ends. We may interfere with mistakes about the facts but not mistakes about values. “What’s your reason to jump out of the window?”

Paternalism and consent What are the cases in which paternalism seems more easily justifiable? What do they tell us? “Future-oriented consent”: although children do not welcome their parents’ intervention now, they will in the future. “Parental paternalism may be thought of as a wager by the parent on the child’s subsequent recognition of the wisdom of the restriction” (Gerald Dworkin).

Future-oriented consent Can we extend this idea to adults? Problems: Is it plausible to say that we consent to everything we subsequently come to welcome? “future-oriented consent” does not tell us much ex ante about when and how we can justifiably interfere. Which future moment should we privilege? What if the person who is interfered with never comes to accept the intervention simply because the person is stubborn or stupid?

Hypothetical consent Paternalistic interference is justified if fully rational agents would consent to it. Example: health or security seem to be goods that any person would want in order to pursue what they value, no matter what it is that they ultimately value. ↓ We would consent to paternalistic interference, at least when it is not too onerous, in order to have access to these goods.

Problems with hypothetical consent We often disagree as to the value to be attached to competing values. Example: for a Jehovah’s Witness it might be more important to avoid “impure substances” than to survive. Can we simply rule out her position as irrational?

3 types of cases 1.Cases in which we reasonably disagree as to the importance of competing values (Jeovah’s Witness) 2.Cases in which we attach incorrect weights to some of our values (seatbelts vs security) 3.Cases in which we fail to act in accordance to our preferences and desires.

Weak paternalism Are we really “imposing a good” on someone else in 3? Or is the good one that the person has chosen for herself? Mill’s bridge example. “Cocktail”: imagine you are about to drink a cocktail and I know that you are seriously allergic to one of the components. Can I justifiably prevent you? Why?

Stronger paternalism Consider 2): What does it mean that you are attaching an incorrect weight to the inconvenience of fastening your seatbelt? Doesn’t it mean that we can assume that if you were to be involved in a serious accident you would look back and agree that you were misjudging the inconvenience of not wearing seatbelts? What about 1)?

Paternalism and autonomy Do Paternalism and Autonomy necessarily conflict? Raz: “persons are autonomous when they are author of their own lives” Some restrictions on liberty improve our opportunities to be authors of our own lives because they enhance the “conditions of autonomy”. ↓ Valuing autonomy give us reasons to enact a paternalistic law