Many believe that paternalism is less wrong in intimate relationships. In this paper, we argue that this view cannot be justified by appeal to (i) beneficence, (ii) shared projects, (iii) vulnerability, (iv) epistemic access, (v) expressivism, or (vi) autonomy as nonalienation. We finally provide an error theory for why many may have believed that paternalism is less wrong in intimate relations.

ABSTRACT I motivate ‘Origin Conventionalism’—the view that which facts about one’s origins are essential to one’s existence depends partly on our person-directed attitudes. One important upshot is that the view offers a novel and attractive solution to the Nonidentity Problem. That problem typically assumes that the sperm-egg pair from which a person originates is essential to that person’s existence; in which case, for many future persons that come into existence under adverse conditions, had those conditions not been realized, the individuals (...) wouldn’t have existed. This is problematic because it delivers the counter-intuitive conclusion that it’s not wrong to bring about such adverse conditions since they don’t harm anyone. Origin Conventionalism, in contrast, holds that whether a person’s sperm-egg origin is essential to their existence depends on their person-directed attitudes. I argue that this provides a unique and attractive way of preserving the intuition that the actions in the ‘nonidentity cases’ are morally wrong because of the potential harm done to the individuals in question. (shrink)

Formal views of autonomy rule out substantive rational capacities (reasons-responsiveness) as a condition of autonomous agency. I argue that such views face a number of underappreciated problems: they have trouble making sense of how autonomous agents could be robustly responsible for their choices, face the burden of explaining why there should be a stark distinction between the importance of factual and evaluative information within autonomous agency, and leave it mysterious why autonomy is the sort of thing that has value and (...) ought to be promoted. Moreover, I argue that the alternative view that includes substantive rational capacities need not have the unacceptable political implications it is sometimes thought to have. (shrink)

In many or most instances of paternalism, more than one person acts paternalistically, or more than one person is treated paternalistically. This chapter discusses some complications that arise in such group cases, which are largely ignored in the conceptual debate. First, a group of people who together perform an action may do so for different reasons, which makes it more challenging to determine whether the action is paternalistic. This gives us some reason not to pin the property of being paternalistic (...) on actions, since we may alternatively pin it on reasons for actions and allow that these differ between members in the group. Second, the prevention of harmful consensual interactions is sometimes paternalism towards both or all involved, but only if all benefit from interference with themselves rather than with other members in the group, or if all want the harm or risk (more or less) for its own sake. Third, interrelations between three components of paternalism - interference, benevolence and consent - gives us reason to allow that an action can be paternalistic towards some but not others of those affected. This makes it even more difficult, and less relevant, to determine whether or not actions are paternalistic. (shrink)

If D commits a wrong against V, D typically incurs a corrective duty to V. But how should we respond if V has false beliefs about whether she is harmed by D’s wrong? There are two types of cases we must consider: those in which V is not harmed but she mistakenly believes that she is those in which V is harmed but she mistakenly believes that she is not. I canvass three views: The Objective View, The Subjective View and (...) The Mixed View. The Objective View holds that V’s claim depends on the correct account of harm, rather than her false beliefs, and so D has a duty to offer damages to V in but not in in order to compensate her. The Subjective View holds that, for broadly anti-perfectionist reasons, V’s claim depends on her sincere beliefs, even if they are mistaken, and so D has a duty to compensate V in but not in. The Mixed View holds that we should defer to her beliefs in but not in, so D has a duty to compensate her in both cases. In this article, I argue that we should accept The Mixed View. (shrink)

The unconscionability doctrine in contract law enables a court to decline to enforce a contract whose terms are seriously one-sided, exploitative, or otherwise manifestly unfair. It is often criticized for being paternalist. The essay argues that the characterization of unconscionability doctrine as paternalist reflects common but misleading thought about paternalism and obscures more important issues about autonomy and social connection. The defense responds to another criticism: that unconscionability doctrine is an inappropriate, because economically inefficient, egalitarian tool. The final part discusses (...) more interesting but neglected questions about the scope of accommodation necessary to support fully meaningful autonomous activity. (shrink)

The notion of a non-renounceable right is an integral part of recent liberal reconciliatory attempts to justify apparently paternalistic policies, such as compulsory insurance or providing people with certain goods irrespective of their subjective preferences, non-paternalistically. However, non-renounceable rights cannot be justified non-paternalistically. A critical scrutiny of the liberal reconciliatory arguments in question reveals this and points towards a plausible paternalist justification of the policies in question.

I first distinguish four types of objection to paternalism and argue that only one – the principled objection – amounts to a substantive and distinct normative doctrine. I then argue that this doctrine should be understood as preventing certain facts from playing the role of reasons they would otherwise play. I explain how this filter approach makes antipaternalism independent of several philosophical controversies: On the role reasons play, on what reasons there are, and on how reasons are related to values. (...) I go on to contrast the filter approach with the competing and dominant action-focused approach, which understands objections to paternalism in terms of paternalistic action, behavior, law, policy and the like. Seana Shiffrin and Peter de Marneffe are singled out as prominent recent proponents of this approach. By engaging with their definitions of paternalism, I explain how the action-focused approach makes antipaternalism dependent on the sorting of actions into paternalistic and nonpaternalistic according to what reasons support them. Because one and the same action can be supported by many different reasons, and by different sorts of reasons, such sorting is very difficult. The upshot is that antipaternalism on the action-focused account fails to provide the precise normative implications of the filter approach that I favor. (shrink)

This paper argues that epistemic smothering is not a form of epistemic paternalism. In this sense, it refutes the claim recently made by Valerie Chock and Jonathan Matheson, who defend epistemic smothering as epistemically permissible form of epistemic paternalism. After an outline of what is meant by epistemic paternalism and epistemic smothering, based on the work by Kristoffer Ahlstrom-Vij and Kristie Dotson on these topics, the paper argues against the identification of epistemic smothering as a form of epistemic paternalism. In (...) the conclusion, it also calls for a reconsideration of how exactly to conceive of epistemic paternalism. (shrink)

This thesis concerns the measurement of freedom, and its value. Specifically, I am concerned with three overarching questions. First, can we measure the extent of an individual’s freedom? It had better be that we can, otherwise much ordinary and intuitive talk that we would like to vindicate – say, about free persons being freer than slaves – will turn out to be false or meaningless. Second, in what ways is freedom valuable, and how is this value measured? It matters, for (...) example, whether freedom is valuable only insofar as it enables us to pursue specific ends we happen to value for independent reasons, or whether it is also valuable in itself. In the latter case, but not the former, more freedom will always be better. Likewise, it’s important to get clarity on what ends, exactly, freedom is especially instrumentally valuable in promoting, since this goes to how much we should care about it. And finally, the liberal political tradition asserts that there is a special sphere of personal choices within which individuals should be free to do as they please, for reasons over and above the value of freedom itself. Now, can we measure the extent to which states and individuals respect individual liberties, and can we weigh the importance of respecting liberty against competing values like social welfare? To answer these questions, I follow the axiomatic tradition of social choice theory, and I develop several novel measures of freedom – including the first measure of freedom ever proposed that is sensitive to how modally robustly our options are available – a novel approach to measuring the diversity of an opportunity set, and I develop an account of the value of freedom according to which an important part of why freedom matters is that it enables us to improve our preferences through learning, and I construct ways of measuring the value of freedom along this dimension of value. Finally, in later chapters, I provide a representation result for a measure of illiberalism, i.e. of the degree to which states fail to respect the rights of their citizens, and I extend this result to provide a characterization of moral theories that express concern for respecting the rights of others. The final chapter closes by discussing how this concern may be weighed against concerns for social welfare. (shrink)

Paternalistic behaviour directed towards a person’s informed and competent decisions is often thought to be morally impermissible. This view is supported by what we can call the Anti-Paternalism Principle. While APP might seem plausible when employed to show the wrongness of paternalism by the state, there are some cases of paternalistic behaviour between private, informed, and competent individuals where APP seems mistaken. This raises a difficulty for supporters of APP. Either they need to reject APP to accommodate our intuitions in (...) these cases, or provide grounds for thinking that paternalistic behaviour between certain private individuals is different in a morally relevant sense. In this paper, I explore several possible morally relevant differences, and find all of them unsatisfactory as grounds for maintaining the plausibility of APP. (shrink)

The traditional liberal view on conflicts between care for wellbeing and respect for choice and desire is that we should look to degrees of competence and voluntariness to determine which moral imperative should take priority. This view has likely influenced the common view that children’s choices should be considered only to the extent that this promotes their future autonomy and helps us determine their best interests. I reject both the general traditional liberal view and its application to children. Competence and (...) voluntariness, as well as maturity, are at best proxies for what really matters, which is wellbeing, choice and desire. We typically have reason to respect children’s choices, irrespective of any further positive consequences. If we should more often make children do what they do not want to do, this is mainly because, though we should care about respecting their choices, we should care even more about their wellbeing and future autonomy. (shrink)

I argue that libertarian paternalism is in fact paternalism, or hard paternalism, rather than a form of soft paternalism. I do so on the basis of an analysis of the paternalist act according to which the paternalist act needn’t violate the will of the agent who is the target of that act and the paternalist actor need only suspect that her action may improve the welfare of that target. The paper considers and rejects interpretations of libertarian paternalism as soft paternalism. (...) I then provide an outline as to how libertarian paternalism may be reformed in light of the finding that current libertarian paternalism is hard paternalism. The proposal is to require that the enactment of libertarian paternalist policies be conditional on opinion polling indicating support for those policies from the agents they target. (shrink)

Mill’s harm principle is commonly supposed to rest on a distinction between self-regarding conduct, which is not liable to interference, and other-regarding conduct, which is. As critics have noted, this distinction is difficult to draw. Furthermore, some of Mill’s own applications of the principle, such as his forbidding of slavery contracts, do not appear to fit with it. This article proposes that the self-regarding/other-regarding distinction is not in fact fundamental to Mill’s harm principle. The sphere of protected liberty includes not (...) only self-regarding conduct, but also actions that affect only consenting others. On the other hand, the occasional permissibility of interfering with self-regarding conduct can plausibly be explained by reference to the agent’s consent. Thus, the more important distinction appears to be that between consensual and non-consensual harm, rather than that between the self-regarding and non-self-regarding action. That is, interference can be justified in order to prevent non-consensual harms, but not to prevent consensual harms. It is argued that the harm principle, thus reformulated, both captures Mill’s intentions and is a substantively plausible position. (shrink)

Freedom is one of the central values in political and moral philosophy. A number of theorists hold that freedom should either be the only or at least one of the central distribuenda in our theories of distributive justice. Moreover, many follow Mill and hold that a concern for personal freedom should guide, and limit, how paternalist public policy can be. For the most part, theorists have focussed on a person’s freedom at one specific point in time but have failed to (...) give proper attention to freedom across time. Given that we care about personal freedom now, we have reason to care about future freedom too. But what kind of distribution of freedom across a person’s lifetime should we promote as a matter of legislation and public policy? I argue that none of the candidate principles for the distribution of freedom across time is plausible. Neither a starting gate view, nor a maximisation nor a sufficientarian view is satisfactory, because none adequately reflects our various reasons to value freedom. I show that this result presents a tough challenge for theories of distributive justice and paternalism that set great store by personal freedom. (shrink)

Rawls’ The Law of Peoples does not offer a clear principled account of the way in which liberal and decent peoples should deal with benevolent absolutisms. Within the Rawlsian framework, benevolent absolutisms are a type of society that respects basic human rights and is not externally aggressive. Rawls rules out the use of coercion to engage with benevolent absolutisms but does not provide an alternative strategy. The article develops one, namely, it argues that liberal and decent peoples should use positive (...) incentives to induce benevolent absolutisms to make their transition to the status of well-ordered peoples. In so doing, it offers a principled way to expand Rawls’ international nonideal theory and, in the process, provides a more nuanced approach to the promotion of political participation in international society. The article draws on the literature on economic statecraft and political theory and constructs an incentive model with seven distinct parameters attached to its definition of incentives. Finally, the article provides a real-world example, of how to concretely implement the incentive mechanism. (shrink)

In liberal moral theory, interfering with someone’s deliberate engagement in a self-harming practice in order to promote their own good is often considered wrongfully paternalistic. But what if self-harming decisions are the product of an oppressive social context that imposes harmful norms on certain individuals, such as, arguably, in the case of cosmetic breast surgery? Clare Chambers suggests that such scenarios can mandate state interference in the form of prohibition. I argue that, unlike conventional measures, Chambers’ proposal recognises that harmful, (...) discriminatory norms entail a twofold collective moral obligation: to eliminate the harmful norm in the long run, but also to address unjust harm that is inflicted in the meantime. I show that these two obligations tend to pull in opposite directions, thus generating a serious tension in Chambers’ proposal which eventually leads to an undue compromising of the second obligation in favour of the first. Based on this discussion, I develop an alternative proposal which, instead of prohibiting breast implant surgery, offers compensation for the disadvantages suffered by individuals who decide not to have surgery. (shrink)

Ordinary Language Philosophy has largely fallen out of favour, and with it the belief in the primary importance of analyses of ordinary language for philosophical purposes. Still, in their various endeavours, philosophers not only from analytic but also from other backgrounds refer to the use and meaning of terms of interest in ordinary parlance. In doing so, they most commonly appeal to their own linguistic intuitions. Often, the appeal to individual intuitions is supplemented by reference to dictionaries. In recent times, (...) Internet search engine queries for expressions of interest have become quite popular. Apparently, philosophers attempt to surpass the limits of their own linguistic intuitions by appealing to experts or to factual uses of language. I argue that this attempt is commendable but that its execution is wanting. Instead of appealing to dictionaries or Internet queries, philosophers should employ computer-based linguistic corpora in order to confirm or falsify hypotheses about the factual use of language. This approach also has some advantages over methods employed by experimental philosophers. If the importance of ordinary language is stressed, the use of linguistic corpora is hardly avoidable. (shrink)

In this paper I look at various ways that interpersonal and social relations can be seen as required for autonomy. I then consider cases where those dynamics might play out or not in potentially paternalistic situations. In particular, I consider cases of especially vulnerable persons who are attempting to reconstruct a sense of practical identity required for their autonomy and need the potential paternalist’s aid in doing so. I then draw out the implications for standard liberal principles of paternalism, specifically (...) in clinical or therapeutic situations. The picture of potential paternalism that emerges here is much more of a dynamic, interpersonal scenario rather than a case of two separate individuals making decisions independent of each other. (shrink)

In general, we think that when it comes to the good of another, we respect that person’s will by acting in accordance with what he wills because he wills it. I argue that this is not necessarily true. When it comes to the good of another person, it is possible to disrespect that person’s will while acting in accordance with what he wills because he wills it. Seeing how this is so, I argue, enables us to clarify the distinct roles (...) that the wills of competent and incompetent people should play in third-party deliberations about their welfare. (shrink)

I make the case that what gets called epistemic paternalism isn’t correctly labelled as such. This mislabelling is problematic for two reasons. First, paternalism in general faces strong challenges to its permissibility. Second, the scope for action of epistemic paternalism is somewhat narrow given the typical concerns of applied epistemology. Having clarified epistemic paternalism and discussed the above considerations, this paper introduces epistemic benevolence. The case is made that the epistemic benevolence-based approach can avoid some of the strong challenges that (...) epistemic paternalism faces and is often more suitable for the concerns of applied epistemology than a paternalist approach. To make these points, first, I make the case for a particular analysis of the epistemic paternalist act and, second, I explain epistemically benevolent acts as acts motivated by a concern for the epistemic welfare of another agent or agents. Given this characterisation, I argue that epistemic benevolence includes epistemic paternalism but extends beyond epistemic paternalism. I consider an objection to epistemic benevolence, which motivates laissez faire epistemic liberalism, a rival theoretical approach. Outlining this alternative serves to provide a further theoretical option relevant for work in applied epistemology. I offer some considerations as to why epistemic benevolence approach should still be favoured. (shrink)

Supporters of paternalistic policies argue that interference with risky or dangerous choices for citizens’ own good is permissible, as long as those choices are caused by cognitive irrationality or ignorance. Yet, some liberal thinkers argue that despite human irrationality, paternalistic policies are still wrong because they fail to respect citizens as moral equals. I argue that actually both views are mistaken about what respect for citizens requires, because they conceptualize the citizens’ interests from the wrong standpoint. In order for citizens (...) to be respected as equals, I argue that citizens’ interests must be defined from a joint (second-person) standpoint which is constructed through a dialogical process between policymakers and citizens oriented towards mutual understanding. Furthermore, I argue that engaging citizens in such a dialogue is a distinctive paternalistic intervention in its own right, which unlike other kinds of paternalistic intervention, is compatible with respect for citizens as equals. (shrink)

Supporters of paternalistic policies argue that interference with risky or dangerous choices for citizens’ own good is permissible, as long as those choices are caused by cognitive irrationality or ignorance. Yet, some liberal thinkers argue that despite human irrationality, paternalistic policies are still wrong because they fail to respect citizens as moral equals. I argue that actually both views are mistaken about what respect for citizens requires, because they conceptualize the citizens’ interests from the wrong standpoint. In order for citizens (...) to be respected as equals, I argue that citizens’ interests must be defined from a joint (second-person) standpoint which is constructed through a dialogical process between policymakers and citizens oriented towards mutual understanding. Furthermore, I argue that engaging citizens in such a dialogue is a distinctive paternalistic intervention in its own right, which unlike other kinds of paternalistic intervention, is compatible with respect for citizens as equals. (shrink)

Supporters of paternalistic policies argue that interference with risky or dangerous choices for citizens’ own good is permissible, as long as those choices are caused by cognitive irrationality or ignorance. Yet, some liberal thinkers argue that despite human irrationality, paternalistic policies are still wrong because they fail to respect citizens as moral equals. I argue that actually both views are mistaken about what respect for citizens requires, because they conceptualize the citizens’ interests from the wrong standpoint. In order for citizens (...) to be respected as equals, I argue that citizens’ interests must be defined from a joint (second-person) standpoint which is constructed through a dialogical process between policymakers and citizens oriented towards mutual understanding. Furthermore, I argue that engaging citizens in such a dialogue is a distinctive paternalistic intervention in its own right, which unlike other kinds of paternalistic intervention, is compatible with respect for citizens as equals. (shrink)

En este artículo sostengo que el principio del daño es un mecanismo que tiene como objetivo lograr un equilibrio entre el juicio individual y la estabilidad social. Argumentaré que no apoyo la afirmación de que el principio del daño puede interpretarse de una manera paternalista y, en cambio, sostengo que el propósito del principio de daño, según lo previsto por John Stuart Mill, es engendrar progreso social. Es por eso que el énfasis de Mill, a menudo, cambia de la libertad (...) individual al control social. Al contrario de lo que afirman algunos estudiosos, esto no es el resultado de una inconsistencia en su pensamiento, sino que se deriva de su enfoque sobre el progreso social. (shrink)

This article proposes a theoretical re-conceptualization of power dynamics and their legitimation in contemporary business–society relations using the prism and metaphor of parentalism. The paper develops a typology of forms of parentalism along two structuring dimensions: care and control. Specifically, four ideal-types of parentalism are introduced with their associated practices and power-legitimation mechanisms. As we consider current private governance and authority through this analytical framework, we are able to provide a new perspective on the nature of the moral legitimation of (...) power dynamics in contemporary business–society relations. And we weave the threads between this conceptual frame and historical antecedents, suggesting that business ethicists need to revive old debates on paternalism in light of the current pervasive trend of modernized and subtler forms of parentalism. Implications for business ethics and political CSR are discussed. (shrink)

Works of art can be difficult in several ways. One important way is by making us face up to unsettling truths. Such works typically receive praise. I maintain, however, that sometimes they deserve moral censure. The crux of my argument is that, just as we have a right to know the truth in certain contexts, so too we have a right not to know it. Provided our ignorance does not harm or seriously endanger others, the decision about whether to know (...) the truth ought to be left to us. Within this limit, therefore, difficult art is morally problematic if it intentionally targets those who have chosen not to know. To illustrate the problem, I discuss the literary writings of Søren Kierkegaard, which aim to deceive readers into seeing unpleasant truths about themselves that they seek to ignore. (shrink)

Circumcision of a male child was recently ruled illegal by a court in Germany on the grounds that it violates the child's rights to bodily integrity and self-determination. This paper begins by challenging the applicability of these rights to the circumcision debate. It argues that, rather than a sweeping appeal to rights, a moral analysis of the practice of circumcision will require a careful examination of the interests of the child. I consider three of these interests in some detail. The (...) first is the interest in avoiding a moderate decrease in expected future sexual pleasure. I argue that even if such a decrease were to occur, it is not wholly unreasonable to think that this might actually be a good thing for the child. Second, I consider the interest in self-determination. I argue that this interest is not as strong as it might appear because the adult's circumcision decision is subject to a variety of biases and a significant lack of information. Finally, I consider the child's interest in avoiding the future costs of adult circumcision. I argue that this interest becomes much stronger in the religious case because the child is quite likely to choose to become circumcised as an adult. The likelihood of the child choosing circumcision in the religious case also reduces the extent to which infant circumcision violates his interest in self-determination. I conclude that male infant circumcision falls within the prerogative of parental decision-making in the secular case and even more clearly so in the religious case. Finally, I distinguish male circumcision from female genital cutting in several important respects and argue that we can coherently hold that male circumcision is permissible without also endorsing all forms of female genital cutting. (shrink)

According to the doctrine of informed consent medical procedures are morally permissible when a patient has consented to the treatment. Problematically it is possible for a patient to consent to or refuse treatment which consequently leads to a decline in her best interests. Standardly, such conflicts are resolved by prioritising the doctrine of informed consent above the requirement that the medical practitioner acts in accordance with the duty of care. This means that patient free choice is respected regardless as to (...) whether her choice leads to a decline in her best interests, since to disrespect patient choice would be an instance of ‘unwarranted’ paternalism. This thesis defends the claim that in cases where patient consent comes into conflict with her best interests, paternalistic interference is in fact justified. The ambition of the thesis is thus twofold: in the first place I argue that the doctrine of informed consent cannot be used as an ethical guarantor for medical decision making. Secondly I will conclude that hard paternalism is justified in medical practice, thereby calling for a reversal of the prioritisation of informed consent procedures over the medical practitioner’s duty of care. (shrink)

John Stuart Mill didn’t take his life; but he could have done it. Had he done it when he was twenty, we would have never known what he thought about it. But he didn’t. And many years later he wrote about nature, God, religion and autonomy. My aim in this article is to show how his thoughts about nature and theism affect in fact his stance about autonomy to commit suicide.

:Contemporary behavioural economics has documented common failures of reasoning that apparently make possible policies that benefit individuals by contravening or correcting their judgements. These policies appear to be paternalistic, even though a traditional view would deny that they are paternalistic on the grounds that policies such as nudges do not restrict individual liberty. It appears to many that a new definition of paternalism that takes its cue from behavioural economics is needed. Furthermore, if one revises the definition of paternalism, one (...) must revisit traditional views concerning whether paternalist policies are wise. In Government Paternalism, Julian Le Grand and Bill New make a valuable start, although some corrections are needed. This essay provides a general setting for revising the definition of paternalism and suggests a revised definition of paternalism. (shrink)

This paper analyses J.S. Mill's theory on the relationships between individual autonomy and State powers. It will be argued that there is a significant discrepancy between Mill's general liberal statements aimed to secure individual largest possible autonomy and the specific examples which provide the government with quite wide latitude for interference in the public and private spheres. The paper outlines the boundaries of government interference in the Millian theory. Subsequently it describes Mill's elastic paternalism designed to prevent people from inflicting (...) harm upon others as well as upon themselves, from soft paternalism on issues like compulsory education to hard paternalism on very private matters such as marriage, having children, and divorce by consent. (shrink)

Making decisions is an important component of everyday living, and issues surrounding autonomy and self-determination are crucial for persons with intellectual disabilities. Adults with intellectual disabilities are characterized by the limitations in their intellectual functioning and in their adaptive behavior, which compromises three skill types, and this starts before the age of 18. Though persons with intellectual disabilities are characterized by having these limitations, they are thought to face significant decisionmaking challenges due to their disability. Moving away from this generalization, (...) Article 12 of the United Nations Convention on the Rights of Persons with Disabilities addresses this issue of decision-making for persons with disabilities, recognizing the right to legal capacity. (shrink)

Medical clinicians – doctors, nurses, nurse practitioners etc. – are charged to act for the good of their patients. But not all ways of acting for a patient's good are on par: some are paternalistic; others are not. What does it mean to act paternalistically, both in general and specifically in a medical context? And when, if ever, is it permissible for a clinician to act paternalistically? -/- This paper deals with the first question, with a special focus on paternalism (...) in medicine. While it is easy to give a rough characterization of paternalism (i.e. acting for another's good against that person's will), it is surprisingly difficult to provide a unified account of the myriad of actions that seem to count as paternalistic. After surveying four accounts of paternalism, I argue that two – what I call the authority and beneficence accounts – are the strongest on offer. According to the authority account, a clinician acts paternalistically when, for her patient's good, she usurps his decision-making authority. According to the beneficence account, a clinician acts paternalistically when, for her patient's good, she acts only or overrindingly out of concern for his good. I show how the difference between these accounts matters (in part) for how we should think about the nature of surrogate decision making in medicine. I argue that there are reasons – albeit hardly decisive – to prefer the beneficence account to the authority account. I conclude by considering whether attempts by clinicians to rationally persuade their patients to pursue a particular course of action should be thought of as paternalistic. (shrink)

This article discusses John Stuart Mill's voluntary slavery argument in On Liberty. The author shows that standard interpretations of the argument rely on the assumption that part of Mill's objection to voluntary slavery is the permanent nature of the decision. However, in correspondence, Mill also objects to voluntary ‘coolie’ labour contracts, which he regards as a form of slavery. This produces difficulties for standard interpretations of the voluntary slavery argument. Finally, the author provides a revised interpretation of Mill's argument to (...) solve this problem. (shrink)

I first provide an analysis of Joel Feinberg’s anti-paternalism in terms of invalidation of reasons. Invalidation is the blocking of reasons from influencing the moral status of actions, in this case the blocking of personal good reasons from supporting liberty-limiting actions. Invalidation is shown to be distinct from moral side constraints and lexical ordering of values and reasons. I then go on to argue that anti-paternalism as invalidation is morally unreasonable on at least four grounds, none of which presuppose that (...) people can be mistaken about their own good: First, the doctrine entails that we should sometimes allow people to unintentionally severely harm or kill themselves though we could easily stop them. Second, it entails that we should sometimes allow perfectly informed and rational people to risk the lives of themselves and others, though they are in perfect agreement with us on what reasons we have to stop them for their own good. Third, the doctrine leaves unexplained why we may benevolently coerce less competent but substantially autonomous people, such as young teens, but not adults. Last, it entails that there are peculiar jumps in justifiability between very similar actions. I conclude that as liberals we should reject anti-paternalism and focus our efforts on explicating important liberal values, thereby showing why liberty reasons sometimes override strong personal good reasons, though never by making them invalid. (shrink)

This article first describes a dilemma for liberalism: On the one hand restricting their own options is an important means for groups of people to shape their lives. On the other hand, group members are typically divided over whether or not to accept option-restricting solutions or policies. Should we restrict the options of all members of a group even though some consent and some do not? This dilemma is particularly relevant to public health policy, which typically target groups of people (...) with no possibility for individuals to opt out. The article then goes on to propose and discuss a series of aggregation rules for individual into group consent. Consideration of a number of scenarios shows that such rules cannot be formulated only in terms of fractions of consenters and non-consenters, but must incorporate their motives and how much they stand to win or lose. This raises further questions, including what is the appropriate impact of altruistic consenters and non-consenters, what should be the impact of costs and benefits and whether these should be understood as gross or net. All these issues are dealt with in a liberal, anti-paternalistic spirit, in order to explore whether group consent can contribute to the justification of option-restricting public health policy. (shrink)

Human dignity defines the foundation of mutual respect between persons in the law. In German constitutional law it defends a realm of individual freedom and inviolable protection against the interests of the collective. Dignity as a legal concept is not a good to be balanced or weighed against other goods, but a prohibition norm, not a reason but a constraint, thus guaranteeing a non-consequentialist and especially a non-utilitarian understanding of basic rights.

This article argues for a novel approach to the measurement of freedom of choice, on which the availability of an option is a matter of degree, rather than a bivalent matter of being either available or not. This approach is motivated by case studies involving weakness of will, where deficiencies in willpower seem to impair individual freedom by making certain alternatives much harder to pursue. This approach is perfectly general, however: its graded analysis of option availability can be extended to (...) cases where weakness of will is not involved and can be used to generalize numerous existing measures of freedom. (shrink)

Making decisions is an important component of everyday living, and issues surrounding autonomy and self-determination are crucial for persons with intellectual disabilities. Article 12 (Equal Recognition before the Law) of the UN Convention on the Rights of Persons with Disabilities addresses this issue of decision-making for persons with disabilities: the recognition of legal capacity. Legal capacity means recognizing the right to make decisions for oneself. Article 12 is also moving in the direction of supported decision-making, as an alternative to substituted (...) decision-making. The objective of this paper is to show conceptually the connection between supported decisionmaking and the preservation of personal autonomy for persons with intellectual disabilities. This paper discusses supported decision-making based on Bach and Kerzner's model: (a) legally independent status, (b) supported decision- making status, and (c) facilitated decision-making status. Arguments will be made based on John Stuart Mill's concept of autonomy and arguments against it using Sarah Conly's argument for paternalism. (shrink)

Supporters of paternalistic policies argue that interference with risky or dangerous choices for citizens’ own good is permissible, as long as those choices are caused by cognitive irrationality or ignorance. Yet, some liberal thinkers argue that despite human irrationality, paternalistic policies are still wrong because they fail to respect citizens as moral equals. I argue that actually both views are mistaken about what respect for citizens requires, because they conceptualize the citizens’ interests from the wrong standpoint. In order for citizens (...) to be respected as equals, I argue that citizens’ interests must be defined from a joint (second-person) standpoint which is constructed through a dialogical process between policymakers and citizens oriented towards mutual understanding. Furthermore, I argue that engaging citizens in such a dialogue is a distinctive paternalistic intervention in its own right, which unlike other kinds of paternalistic intervention, is compatible with respect for citizens as equals. (shrink)