According to the influential disrespect account of what paternalism is, and why it is wrong, paternalism involves an anti-egalitarian, disrespectful attitude on the part of the paternalist: X (the paternalist) assumes an attitude of superiority when interfering in Y's matters for Y's good. Pace this account, the article argues that an important, although somewhat overlooked, form of paternalism is not, all things considered, insulting. This form of paternalism focusses on people's occasional lack of appropriate self-respect or their failure to see (...) themselves as equals or to stand vis-à-vis others as such. (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)

Some scholars working on the ethics of paternalism are interested in whether there is a systematic normative connection between hard paternalism and people’s moral rights. One affirmative view is that hard paternalism is pro tanto wrong inasmuch as it always involves a rights infringement. Daniel Groll defends this view on the grounds that hard paternalism always infringes a competent adult’s right to be the only one to act only for his own good. I call this right the right to self-beneficence. (...) In this note, I argue that Groll misidentifies a right that competent adults have. Rather than the right to self-beneficence, I argue that if hard paternalism infringes any particular right, it is a right that a competent adult has against others “taking over” matters that fall within his sphere of legitimate agency or, by extension, the legitimate exercise of his agency. I call this right the right against legitimate agency interference. (shrink)

Journal of Applied Philosophy, EarlyView.

Politics, Philosophy & Economics, Volume 21, Issue 1, Page 55-74, February 2022. Many find that the objectionable nature of paternalism has something to do with belief. However, since it is commonly held that beliefs are directly governed by epistemic as opposed to moral norms, how could it be objectionable to hold paternalistic beliefs about others if they are supported by the evidence? Drawing on central elements of relational egalitarianism, this paper attempts to bridge this gap. In a first step, it (...) argues that holding paternalistic beliefs about others implies a failure to regard them as equals in terms of their moral agency. In a second step, it shows that the fact that we should regard others as equals in this sense raises the threshold for sufficiency of evidence for paternalistic beliefs to be epistemically justified. That is, moral reasons of relational equality encroach on the epistemic. However, these reasons are not decisive. In cases where others are about to jeopardize critical goods such as their lives, mobility or future autonomy, relational equality sometimes calls for paternalistic action and, by extension, the formation of beliefs that render such action rational. The upshot is that in order to meet demands of relational equality we have a pro tanto reason to not hold paternalistic beliefs about others. (shrink)

Deceased organ donation is widely considered as a case of easy rescue―that is, a case in which A may bestow considerable benefits on B while incurring negligent costs herself. Yet, the policy implications of this observation remain unclear. Drawing on Christopher H. Wellman’s samaritan account of political obligations, the paper develops a case for a so-called opt-out system, i.e., a scheme in which people are defaulted into being donors. The proposal’s key idea is that we may arrange people’s options in (...) specific ways for the sake of others. (shrink)

The aim of this article is twofold. First is to demonstrate that most values that underpin public health policy are a source of reasonable disagreement amongst citizens to whom said policy applies....

A common objection to paternalism concerns its expressive content. Many reject paternalistic policies and actions on the ground that they arguably involve insulting expressions of disrespect toward those subjected to them. The paper challenges this view. It argues that refraining from acting paternalistically can be disrespectful. Specifically, the paper argues that there is a relevant way in which A disregards the moral worth of B if A stands idly by when B is about to act very imprudently. If true, treating (...) others with equal respect and concern, as relational egalitarians and others rightly ask us to do, will somewhat surprisingly sometimes involve treating them paternalistically. (shrink)

Journal of Political Philosophy, EarlyView.

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)

This paper argues that the moral value of unconditional forgiveness is more complicated and constrained than it is often taken to be. When we unconditionally forgive, we engage with someone in a way that doesn’t take seriously their perspective about the meanings and values at stake in our relations with them. Other things being equal, this is problematic; it is normatively condescending, belittling the place of the other person’s moral agency in our relations with them. This doesn’t mean that unconditional (...) forgiveness is always bad or impermissible. It does, though, complicate how we should think about its moral value. (shrink)

Analytic Philosophy, Volume 63, Issue 2, Page 73-89, June 2022.

Social media companies commonly design their platforms in a way that renders them addictive. Some governments have declared internet addiction a major public health concern, and the World Health Organization has characterized excessive internet use as a growing problem. Our article shows why scholars, policy makers, and the managers of social media companies should treat social media addiction as a serious moral problem. While the benefits of social media are not negligible, we argue that social media addiction raises unique ethical (...) concerns not raised by other, more familiar addictive products, such as alcohol and cigarettes. In particular, we argue that addicting users to social media is impermissible because it unjustifiably harms users in a way that is both demeaning and objectionably exploitative. Importantly, the attention-economy business model of social media companies strongly incentivizes them to perpetrate this wrongdoing. (shrink)

It is sometimes—but not always—permissible to let others do wrong. This paper is about why that is so.

Algorithmic systems and predictive analytics play an increasingly important role in various aspects of modern life. Scholarship on the moral ramifications of such systems is in its early stages, and much of it focuses on bias and harm. This paper argues that in understanding the moral salience of algorithmic systems it is essential to understand the relation between algorithms, autonomy, and agency. We draw on several recent cases in criminal sentencing and K–12 teacher evaluation to outline four key ways in (...) which issues of agency, autonomy, and respect for persons can conflict with algorithmic decision-making. Three of these involve failures to treat individual agents with the respect they deserve. The fourth involves distancing oneself from a morally suspect action by attributing one’s decision to take that action to an algorithm, thereby laundering one’s agency. (shrink)

Progressive family policy regimes typically aim to promote and protect women’s opportunities to participate in the workforce. These policies offer significant benefits to affluent, two-parent households. A disproportionate number of low-income and impoverished families, however, are headed by single mothers. How responsive are such policies to the objectives of these mothers and the needs of their children? This chapter argues that one-size-fits-all family policy regimes often fail the most vulnerable household and contribute to intergenerational poverty in two ways: by denying (...) at-risk children adequate parenting, and by undermining their mothers’ legitimate interest in nurturing and caring for their own children. The capabilities of these mothers and the well-being of their children are better served by policies which recognise maternal caregiving as a productive and valuable occupation meriting equal respect and social support. (shrink)

In this article, we develop and defend an account of the normative significance of nonhuman animal agency. In particular, we examine how animals’ agency interests impact upon the moral permissibility of our interactions with them. First, we defend the claim that nonhuman animals sometimes have rights to self-determination. However, unlike typical adult humans, nonhuman animals cannot exercise this right through the giving or withholding of consent. This combination of claims generates a puzzle about the permissibility of our interactions with nonhuman (...) animals. If animals sometimes have rights to self-determination, but lack the capacity to consent, then when, if ever, is it permissible for us to touch them, hold them, bathe them, or confine them? In the second half of the article, we develop a solution to this puzzle. We argue that while we cannot obtain animals’ consent, they can engage in authoritative communications of will through acts of “assent” and “dissent.”. (shrink)

Almost everyone would agree that vote buying is morally wrong, and that prohibitions on vote buying are morally justified. Yet, recently, several philosophers have argued that vote buying is morally permissible, and that it should be legally permitted. This paper begins by examining and criticising arguments that have been offered in defence of vote buying. I then go on to consider existing attempts to explain the wrongness of vote buying, arguing that none is wholly successful. I then advance a novel (...) account of the wrongness of vote buying. Vote buying is objectionable, I argue, because it involves a failure of respect for one’s fellow citizens as autonomous agents. I also consider the implications of my account for a number of other controversial practices. (shrink)

The development of personal technologies has recently shifted from devices that seek to capture user attention to those that aim to improve user well-being. Digital wellness technologies use the same attractive qualities of other persuasive apps to motivate users towards behaviors that are personally and socially valuable, such as exercise, wealth-management, and meaningful communication. While these aims are certainly an improvement over the market-driven motivations of earlier technologies, they retain their predecessors’ focus on influencing user behavior as a primary metric (...) of success. Digital wellness technologies are still persuasive technologies, and they do not evade concerns over whether their influence on users is ethically justified. In this paper, we describe several ethical frameworks with which to assess the justification of digital wellness technologies’ influence on users. We propose that while some technologies help users to complete tasks and satisfy immediate preferences, other technologies encourage users to reflect on the values underlying their habits and teach them to evaluate their lives’ competing demands. While the former approach to digital wellness technology is not unethical, we propose that the latter approach is more likely to lead to skillful user engagement with technology. (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)

Public and research libraries have long provided resources in electronic formats, and the tension between providing electronic resources and patron privacy is widely recognized. But assessing trade-offs between privacy and access to electronic resources remains difficult. One reason is a conceptual problem regarding intellectual freedom. Traditionally, the LIS literature has plausibly understood privacy as a facet of intellectual freedom. However, while certain types of electronic resource use may diminish patron privacy, thereby diminishing intellectual freedom, the opportunities created by such resources (...) also appear liberty-enhancing. Adjudicating between privacy loss and enhanced opportunities on intellectual freedom grounds must therefore provide an account of intellectual freedom capable of addressing both privacy and opportunity. I will argue that intellectual freedom is a form of positive freedom, where a person’s freedom is a function of the quality of her agency. Using this view as the lodestar, I articulate several principles for assessing adoption of electronic resources and privacy protections. (shrink)

Journal of Political Philosophy, EarlyView.

Moore and Donnelly argue in the paper ‘The job of “ethics committees”’ that research ethics committees should be renamed and that their job should be specified as “review of proposals for consistency with the duly established and applicable code” only.1 They raise a large number of issues, but in this comment I briefly want to suggest that two of their arguments are fundamentally flawed. The first flawed argument is the argument related to the separation of powers. Moore and Donnelly proceed (...) from the premise that it is pro tanto better to have an institutional arrangement that separates code-making powers and decisional powers, and then proceed to argue that this separation is not feasible for what they call ‘ethics consistency review’ because “no matter who established any prespecified review standards, the review decision maker must be empowered at review to revise those standards when this would make for an ethical improvement. This is because any understanding of ethics-consistency standards themselves and of their implications for any case is fallible and improvable in …. (shrink)

When are we morally obligated as a society to help the homeless, and is coercive interference justified when help is not asked for, even refused? To answer this question, we propose a comprehensive taxonomy of different types of homelessness and argue that different levels of autonomy allow for interventions with varying degrees of pressure to accept help. There are only two categories, however, where paternalism proper is allowed, be it heavily qualified. The first case is the homeless person with severely (...) diminished autonomy as a result of mental illness, and the second case is the homeless person who runs a risk of serious and imminent harm to self. In the first case, namely, that of soft paternalism, we argue that coercive intervention in the case of a refusal to accept help should be focused on the provision of housing that meets basic needs—needs that we outline in the article. In the case of imminent and severe harm to self, the case of hard paternalism, we argue that forced intervention can only be allowed if it is temporary and local, namely focused on getting someone out of harm’s way. (shrink)

Many think that it would be wrong to defend an individual from attack if he competently and explicitly refuses defensive intervention. In this paper, I consider the extent to which the preferences of victims affect the permissibility of defending groups or aggregates. These cases are interesting and difficult because there is no straightforward sense in which a group can univocally consent to or refuse defensive intervention in the same way that an individual can. Among those who have considered this question, (...) the dominant view is that that consent imposes only an extremely weak constraint on defending groups. I argue that this is mistaken and defend a much more robust requirement. Indeed, on the account that I develop there are cases in which the refusal of a single member of a victim is enough to make it impermissible to defend a much larger group. At the heart of my account is the idea that consent functions as an internal component of the broader requirement that defensive harms be proportionate: if a victim validly refuses defensive intervention, the fact that defence will benefit him cannot be used to justify harming innocents as the lesser-evil. An important implication of this view is that what constitutes sufficient consent from the members of a victim group will vary on a case-by-case basis. (shrink)

The choice argument against sweatshop regulations states that public officials should not prohibit workers from accepting jobs that require long hours, low pay, and poor working conditions, because enforcing such regulations would be disrespectful to the workers who choose to work in sweatshops. Critics of the choice argument reply that these regulations can be justified when workers only choose to work in sweatshops because they lack acceptable alternatives and are unable to coordinate to achieve better conditions for all workers. My (...) thesis is that the presence of unacceptable alternatives to sweatshop labor or barriers to coordination cannot justify sweatshop regulations such as minimum wage and maximum hour laws. Although officials should promote alternatives to difficult and dangerous sweatshop labor, they should not do so by limiting workers’ and employers’ options through coercive regulation. And the fact that sweatshop workers may face coordination problems does not undermine the claim that sweatshop workers choose to work in sweatshops, just as other workers face coordination problems but nevertheless make occupational choices. Furthermore, efforts to restrict sweatshop workers’ choices are morally risky and may not promote workers’ wellbeing or wellbeing in general. (shrink)

This paper critically assesses the possibility of moral enhancement with ambient intelligence technologies and artificial intelligence presented in Savulescu and Maslen (2015). The main problem with their proposal is that it is not robust enough to play a normative role in users’ behavior. A more promising approach, and the one presented in the paper, relies on an artifi-cial moral reasoning engine, which is designed to present its users with moral arguments grounded in first-order normative theories, such as Kantianism or utilitarianism, (...) that reason-responsive people can be persuaded by. This proposal can play a normative role and it is also a more promising avenue towards moral enhancement. It is more promising because such a system can be designed to take advantage of the sometimes undue trust that people put in automated technologies. We could therefore expect a well-designed moral reasoner system to be able to persuade people that may not be persuaded by similar arguments from other people. So, all things considered, there is hope in artificial intelli-gence for moral enhancement, but not in artificial intelligence that relies solely on ambient intelligence technologies. (shrink)

Many people feel that respecting a person’s autonomy is not sufficiently important to obligate us to stay out of their affairs in all cases; but the ground for interference may often turn out to be a hunch that the agent cannot really be competent, or cannot really know what her decision implies; for if she were both of these things, surely she would not make such a foolish decision. This paper suggests a justification of paternalism that does not rely on (...) such appeals. I argue that in cases where an agent will undergo a significant alteration in their evaluative outlook – ‘evaluative shift’ – three central, persuasive objections to paternalism lose their force, and offer a prima facie case for paternalism in some of these cases. I then suggest that we can extend this argument to some cases where evaluative alteration is not predictable, but where the risk and harm are both significant. In such cases, paternalism may be justified. (shrink)

In ‘Rational Persuasion as Paternalism', George Tsai argues that providing another person with reasons or evidence can be a morally objectionable form of paternalism. I believe Tsai’s thesis is importantly correct, denying the widely accepted identification of rational persuasion with respectful treatment. In this comment, I disagree about what is centrally wrong with objectionable rational persuasion. Contrary to Tsai, objectionable rational persuasion is not wrong because it undermines the value of an agent’s life. It is wrong because it is contrary (...) to an agent’s will. (shrink)

The scarcity of livers available for transplants forces tough choices upon us. Lives for those not receiving a transplant are likely to be short. One large group of potential recipients needs a new liver because of alcohol consumption, while others suffer for reasons unrelated to their own behaviour. Should the former group receive lower priority when scarce livers are allocated? This discussion connects with one of the most pertinent issues in contemporary political philosophy; the role of personal responsibility in distributive (...) justice. One prominent theory of distributive justice, luck egalitarianism, assesses distributions as just if, and only if, people's relative positions reflect their exercises of responsibility. There is a principled luck egalitarian case for giving lower priority to those who are responsible for their need. Compared to the existing literature favouring such differentiation, luck egalitarianism provides a clearer rationale of fairness, acknowledges the need for individual assessments of responsibility, and requires initiatives both inside and outside of the allocation systems aimed at mitigating the influence from social circumstances. Furthermore, the concrete policies that luck egalitarians can recommend are neither too harsh on those who make imprudent choices nor excessively intrusive towards those whose exercises of responsibility are assessed. (shrink)

Several authors have recently advocated a so-called new case for paternalism, according to which empirical findings from distinct decision sciences provide compelling reasons in favour of paternalistic interference. In their view, the available behavioural and neuro-psychological findings enable paternalists to address traditional anti-paternalistic objections and reliably enhance the well-being of their target agents. In this paper, I combine insights from decision-making research, moral philosophy and evidence-based policy evaluation to assess the merits of this case. In particular, I articulate and defend (...) three complementary arguments that, I claim, challenge even the best available calls for such case. In doing so, I identify the main justificatory challenges faced by the new paternalists and explicate the implications of these challenges for the ongoing philosophical debate about the justifiability of paternalistic interference. (shrink)

Many liberal egalitarians support laws that prevent people from making exploitative and unconscionable contracts. These contracts may include low-wage labor agreements or payday loans, for example. I argue that liberal egalitarians should rethink their support for laws that limit the freedom to make these illiberal contracts, as long as the contracts are voluntary and do not violate people’s other enforceable rights. Paternalistic considerations cannot justify limits on illiberal contracts because they are not only likely to misfire; they also express condescending (...) and inegalitarian judgments of citizens. I then consider Seana Shiffrin’s argument that officials may avoid paternalism while still deterring illiberal contracts if they instead refuse to use public institutions to accommodate contracts that are contrary to the fundamental values on which those institutions are based. This argument encounters a dilemma. Officials may refuse to enforce illiberal contracts and ban private enforcement of illiberal contracts, but this strategy encounters the charges of paternalism it aimed to avoid. Or, officials may refuse to enforce illiberal contracts but tolerate private enforcement, but this approach would make the worst off members of society even more vulnerable and marginalized. Therefore, liberal egalitarians should support public enforcement of illiberal contracts because the alternatives are worse. (shrink)

Epistemic paternalism is the thesis that a paternalistic interference with an individual's inquiry is justified when it is likely to bring about an epistemic improvement in her. In this article I claim that in order to motivate epistemic paternalism we must first account for the value of epistemic improvements. I propose that the epistemic paternalist has two options: either epistemic improvements are valuable because they contribute to wellbeing, or they are epistemically valuable. I will argue that these options constitute the (...) foundations of a dilemma: either epistemic paternalism collapses into general paternalism, or a distinctive project of justified epistemic paternalism is implausible. (shrink)

In this book I argue that school integration is not a proxy for educational justice. I demonstrate that the evidence consistently shows the opposite is more typically the case. I then articulate and defend the idea of voluntary separation, which describes the effort to redefine, reclaim and redirect what it means to educate under preexisting conditions of segregation. In doing so, I further demonstrate how voluntary separation is consistent with the liberal democratic requirements of equality and citizenship. The position I (...) defend is not opposed to integration but rather is a justified response to the daily experience of frustration and disappointment with a system that has failed members of marginalized groups for too long. I argue that most voluntary separation experiments in education, far from being motivated by a sense of racial, cultural or religious exclusion, are in fact driven among other things by a desire for a quality education, not to mention community membership and self respect. As such, voluntary separation represents a morally robust pragmatic strategy that is able to answer liberal challenges concerning involuntary stratification, ethnocentrism and democratic deliberation. (shrink)

Journal Name: SATS Issue: Ahead of print.

I argue that public officials and health workers ought to respect and protect women’s rights to make risky choices during childbirth. Women’s rights to make treatment decisions ought to be respected even if their decisions expose their unborn children to unnecessary risks, and even if it is wrong to put unborn children at risk. I first defend a presumption of medical autonomy in the context of childbirth. I then draw on women’s birth stories to show that women’s medical autonomy is (...) often ignored during labor. Medical interventions are performed during childbirth without women’s consent. Childbirth is risky and some coercive medical interventions may be understood as attempts to protect children and to prevent mothers from acting impermissibly. However, even if it is wrong to make risky choices during childbirth, women have rights to do wrong in these cases. Therefore, coercive medical interventions are impermissible during childbirth and institutions should adopt specific protections for obstetric autonomy. (shrink)

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 scrutinizes the tension between individuals’ rights and paternalism. I will argue that no normative account that includes rights of individuals can justify hard paternalism since the infringement of a right can only be justified with the right or interest of another person, which is never the case in hard paternalism. Justifications of hard paternalistic actions generally include a deviation from the very idea of having rights. The paper first introduces Tom Beauchamp as the most famous contemporary hard paternalist (...) by outlining his moral theory (principlism) and showing why it, as it stands, has to allow for hard paternalism. Secondly, the paper focuses on the notion of rights within principlism. I will employ traditional theories of rights to make sense of rights in principlism. Unfortunately, this attempt fails. In the third part, then, I claim that rights can only be limited with reference to the rights or interests of others. This structure is the very point of rights, it is their bite. I will argue for this claim and show its implications. The most important implication is that not only principlism, but every normative theory that includes rights of individuals, has to abolish hard paternalism. (shrink)

Political philosophers have become increasingly interested in questions of justice as applied to health. Much of this literature works from a distributive understanding of justice. In the recent debate, however, ‘relational’ egalitarians have proposed a different way of conceptualising equality, which focuses on the quality of social relations among citizens and/or how social institutions ‘treat’ citizens. This paper explores some implications of a relational approach to health, with particular focus on health care, health inequalities and health policy. While the relational (...) account can add interesting perspectives to current debates on justice and health, we also highlight some tensions and difficulties relational egalitarians might encounter and some discontinuities between the implications of a relational account and current discourse on health equity. (shrink)

In this article I argue for a particular analysis of paternalism. I start by examining Dworkin's conditions for the paternalist act and make a case for alternative conditions. I argue that the paternalist actor acts irrespective of what she believes the wishes of the target of her action are and the paternalist actor acts because she has a positive epistemic standing that the act may or will improve the welfare of the target of her action. I also argue that it (...) is consistent with my analysis that there are paternalist acts that don't interfere with the autonomy of the object of the paternalist act. I describe some such acts and make the case that such acts, when they are paternalist acts, may be morally permissible and outline the factors that bear on their permissibility. Finally I locate my analysis in the literature by comparing it to a number of other accounts. (shrink)

This chapter concerns the normativity of the concepts of paternalism and libertarian paternalism. The first concept is central in evaluating public health policy, but its meaning is controversial. The second concept is equally controversial and has received much attention recently. It may or may not shape the future evaluation of public health policy. In order to facilitate honest and fruitful debate, I consider three approaches to these concepts, in terms of their normativity. Concepts, I claim, may be considered nonnormative, normatively (...) charged, or normative in that they involve more complex relationships between values or duties. While the last approach is often best, other approaches may be appropriate depending on the context and purpose of discussion. The chapter’s conceptual investigation is illustrated by application to two public health policies: a tax on the consumption of fat and the encouragement of health-promoting food displays in restaurants and supermarkets. (shrink)

In this article I assess the ability of motivational accounts of paternalism to respond to a particular challenge: can its proponents adequately explain the source of the distinctive form of disrespect that animates this view? In particular I examine the recent argument put forward by Jonathan Quong that we can explain the presumptive wrong of paternalism by relying on a Rawlsian account of moral status. I challenge the plausibility of Quong's argument, claiming that although this approach can provide a clear (...) response to the explanatory challenge, it is only successful in doing so when it relies on the strength of its rival: the argument from personal autonomy. In doing so I illustrate that such responses are conceptually dependent on an account of respect for persons, and thus much of the relevant controversy is actually disagreement over how we respect other individuals. (shrink)

Most anti-paternalists claim that informed and competent self-regarding choices are protected by autonomy, while ill-informed or impaired self-regarding choices are not. Joel Feinberg, among many others, argues that we can in this way distinguish impermissible “hard” paternalism from permissible “soft” paternalism. I argue that this view confronts two related problems in its treatment of ill-informed decision-makers. First, it faces a dilemma when applied to decision-makers who are responsible for their ignorance: it either permits too much, or else too little, intervention (...) to satisfy its proponents. Second, the most promising rationales in favor of the view ignore the distinction between an agent’s voluntarily bringing about some state of affairs, on the one hand, and an agent’s voluntarily assuming a risk, on the other. I conclude that a decision-maker’s ignorance is irrelevant to the permissibility of intervention on her behalf. If it is permissible to intervene in a given ill-informed choice, it would be permissible to intervene in an otherwise similar but informed choice, at least provided that intervention would produce similar benefits in both cases. This shows that we should sometimes accept straightforwardly paternalistic rationales. (shrink)

Public health policies which involve active intervention to improve the health of the population are often criticized as paternalistic. This article argues that it is a mistake to frame our discussions of public health policies in terms of paternalism. First, it is deeply problematic to pick out which policies should count as paternalistic; at best, we can talk about paternalistic justifications for policies. Second, two of the elements that make paternalism problematic at an individual level—interference with liberty and lack of (...) individual consent—are endemic to public policy contexts in general and so cannot be used to support the claim that paternalism in particular is wrong. Instead of debating whether a given policy is paternalistic, we should ask whether the infringements of liberty it contains are justifiable, without placing any weight on whether or not those infringements of liberty are paternalistic. Once we do so, it becomes apparent that a wide range of interventionist public health policies are justifiable. (shrink)

I argue that the epistemological virtues of concrete thinking, self-transparency, and narrative understanding developed by care ethicists can help international development practitioners combat their own temptations to engage in “unconscious unjustified paternalism” (UUP). I develop the concept of UUP—a type of paternalism in which one party unjustifiably substitutes her judgment for another's because of difficulty distinguishing her desires for the other from the other's good. I show that the temptation to UUP is endemic to development and that care ethics contains (...) virtues for combating it. Key to my claim is a view of caregiving as a practice of negotiating conflict. (shrink)