This book sheds light on various ethical challenges military and humanitarian health care personnel face while working in adverse conditions. Contexts of armed conflict, hybrid wars or other forms of violence short of war, as well as natural disasters, all have in common that ordinary circumstances can no longer be taken for granted. Hence, the provision of health care has to adapt, for example, to a different level of risk, to scarce resources, or uncommon approaches due to external incentives or (...) requirements. This affects the practice of health care as well as its ethics. This book offers a panoramic overview on various challenges healthcare faces in extraordinary situations and provides new insights from practitioners’ as well as from academic scholars’ perspectives. (shrink)

Governments often aim to improve children’s wellbeing by targeting the decision-making of their parents. In this paper, I explore this phenomenon, providing an ethical evaluation of the ways in which governments target parental decision-making in the context of anti-poverty policies. I first introduce and motivate the concept of parent-targeted paternalism to categorize such policies. I then investigate whether parent-targeted paternalism is ever pro tanto wrong, arguing that it is when directed at parents who meet a threshold of parental competency. I (...) next explore the factors that affect the degree of pro tanto wrongness of paternalistic anti-poverty policies targeting parents, and provide an account of the conditions under which such policies are on balance permissible, and when they are not. Finally, I illustrate the plausibility and usefulness of my framework by considering a case. (shrink)

Soda taxes are controversial. While proponents point to their potential health benefits and the public projects that could be funded with their revenue, critics argue that they are paternalistic and regressive. In this paper, we explore the prospects for designing a just soda tax, one that appropriately balances the often-competing ethical considerations of promoting social welfare, respecting people’s autonomy, and ensuring distributive fairness. We argue that policymakers have several paths forward for designing a just soda tax, but that the considerations (...) relevant to ethical policy design are more complicated than is sometimes acknowledged. (shrink)

Journal of Political Philosophy, EarlyView.

_ Source: _Page Count 18 There are two ways to transfer a bodily right. One might transfer a bodily right in a detaching way – that is, without transferring jurisdiction over one’s future bodily choices. Alternately, one might transfer a bodily right in an attaching way – that is, in a way that transfers such jurisdiction. For instance, A might sell his kidney to B for money paid at the time of the transplant. Alternately, A might accept money now, agreeing (...) to give up his kidney some time down the road. In the latter case and not the former, B acquires normative jurisdiction over A’s future bodily choices. In this paper I will argue that the distinction between attaching and detaching transfers of bodily rights has implications regarding whether certain contracts and agreements should be legally enforced – and whether problems arise when the moral and legal transferability of these rights comes apart. (shrink)

In this paper I first argue that we do not need to intend all the features of X in order to consent to X. I will present cases in which agents intend to consent to gambles, and intend to consent to have sex with people under certain descriptions, de re, rather than de dicto. Next, I argue that deception – even deception about features of a sexual act that qualify as “deal-breakers” for a participant – might not always have the (...) power to undermine sexual consent. In both sections I craft my arguments by appealing to a proposal about the scope of rights. I suggest that we may have intentions regarding our sexual experiences that do not map onto the rights that we actually hold pertaining to those sexual experiences. (shrink)

Journal of Applied Philosophy, EarlyView.

Whatever else liberalism involves, it involves the idea that it is objectionable, and often wrong, for the state, or anyone else, to intervene, in certain ways, in certain choices. This article aims to evaluate different possible sources of support for this core liberal idea. The result is a pluralistic view. It defends, but also stresses the limits of, some familiar elements: that some illiberal interventions impair valuable activities and that some violate rights against certain kinds of invasion. More speculatively, it (...) points to two further sources of support for liberalism, each of which represents a certain kind of social standing: a self-sovereignty compromised simply by being subject to certain kinds of commands and a relational equality compromised by the condemnation of choices with which one’s group is identified. (shrink)

This article examines the implications for contract law of Rawls' theory of justice as fairness. It argues that contract law as an institution is part of the basic structure of society and as such subject to the principles of justice. Discussing the basic structure in relation to contract law is particularly interesting because it is instructive for both contract law and Rawlsian theory. On the one hand, justice as fairness has clear normative implications for the institution of contract law. On (...) the other hand, this discussion forces us to critically assess the meaning and appeal of the concept of a basic structure in justice as fairness. (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)

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)

According to T.M. Scanlon, the core idea of contractualism consists in the claim that what we are morally required to do is conceptually grounded in the value of living in “relations of mutual recognition” with others. Specifically, Scanlon's contractualist idea of “living in relations of mutual recognition with others” requires that one act only in ways that cannot be reasonably rejected by all of those affected, according to the results of a hypothetical reflection conducted within one's own mind. I claim, (...) however, that Scanlon is mistaken to rely on a single individual's hypothetical reflection (monological reflection) to determine what no one affected could reasonably reject. Instead, following Jürgen Habermas, I claim that we must engage in actual dialogue with all who stand to be affected, in order to live in relations of mutual recognition with others. (shrink)

People are often involuntarily laid off from their jobs through no fault of their own. Employees who are dismissed in this manner cannot always legitimately hold employers accountable for these miserable situations because the decision to implement layoffs is often the best possible outcome given the context—that is, layoffs in and of themselves may be “necessary evils.” Yet, even in circumstances in which layoffs qualify as “necessary evils,” morality demands that employers respect the dignity of those whose employment is involuntarily (...) terminated. In this paper I argue that to preserve the dignity of employees who are involuntarily terminated, in most cases employers have a substantial reason to offer a special kind of unemployment benefit, “severance pay.” To support my claim I draw and expand upon Bernard Williams’s analysis of “agent-regret,” which I believe greatly helps to address and articulate employers’ obligations in the context of involuntary termination. (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)

The justice of criminal punishment depends in part on the possibility of holding people accountable for their choices. There is a wide variation between nations on the age at which juveniles can be prosecuted in adult criminal courts. This variation reflects disagreement about the underlying logic of responsibility. This paper examines the philosophical difference between adults and children as agents. The paper argues that the moral status of children is importantly distinct from adults, specifically with respect to how responsibility should (...) be mitigated. The paper explains this in terms of the developmental aspect of childhood. By considering empirical evidence from psychology and neuroscience we can understand the mistakes that juveniles make as a form of developmental impairment. The paper shows why these findings lead to the conclusion that the practice of trying children as adults is immoral and should be eliminated. (shrink)

Modern military organizations are paternalistic organizations. They typically recognize a duty of care toward military personnel and are willing to ignore or violate the consent of military personnel in order to uphold that duty of care. In this paper, we consider the case for paternalism in the military and distinguish it from the case for paternalism in medicine. We argue that one can consistently reject paternalism in medicine but uphold paternalism in the military. We consider two well-known arguments for the (...) conclusion that military organizations should not be entitled to use experimental drugs on troops without first obtaining the informed consent of those troops. We argue that both of these are unsuccessful, in the absence of an argument for the rejection of paternalism in the military altogether. The case for military paternalism is widely accepted. However, we consider three ways in which it could be challenged. (shrink)

In this paper, we defend the ethics of clinical research against the charge of paternalism. We do so not by denying that the ethics of clinical research is paternalistic, but rather by defending the legitimacy of paternalism in this context. Our aim is not to defend any particular set of paternalistic restrictions, but rather to make a general case for the permissibility of paternalistic restrictions in this context. Specifically, we argue that there is no basic liberty-right to participate in clinical (...) research and that considerations of distributive fairness justify some paternalistic protections of research subjects. (shrink)

Poor pregnancy outcomes and inequalities in these outcomes remain a major challenge, even in prosperous societies that have high-quality health care and public health policy in place. In this article, we propose that justice demands the improvement of what we call the ‘health agency’ of parents-to-be as part of a response to these poor outcomes. We take health agency to have three aspects: the capacity to form health-goals one has reason to value, the control one perceives to have over achieving (...) those health-goals and the freedom one has to achieve those health-goals. We will moreover argue that this demand of justice can be best based on a perfectionist rather than neutralist method of justification. Subsequently, we will argue that perfectionist policy may be paternalistic but not wrongfully paternalistic. This leads us to conclude that perfectionism should be adopted to inform and justify public health policy that is aimed at improving health agency in general and counteracting poor pregnancy outcomes and inequalities in perinatal health outcomes in particular. (shrink)

ABSTRACT:Drawing upon John Rawls's framework inThe Law of Peoples,this paper argues that MNEs have a responsibility to promote well-ordered social and political institutions in host countries that lack them. This responsibility is grounded in a negative duty not to cause harm. In addition to addressing the objection that promoting well-ordered institutions represents unjustified interference by MNEs, the paper provides guidance for managers of MNEs operating in host countries that lack just institutions. The paper argues for understanding corporate responsibility in relation (...) to the specific institutional environment in which MNEs operate. (shrink)

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)

Journal of Political 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)

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)

Some bioethicists and political philosophers argue that rich states should restrict the immigration of health workers from poor countries in order to prevent harm to people in these countries. In this essay, I argue that restrictions on the immigration of health workers are unjust, even if this immigration results in bad health outcomes for people in poor countries. I contend that negative duties to refrain from interfering with the occupational liberties of health workers outweighs rich states' positive duties to prevent (...) harm to people in sending countries. Furthermore, I defend this claim against the objection that health workers in poor countries acquire special duties to their compatriots that render them liable to coercive interference. (shrink)

Some bioethicists and political philosophers argue that rich states should restrict the immigration of health workers from poor countries in order to prevent harm to people in these countries. In this essay, I argue that restrictions on the immigration of health workers are unjust, even if this immigration results in bad health outcomes for people in poor countries. I contend that negative duties to refrain from interfering with the occupational liberties of health workers outweighs rich states' positive duties to prevent (...) harm to people in sending countries. Furthermore, I defend this claim against the objection that health workers in poor countries acquire special duties to their compatriots that render them liable to coercive interference. (shrink)

This paper defends a right to the justification of contract, with reciprocal and general reasons, and explores its main implications for the law of contract and its theory. It argues that the leading essentialist and other monist contract theories, offering blueprints for an ideal contract law based on the alleged ultimate value or essential characteristic of contract law, cannot justify the basic structure of contract law. Instead, it argues, a critical discourse theory of contract can contribute to the realisation of (...) the right to justification of contract by exposing patterns of contractual injustice, in particular exploitation and domination by contract, that contract law can and should prevent. (shrink)

: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)

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)

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)

On Jeff McMahan's influential ‘responsibility account’ of moral liability to defensive killing, one can forfeit one's right not be killed by engaging in an ordinary, morally permissible risk-imposing activity, such as driving a car. If, through no fault of hers, a driver's car veers out of control and toward a pedestrian, the account deems it no violation of the driver's right to save the pedestrian's life at the expense of the driver's life. Many critics reject the responsibility account on the (...) grounds that, first, it has draconian implications for threateners like the driver, and second, it contravenes the plausible principle that wronging one's victim is necessary for forfeiting one's rights. But I argue, drawing on the account's luck-egalitarian underpinnings, that the account lacks the draconian implications widely attributed to it, and contrary to what many assume, wrongdoing is unnecessary for rights-forfeiture. Via these arguments, I seek both to deepen our understanding of the responsibility account, and to reissue it in a more plausible and attractive form. (shrink)

This paper explores the debate between perfectionists and anti-perfectionists in the context of children. It suggests that the most influential and compelling arguments in favour of anti-perfectionism are adult-centric. It does this by considering four leading reasons given in favour of anti-perfectionism and shows that none apply in the case of children. In so doing, the paper defends a perfectionist account of upbringing from the attacks made against perfectionism more generally. Furthermore, because the refutation of the various anti-perfectionist arguments are (...) made exclusively dealing with children, the paper suggests that the perfectionist view of upbringing is compatible with anti-perfectionist restrictions on dealing with adults. This dual view combining perfectionism for children and anti-perfectionism for adults is referred to as restricted perfectionism. (shrink)

This paper explores the debate between perfectionists and anti-perfectionists in the context of children. It suggests that the most influential and compelling arguments in favour of anti-perfectionism are adult-centric. It does this by considering four leading reasons given in favour of anti-perfectionism and shows that none apply in the case of children. In so doing, the paper defends a perfectionist account of upbringing from the attacks made against perfectionism more generally. Furthermore, because the refutation of the various anti-perfectionist arguments are (...) made exclusively dealing with children, the paper suggests that the perfectionist view of upbringing is compatible with anti-perfectionist restrictions on dealing with adults. This dual view combining perfectionism for children and anti-perfectionism for adults is referred to as restricted perfectionism. (shrink)

In contemporary paternalism literature, persuasion is commonly not considered paternalistic. Moreover, paternalism is typically understood to be problematic either because it is seen as coercive, or because of the insult of the paternalist considering herself superior. In this paper, I argue that doctors who persuade patients act paternalistically. Specifically, I argue that trying to persuade a patient (here understood as aiming for the patient to consent to a certain treatment, although he prefers not to) should be differentiated from trying to (...) convince him (here understood as aiming for the patient to want the treatment) and recommending (the doctor merely providing her professional opinion). These three forms of influence are illustrated by summaries of video-recorded hospital encounters. While convincing and recommending are generally not paternalistic, I argue that persuasion is what I call communicative paternalism and that it is problematic for two reasons. First, the patient’s preferences are dismissed as unimportant. Second, the patient might wind up undergoing treatment against his preferences. This does not mean that persuasion always should be avoided, but it should not be undertaken lightly, and doctors should be aware of the fine line between non-paternalism and paternalism. The fact that my analysis of paternalism differs from traditional accounts does not imply that I deem these to be wrong, but rather that paternalism should be considered as a more multi-faceted concept than previous accounts allow for. (shrink)

In contemporary paternalism literature, persuasion is commonly not considered paternalistic. Moreover, paternalism is typically understood to be problematic either because it is seen as coercive, or because of the insult of the paternalist considering herself superior. In this paper, I argue that doctors who persuade patients act paternalistically. Specifically, I argue that trying to persuade a patient (here understood as aiming for the patient to consent to a certain treatment, although he prefers not to) should be differentiated from trying to (...) convince him (here understood as aiming for the patient to want the treatment) and recommending (the doctor merely providing her professional opinion). These three forms of influence are illustrated by summaries of video-recorded hospital encounters. While convincing and recommending are generally not paternalistic, I argue that persuasion is what I call communicative paternalism and that it is problematic for two reasons. First, the patient’s preferences are dismissed as unimportant. Second, the patient might wind up undergoing treatment against his preferences. This does not mean that persuasion always should be avoided, but it should not be undertaken lightly, and doctors should be aware of the fine line between non-paternalism and paternalism. The fact that my analysis of paternalism differs from traditional accounts does not imply that I deem these to be wrong, but rather that paternalism should be considered as a more multi-faceted concept than previous accounts allow for. (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)

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)

In this essay I argue that the same considerations that justify the strong commitment to anti-paternalism that has been affirmed in bioethics over the past half century, also calls for anti-paternalistic public health policies. First, I frame the puzzle—why are citizens morally entitled to make unhealthy and medically inadvisable decisions as patients but not as consumers? I then briefly sketch the reasons why bioethicists typically reject paternalism. Next, I argue that those same reasons tell against paternalism in public health ethics (...) as well. Patients do not waive their rights to make medically inadvisable decisions when they leave their physician’s care. James Wilson disagrees. After I sketch Wilson’s arguments for paternalism in public health policy, I then argue, contra Wilson, that public health paternalism is wrong for the same reason that medical paternalism is wrong, and that the prevalence of paternalism in public policy does not mean that paternalism is morally permissible. I discuss the state’s authority to enforce paternalistic policies and I sketch an anti-paternalist vision for health policymakers. To close, I consider several objections. (shrink)

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)

Do states have a right to exclude prospective immigrants as they see fit? According to statists the answer is a qualified yes. For these authors, self-determining political communities have a prima facie right to exclude, which can be overridden by the claims of vulnerable groups such as refugees and children born in the state’s territory. However, there is a concern in the literature that statists have not yet developed a theory that can protect children born in the territory from being (...) excluded from the political community. For if the self-determining political community has the right to decide who should form the self in the first place, then that right should count against both newcomers by immigration and newcomers by birth. Or so the concern goes. In this essay, I defend statism against this line of criticism and provide a liberal justification for the inclusion of children born within the state’s borders. My account leads to some surprising implication for citizenship law, as well as immigration arrangements in the area of asylum and unauthorized immigration. (shrink)

Several influential characterizations of paternalism or its distinctive wrongness emphasize a belief or judgement that it typically involves—namely, 10 the judgement that the paternalized is likely to act irrationally, or some such. But it's not clear what about such a belief can be morally objectionable if it has the right epistemic credentials (if it is true, say, and is best supported by the evidence). In this paper, I elaborate on this point, placing it in the context of the relevant epistemological (...) discussions. I explain how 15 evidentialism is opposed to such thoughts; I show that possible ways of rejecting evidentialism (along lines analogous to those of pragmatic encroachment) won't work; and I sketch an account of the wrongness of paternalism that doesn't depend on any flaw in the belief about others' likely behaviour. (shrink)

Das von Cass Sunstein und Richard Thaler ausgearbeitete Projekt eines Libertären Paternalismus stellt fraglos einen der zurzeit meistdiskutierten neopaternalistischen Theorieentwürfe dar. Als hybride Mischung zwischen Theorieprogramm, politischer Bewegung und praxis- und anwendungsorientiertem Policy-Manual, das zuweilen Züge eines populären philosophischen Lebensratgebers trägt, hat Libertärer Paternalismus viel Zuspruch, aber auch heftige Kritik auf sich gezogen, die in diesem Aufsatz auf ihre Plausibilität geprüft werden. Zu diesem Zweck geben die Autoren zunächst einen kurzen Überblick über Ausgangspunkte, Leitorientierungen und Problemvorgaben des Theorie- und Politikprogramms (...) des Libertären Paternalismus. In einem zweiten Schritt werden zentrale Konzepte und Unterscheidungen des libertär paternalistischen Rationales vorgestellt und problematisiert. Daran anschließend werden drei der prominentesten Kritikpunkte an Libertärem Paternalismus auf den Prüfstand gestellt. Hierzu gehören der Manipulationseinwand, Kritiken, die sich auf grundlegende Rechtfertigungsprobleme des Libertären Paternalismus beziehen, und Einwände, die auf langfristige negative Folgen des Nudging verweisen. (shrink)

This paper is concerned with the practical importance of different forms of paternalism for educational theory and practice. Contrary to the traditional treatment of paternalism as a sometimes necessary and rather messy aspect of educational practices, I demonstrate that paternalism is to be regarded as an “indigenous concept” of educational theory and as the ‘indigenous model of justification’ that underlies the structure of educational practices. Based on an analysis of the intricate nexus between autonomy-oriented forms of paternalism and educational forms (...) of autonomy-based perfectionism I furthermore argue that a perfectionistically structured conception of autonomy provides a more adequate evaluative framework for justifying autonomy as an educational aim than alternative educational regimes of autonomy can deliver. Finally, I discuss some major theoretical problems of bridging the gap between general ethical principles and their application in practical fields. (shrink)

Andreas Schmidt and Neil Levy have recently defended nudging against the objection that nudges fail to treat nudgees as rational agents. Schmidt rejects two theses that have been taken to support the objection: that nudges harness irrational processes in the nudgee, and that they subvert the nudgee’s rationality. Levy rejects a third thesis that may support the objection: that nudges fail to give reasons. I argue that these defences can be extrapolated from nudges to some nonconsensual neurointerventions; if Schmidt’s and (...) Levy’s defences succeed, then some nonconsensual neurointerventions neither harness irrationality, nor subvert rationality, nor fail to give reasons. This, I claim, poses a challenge both to opponents of nonconsensual neurointerventions, and to defenders of nudging. (shrink)