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.

According to relational egalitarianism, justice requires equal relations. The theory applies to those who stand in the relevant social relations. In this paper, I distinguish four different accounts of what it means to be socially related and argue that in all of them, self-relations—how a person relates to themselves—fall within the scope of relational egalitarianism. I also point to how this constrains what a person is allowed to do to themselves.

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)

Beneficence and respect for autonomy are two of the most fundamental moral duties in general and in bioethics in particular. Beyond the usual questions of how to resolve conflicts between these duties in particular cases, there are more general questions about the possible forms of the interactions between them. Only recognition of the full spectrum of possible interactions will ensure optimal moral deliberation when duties potentially conflict. This paper has two simultaneous objectives. The first is to suggest a typological scheme (...) of all possible modes of interaction; these will be classified under the “discrete,” “semi-discrete,” and “non-discrete” categories, according to whether the meaning and/or forms of expression of each duty are treated as independent from or rather as constrained by the other. The second objective is to show that all logical possibilities of interaction indeed have real expressions in medical ethics, to provide clear illustrations of each, and in particular to stress those that have usually escaped recognition. (shrink)

Relational egalitarianism is a theory of justice according to which people must relate as equals. However, not just any inegalitarian relation is unjust, i.e., the fact that parents do not relate as equals to their children is not unjust. Whereas an adult treating another adult paternalistically is objectionable from the point of view of relational egalitarianism, parent-child paternalism is not. What may explain this difference in judgment? I refer to this as the Puzzle. I discuss four justifications of the Puzzle (...) and argue that none of them is satisfactory. In the final part of the paper, I discuss where this leaves relational egalitarianism as a theory of justice. (shrink)