Knowing and Not‐Knowing For Your Own Good: The Limits of Epistemic Paternalism

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.     

Children and the Limits of Paternalism

Philosophers disagree about what precisely makes an act paternalistic, and about whether, when, and why paternalistic acts are morally objectionable. Despite these disagreements, it might seem uncontroversial to think that it is permissible to paternalize children. When paternalism seems morally objectionable, that is usually because an adult has been treated in a way that seems appropriate only for children. But, we might think, there can be nothing morally objectionable about treating children as children. In this paper, however, I argue that there are limits to how we may permissibly paternalize children. I begin in Section 1 by describing and endorsing Jonathan Quong’s account of paternalism, which defines paternalistic acts as those that involve particular kinds of judgments that the paternalizer makes about the capacities of the paternalizee. In Section 2, I identify a distinction between two kinds of paternalism: ‘compensatory’ paternalism, and ‘non-compensatory’ paternalism. In Section 3, I argue that compensatory paternalism is usually permissible in the case of children. In section 4, I argue that non-compensatory paternalism is much harder to justify than compensatory paternalism, and because of this, it is sometimes impermissible even when directed at children.     

Autonomy, Slavery, and Mill's Critique of Paternalism

Critics have charged that John Stuart Mill's discussion as of paternalism in On Liberty is internally inconsistent, noting, for example, the numerous instances in which Mill explicitly endorses examples of paternalistic coercion. Similarly, commentators have noted an apparent contradiction between Mill's political liberalism – according to which the state should be neutral among competing conceptions of the good – and Mill's condemnation of non-autonomous ways of life, such as that of a servile wife. More generally, critics have argued that while Mill professes an allegiance to utilitarianism, he actually abandons it in favor of a view that values personal autonomy as the greatest intrinsic good. This paper presents an interpretation of Mill that provides a viable and consistent treatment of paternalism, thereby refuting each of the aforementioned critiques. Mill's views, it argues, are consistently utilitarian. Moreover, the interpretation accounts for all of Mill's departures from his otherwise blanket prohibition of paternalistic legislation. In particular, it explains his most notorious example, the condemnation of voluntary contracts for slavery. The interpretation emphasizes Mill's conceptual linkage between autonomy and utility, noting his implicit use of at least three different senses of the notion of autonomy.     

Another Look at Paternalism

ABSTRACT This paper attempts to provide some new insights into the problem of justifying paternalism. To begin with, there is a general analysis of the concept of paternalism which examines the conditions that must be present for it to occur. A distinction is then drawn between two contexts in which paternalism exists—first, where it applies to individuals or clearly specifiable groups and second, where it applies to society in general. Different approaches to justification are required in each case. It is argued that paternalism of the former type has to meet two necessary and sufficient conditions for it to be acceptable and a good deal of the paper is devoted to a discussion of these two conditions and the ways of determining when they are satisfied. Paternalism of the latter type which applies to the whole society is more difficult to justify, mainly because it applies indiscriminately to everyone regardless of their particular capacities, interests etc., but some suggestions are made as to when such paternalism may nevertheless be justified.     

The Normative Core Of Paternalism

The philosophical debate on paternalism is conducted as if the property of being paternalistic should be attributed to actions. Actions are typically deemed to be paternalistic if they amount to some kind of interference with a person and if the rationale for the action is the good of the person interfered with. This focus on actions obscures the normative issues involved. In particular, it makes it hard to provide an analysis of the traditional liberal resistance to paternalism. Given the fact that actions most often have mixed rationales, it is not clear how we should categorize and evaluate interfering actions for which only part of the rationale is the good of the person. The preferable solution is to attribute the property of being paternalistic not to actions, but to compounds of reasons and actions. The framework of action–reasons provides the tools for distinguishing where exactly paternalism lies in the complex web of reasons and actions.     

Hume and the Problem of Paternalism: When is Humanity Sufficient?

Hume states that if a group of powerless, rational creatures lived amongst human beings, then humans would be required to treat this species with humanity but not with justice. Michael Ridge has argued that this implies humans would be required to engage in a morally dubious form of paternalism toward this imagined species. I argue that a proper understanding of why this imagined species is excluded from the scope of justice shows Hume has a plausible moral reason for requiring paternalism in this instance. The reason the imagined species is excluded is that they are incapable of feeling what I term “the pain of dependence,” or unease arising from complete dependence upon those who are more powerful. Those capable of the pain of dependence will have reason to resent exclusion from the scope of justice (and the accompanying susceptibility to paternalism). However, I contend that Hume did not think that the imagined species was capable of feeling the pain of dependence. This means that the imagined species would not consider themselves wronged when subject to paternalistic treatment, and, consequently, there is good reason to think the sort of paternalism that Hume's theory allows is not morally objectionable.     

Technological paternalism: On how medicine has reformed ethics and how technology can refine moral theory

The objective of this article is to investigate ethical aspects of technology through the moral term “paternalism”. The field of investigation is medicine. The reason for this is twofold. Firstly, “paternalism” has gained moral relevance through modern medicine, where physicians have been accused of behaving paternalistic and threatening patients’ autonomy. Secondly, medicine is a brilliant area to scrutinise the evaluative aspects of technology. It is argued that paternalism is a morally relevant term for the ethics of technology, but that its traditional conception is not adequate to address the challenges of modern technology. A modification towards a “technological paternalism” is necessary. That is, “technological paternalism” is a fruitful term in the ethics of technology. Moreover, it is suited to point out the deficiencies of the traditional concept of paternalism and to reform and vitalise the conception of paternalism in ethics in order to handle the challenges of technology.     

Reviving Ulysses contracts

Ulysses contracts have faced paternalism objections since they first were proposed. Since the contracts are designed to override a present request from a legally competent patient in favor of a past request made by that patient, enforcement of these contracts was argued to be unjustifiable strong paternalism. Recent legal developments and new theories of practical reasoning suggest that the discussion of Ulysses contracts should be revived. This paper argues that with a proper understanding of the future-directed planning embodied in Ulysses contracts, the charge of strong paternalism can be answered, and the enforcement of some Ulysses contracts may be justified under the rubric of weak paternalism.     

Governing [through] Autonomy. The Moral and Legal Limits of “Soft Paternalism”

Legal restrictions of the right to self-determination increasingly pretend to be compatible with the liberal concept of autonomy: they act upon a ‘soft’ or autonomy-orientated paternalistic rationale. Conventional liberal critique of paternalism turns out to be insensitive to the intricate normative problems following from ‘soft’ or ‘libertarian’ paternalism. In fact, these autonomy-oriented forms of paternalism could actually be even more problematic and may infringe liberty rights even more intensely than hard paternalistic regulation. This paper contributes to the systematic differentiation of soft and hard paternalism by discussing the (legal) concept of autonomy and elaborates the moral and legal limits of autonomy-orientated paternalism.     

Technology, Recommendation and Design: On Being a ‘Paternalistic’ Philosopher

Philosophers have talked to each other about moral issues concerning technology, but few of them have talked about issues of technology and the good life, and even fewer have talked about technology and the good life with the public in the form of recommendation. In effect, recommendations for various technologies are often left to technologists and gurus. Given the potential benefits of informing the public on their impacts on the good life, however, this is a curious state of affairs. In the present paper, I will examine why philosophers are seemingly reluctant to offer recommendations to the public. While there are many reasons for philosophers to refrain from offering recommendations, I shall focus on a specific normative reason. More specifically, it appears that, according to a particular definition, offering recommendations can be viewed as paternalistic, and therefore is prima facie wrong to do so. I will provide an argument to show that the worry about paternalism is unfounded, because a form of paternalism engendered by technology is inevitable. Given the inevitability of paternalism, I note that philosophers should accept the duty to offer recommendations to the public. I will then briefly turn to design ethics, which has reconceptualised the role of philosophers and, in my mind, fitted well with the inevitability of paternalism. Finally, I shall argue that design ethics has to be supplemented by the practice of recommendation if it is to sustain its objective.     

Relational Autonomy and the Social Dynamics of Paternalism

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 (anti-) 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.     

Against Two Modest Conceptions of Hard Paternalism

People in our liberal pluralistic society have conflicting intuitions about the legitimacy of coercive hard paternalism, though respect for agency provides a common source of objection to it. The hard paternalist must give adequate reasons for her coercion which are acceptable to a free and equal agent. Coercion that fails to meet with an agent’s reasonable evaluative commitments is at least problematic and risks being authoritarian. Even if the coercer claims no normative authority over the coercee, the former still uses coercion to replace the latter’s reasons or will with his own reasons or will. But does every hard paternalistic view have to invite such objection? Throughout I will assume that defenders of what I will call “Neutral Paternalism” (NP) and “Commonsense Paternalism” (CP) aim to offer reasons for coercion all can reasonably endorse despite evaluative diversity, in opposition to more objectionable forms of coercive paternalism, such as those which defend it on religious or perfectionist grounds. I will argue, nonetheless, that Gerald Dworkin’s defense of NP and Danny Scoccia’s defense of CP succumb to the same problems of objectionable imposition that saddle other forms of coercive paternalism. The shortcomings in their views suggest that even modest hard paternalism is nonetheless problematic for liberals.     

Bioethics reformation style

The Hippocratic model is inadequate because it is too paternalistic, argues Rebecca D. Pentz in her response to Cameron. Instead, we would do well to think of the patient/doctor relationship in Reformation terms, using the pastor/congregation relationship as a model. Rejecting Hippocratic paternalism is not tantamount to an assertion of absolute autonomy; it entails patient responsibility, shared with the physician.     

Professional Paternalism

This article points out how far-reaching the changes in our public life would actually have to be if we wanted to avoid paternalism altogether. For example, the widespread view that only a physician with training at a recognized institution should be allowed to perform surgery or that only an educated lawyer may provide legal council is clearly paternalistic. In fact, many professional regulations, not just in medicine and law, but also in engineering and many other areas of expertise, have a strongly paternalistic function. Moreover, this problem is located in a sphere that is neither clearly private, nor seems to be part of a state-legislated public sphere. Professional organizations are neither governments, nor necessarily democratic, but they are often state-certified and produce binding regulations for issues of public interest. The author bites the bullet and accepts professional paternalism, while insisting that special care should be placed on how to design an appropriate professional code of conduct.     

The role of values in road safety culture: Examining the valuation of freedom to take risk,risk taking and accident involvement in three countries

National focus on individual freedom versus paternalistic values is a fundamental theme, which defines the status of traffic safety in different countries. The present study examines the role of such values in road safety culture based on survey data from car and bus drivers from three countries with distinctly different road safety records: Norway (N = 596), Israel (N = 129) and Greece (N = 386). While Norway has the highest road safety level in Europe, and Israel also performs better than the EU average, the road safety level in Greece was far below the EU average. As these positions reflect differences in policies and national regulations in drivers’ freedom to take risk, we hypothesize a higher focus on individual freedom to take risk and lower focus on paternalism among the Greek drivers. Results indicate, in accordance with our hypothesis, that the Greek drivers value freedom to take risk in traffic higher than drivers from Norway and Israel. Greek drivers also expect higher levels of risk taking from other drivers in their country, they report higher levels of risky driving themselves, and are more often involved in accidents. Thus, it seems that values have an important role in Road Safety Culture (RSC), legitimizing and motivating risky driving, which are related to accidents. We found, however, contrary to our hypotheses, that the Greek drivers also had the most paternalistic attitudes among the drivers in the three countries. In the present paper, we try to solve this Greek paradox.     

Informed consent in psychiatric practice: The primacy of ethics over law

In recent years, concern with informed consent in psychiatry has led to an overemphasis on legal formulations of the problem and a heated debate about when physician paternalism can be justified. This paper proposes that the principle of respect for persons provides better guidance for treatment decisions than do legal guidelines based on a questionable standard of competency.     

Paternalism and the Ill-Informed Agent

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.     

The morality of weapons research

I ask whether weapons research is ever justified. Weapons research is identified as the business of the engineer. It is argued that the engineer has responsibility for the uses to which the tools that he designs can be put, and that responsibility extends to the use of weapons. It is maintained that there are no inherently defensive weapons, and hence there is no such thing as ‘defensive’ weapons research. The issue then is what responsibilities as a professional the engineer has in regard to such research. An account is given to ground the injunction not to provide the means to harm as a duty for the engineers. This account is not, however, absolutist, and as such it allows justifiable exceptions. The answer to my question is thus not that weapons research is never justified but there must be a strong assurance that the results will only be used as a just means in a just cause.     

Some social features of cognition

This paper describes and assesses a number of dispositions which are instrumental in allowing us to take on the opinions of others unselfconsciously. It is argued that these dispositions are in fact reliable in the environments in which they tend to come into play. In addition, it is argued that agents are, by their own lights, justified in the beliefs they arrive at as a result of these processes. Finally, these processes are argued to provide a basis for rejecting the claim that fixation of belief is radically holistic.