Paternalism

by

Gerald B. Dworkin

• LAST REVIEWED: 26 October 2015
• LAST MODIFIED: 26 October 2015
• DOI: 10.1093/obo/9780195396577-0288

Introduction

The government requires people to contribute to a pension system (Social Security). It requires motorcyclists to wear helmets. It forbids people from swimming at a public beach when lifeguards are not present. It forbids the sale of various drugs deemed to be ineffective. It forbids the sale of various drugs believed to be harmful. It does not allow consent to certain forms of assault to be a defense against prosecution for that assault. It requires hunters to wear colored jackets and divers to be certified. The civil law does not allow the enforcement of certain kinds of contracts (e.g., enforcing gambling debts). It requires minors to have blood transfusions even if their religious beliefs forbid it. Persons may be civilly committed if they are a danger to themselves. Doctors do not always tell their patients the truth about their medical condition. A physician may deceive a patient by prescribing a placebo. A physician may tell a husband that his wife died peacefully when in fact she died in agony. A husband may hide the sleeping pills from a depressed wife. A philosophy department may require a student to take logic courses. A wife may lie to her husband about where they are going in order conceal a surprise birthday party. The President may lie about the deal he made with the Russians during the Cuban missile crisis. All of these rules, policies, and actions may be done for various reasons, may be justified by various considerations. When they are justified solely on the grounds that the person affected would be better off, or would be less harmed—as a result of the rule, policy, etc.—and when the rule or policy limits your freedom or autonomy, we have an instance of paternalism. As the examples indicate, the question of paternalism is one that arises in many different areas of our personal and public life. As such, it is an important realm of applied ethics. But it also raises certain theoretical issues. Perhaps the most important is: what powers it is legitimate for a state, operating both coercively and in terms of incentives, to possess? It also raises questions about the proper ways in which individuals, either in an institutional or purely personal setting, should relate to one another. How should we think about individual autonomy and its limits? What is it to respect the personhood of others? What is the trade-off, if any, between regard for the welfare of another and respect for their right to make their own decisions?

General Overviews

A number of books have appeared which seek to cover many of the topics that are concerned with the definition and Justification of paternalism. The initial literature appeared in the 1980s. Feinberg 1986 is essential for its thorough coverage of the issues as they arise in criminal law, while Feinberg 1971 is an early article outlining his views. Kleinig 1983 and VanDeVeer 1986, while somewhat dated, also provide good general overviews. Conly 2014 is a recent defense of paternalism. Sartorius 1983 is an anthology of articles as is Coons and Weber 2013. LeGrand and New 2015 is the newest book directed to various areas of social policy.

• Conly, Sarah. Against Autonomy: Justifying Coercive Paternalism. Cambridge, UK: Cambridge University Press, 2014.

  The most recent of the general books in this section. It is a defense of paternalism against its critics, covering some topics, such as Food Policy, which were not at issue in the 1980s.

• Coons, Christian, and Michael Weber, eds. Paternalism: Theory and Practice. Cambridge, UK: Cambridge University Press, 2013.

  DOI: 10.1017/CBO9781139179003

  Contains many articles of interest from contemporary authors including topics such as volunteer slavery and libertarian paternalism.

• Feinberg, Joel. “Legal Paternalism.” Canadian Journal of Philosophy 1.1 (1971): 105–124.

  An introduction to the book-length treatment of this subject.

• Feinberg, Joel. Harm to Self. Vol. 3 of The Moral Limits of the Criminal Law. Oxford: Oxford University Press, 1986.

  Part of a four-volume set on the moral limits of criminal law, this is the most thorough and influential treatment of the harm principle and its limits. Essential reading.

• Kleinig, John. Paternalism. Totawa, NJ: Rowman and Allanheld, 1983.

  A thorough general treatment of the liberal antipathy to paternalism while allowing for a limited role for legitimate paternalism.

• LeGrand, Julian, and Bill New. Government Paternalism: Nanny State or Helpful Friend? Princeton, NJ: Princeton University Press, 2015.

  DOI: 10.1515/9781400866298

  A very comprehensive examination of many different areas of social policy with respect to the paternalistic issues.

• Sartorius, Rolf Paternalism. Minneapolis: University of Minnesota Press, 1983.

  Somewhat dated but still contains interesting material.

• VanDeVeer, Donald. Paternalistic Intervention: The Moral Bounds on Benevolence. Princeton, NJ: Princeton University Press, 1986.

  DOI: 10.1515/9781400854066

  Very thorough overview of many relevant topics including consent, euthanasia, and the limits of permissible risk taking.