20

Feb

2013

The Cambridge Book Club features Paternalism

 
paternalism

How free should we be?

This month's Cambridge Book Club pick is all about ethical issues associated with paternalism. Should other people, like government officials, be able to infringe on our rights to choose the way we eat, work, socialize, spend, live, and die? Learn more with this exclusive excerpt.

 

It’s no secret that soda isn’t good for us. It’s rotting our teeth, giving us brain cancer, and sending our risk for diabetes off the charts. So when Mayor Bloomberg instituted the soda-size restrictions that will go into effect across New York City on March 12, he did it for our own good—but he also raised a huge question about paternalism, or the kinds of decisions other people can make for us when it’s in our best interest.

This month, the Cambridge Book Club is featuring Paternalism, a new edited volume that explores this important philosophical, political, legal, and social issue. This week, read an excerpt from the book to learn all about the issue, the long controversy, and how paternalism is a part of our daily lives. Download the full excerpt here.

Introduction: Paternalism—Issues and trends

John Stuart Mill famously decried paternalism of any kind, whether it is carried out by private individuals or the state:

“[T]he sole end for which mankind are warranted, individually or collectively, in interfering with the liberty of action of any one of their number, is self-protection . . . the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.”1

Equally famously, critics have charged that Mill’s utilitarianism is inadequate to ground such an absolute prohibition. If there is a case for an absolute ban on paternalism, many have thus thought, it must be grounded instead in the fundamental importance of one of a family of considerations that includes liberty, freedom, and autonomy. However, it is unclear whether this move really helps, or so we will suggest.

This mere snippet from the historical debate is enough to show that paternalism is a topic that engages deep philosophical issues in normative ethics and political philosophy, including the significance and nature of freedom and autonomy, and the relation between individuals and the state. But interest in the topic is of course not primarily due to its theoretical depth. Instead, it is due to practical considerations. A wide variety of policies and laws in the United States and elsewhere are considered paternalistic, and are controversial for just that reason. For instance, there are laws that require motorcyclists to wear helmets and passengers in cars to wear seatbelts. Government agencies regulate both prescription and recreational drugs. Taxes are levied on cigarettes, and bans on trans-fats have been enacted. Participation in pension programs, such as Social Security in the United States, is mandatory. Mill’s negative view of paternalism is reflected in some identifying policies along these lines as part of an ever-growing “nanny-state.” Because paternalism in this way raises significant theoretical and practical concerns, it has been a topic of long-standing interest to moral and political philosophers as well as political actors and the lay public.

Interest has been heightened recently due to an alleged breakthrough, a way of squaring paternalism with libertarian concerns for that family of values that includes liberty, freedom, and autonomy. This “libertarian paternalism,” championed by Richard Thaler and Cass Sunstein in their recent bestseller, Nudge: Improving Decisions About Health, Wealth, and Happiness, raises new and interesting questions, especially in virtue of its appeal to recent research in psychology and behavioral economics.2 The essays in this volume address the fundamental and long-standing issues raised by paternalism as well as the debate sparked by Thaler and Sunstein. In this introduction we will not summarize each of the contributions to the volume. Instead, more helpfully we hope, we will touch on some of the key aspects of the present-day discussion of paternalism, so as to provide a broad context for thinking about the essays herein. Our discussion of these new developments will be framed by a central question in both classic and contemporary debates: What, if anything, makes paternalism morally problematic? Where appropriate, of course, we will indicate how specific contributions to this volume figure in the larger narrative.

Normative debates about paternalism – or at least “hard” paternalism – don’t usually concern whether it is problematic but rather how problematic it is.3 Specifically, most assume that we have a pro-tanto reason to avoid paternalism towards competent adults. The real debate concerns if it can nevertheless ever be justified, and if so, when. Despite this, in recent years it has become surprisingly difficult to explain exactly why paternalism is even pro-tanto objectionable, and more difficult still to defend its absolute prohibition. It has become more difficult not because the world has somehow changed but rather because philosophical reflection has made it clearer what paternalism does and does not involve. Crucially, there’s a growing consensus that it needn’t be regarded as coercion, removal of choice, or even disregard for the target’s evaluative perspective. Because of this, some traditional views about why paternalism is pro-tanto wrong are no longer available. We make this point not to advocate paternalism, but to help illustrate why despite all the attention previously paid to it, it remains a rich and evolving topic for discussion.

Of course, one might skeptically insist that it is paternalism’s very richness that makes it problematic as a focus of direct study. After all, in paternalism, perhaps more than any other topic in moral and political philosophy, deep conflicts between competing traditions emerge, not only about the limits of state authority, but in more general disputes about the relative priority of well-being, freedom, choice, and autonomy, and whether these are ideals to be promoted or respected. The skeptic about the direct study of paternalism might then insist that no progress can be made without first resolving these deeper disputes. But this assumes what we might call a “top-down” approach: General philosophical issues must be solved first, the results of which are then simply applied to ground-level disputes in political philosophy or applied ethics. The top-down approach, however, is both methodologically questionable and difficult to consistently maintain. For example, it would presumably be a reductio of any broad theoretical view if it entailed that we may not stop a friend from drinking the gasoline she thinks is gin. So our verdicts about paternalism needn’t be a mere application of our more general commitments in moral and political philosophy. Rather, the opposite may be true: Careful reflection on paternalism’s moral status may help illuminate or adjudicate debates about those deeper issues. Indeed, if we see the coercive power of the state as justified in part by its claim to benefit those subject to its power, it appears state authority itself rests on a kind of paternalistic rationale. Paternalism’s relevance to wider debates is also apparent in Christopher Wellman’s complaint that Rawls’ Principle of Fairness is objectionably paternalistic; Richard Arneson’s contribution in this volume defends Rawls on this score.4 In this debate, paternalism’s status is treated as determining, rather than being determined by, our more general normative commitments.

So just as consensus at the theoretical level may be useful in drawing conclusions about how we should regard paternalism, consensus about paternalism may inform our more general theoretical positions.5 With that in mind, it is worth returning to the widely held view that paternalism is inherently problematic – that there is always at least some pro-tanto reason to avoid it. But what, precisely, makes paternalism problematic? And what does this reveal about deeper moral views? At least this much initially seems obvious: The problem does not lie in its end alone – in the fact that paternalism is undertaken for the good of or the sake of its targets.6 Paternalism appears to be very broadly speaking benevolent. But there’s nothing wrong with benevolence per se. What makes paternalism at least pro-tanto wrong, then, presumably has to do with the means – with how it goes about benefiting its target. For example, forcing you to have a second helping of broccoli casserole – a tasty and healthy choice – is objectionable to the extent that it is because I am forcing you to do it. It would likewise be objectionable, and apparently for the same reason, if I forced you to eat it for a scientific experiment I am conducting. What is pro-tanto wrong with paternalism in this case, apparently then, has nothing to do with the fact that I am trying to improve your health or please your palate. That it is good for you may speak in its favor. That it promotes my scientific experiment seems to count less, most likely because I am the beneficiary rather than you who are forced to eat the casserole. In both cases, however, it seems most plausible that the reasons to force you to eat the casserole are too weak to outweigh the reason not to coerce you. Generalizing from this example, we might suspect that what’s wrong with paternalism is rather straightforward: Paternalism involves some form of coercion or interference, which requires special justification. Advocates of a general prohibition on paternalism are, then, simply those who think this justification cannot be met – the well-being of the target of paternalism never outweighs the morally problematic use of coercion.

But such an account will not do. As is now more widely recognized, omissions can be paternalistic, and thereby problematic, even though the omission would not otherwise require any justification. Here, fascinatingly, paternalism’s benevolence appears to contribute to what makes it problematic. To illustrate, we may omit telling you about tonight’s concert because we believe that we ought not tempt you. This omission may require no justification: if we had simply not felt like telling you, we would do nothing objectionable. But when we omit for your sake, it seems you have greater grounds to object. Specifically, our omission seems to involve reasoning for you – we’ve weighed the options for you, and decided not to tell you partly because we believe you might reach a different and “imprudent” conclusion. This feature of paternalism – a sort of reasoning for another – has not always been explicitly highlighted, but takes center stage in Seana Shiffrin’s recent but already highly influential characterization of paternalism. On Shiffrin’s view, paternalism by A towards B is behavior (including omissions) meeting the following conditions:

  1. aimed to have (or to avoid) an effect on B or her sphere of legitimate agency
  2. involving the substitution of A’s judgment or agency for B’s
  3. directed at B’s own interests or matters that legitimately lie within B’s control
  4. undertaken such that, compared to B’s judgment or agency with respect to those interests or other matters, A regards her judgment or agency to be (or as likely to be), in some respect, superior to B’s.7

This view in fact highlights two features of paternalism that have historically been overlooked or under-emphasized: i) paternalism may not involve coercion or active interference; ii) it needn’t involve a specific concern for the target’s well-being. The definition is not merely a potential theoretical advancement, it also sheds light on types of paternalistic practices and policies that, historically, have gone unappreciated. Daniel Haybron and Anna Alexandrova’s contribution to this volume is an excellent illustration of the point, as it uses some of Shiffrin’s insights to turn the tables on those who argue happiness-driven economics is objectionably paternalistic in a way that more traditional “minimalist” methodology in economics is not. And Sigal Ben-Porath’s contribution uses some of these same insights to shed light on the paternalism that is at the heart of contemporary debates about school choice.

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