The Ethics of Human Rights (47): What’s So Funny About Paternalism?

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ethics of human rights / freedom / health / justice / law / philosophy

finger pointing

In general, those who promote human rights will not be tempted to engage in paternalistic policies. That’s because human rights are about protecting people against each other, not about protecting people against themselves. And one of the foundations of human rights is the moral value of personal autonomy: people have a right to organize their lives according to their own plans and reasons, free from the influence and manipulation of others, even if others believe they are mistaken or self-destructive. Personal autonomy in this sense of the word is the basis of rights such as the right to privacy, property, political participation etc.

So, paternalism can be seen as detrimental to human rights. On the other hand, all societies are to some extent paternalistic, with the apparent consent of all. So what’s the deal? Let’s go through this topic in a systematic way, starting with some definitions, typologies and proposed justifications of paternalism, in order to end up with a clearer vision about paternalism’s temptations, dangers and limits.

Definition of paternalism

Paternalism is

  • interference
  • usually by the government
  • with an agent’s strictly self-regarding actions
  • and against the will of the agent.

It’s the use of coercion, force or incentives, against the initial will of the agent, with the purpose of imposing or preventing a certain type of action or lifestyle that has, respectively, positive or negative consequences for the agent and that does not harm or benefit a third party.

The purpose of paternalism is therefore to make the agent who is the object of paternalistic force, better off. She’s better off because she is forced, by the paternalist, to do good things to herself or to abstain from doing harm to herself.

Types of paternalism

This definition allows us to distinguish two types of paternalism: positive and negative (these qualifiers do not imply value judgments):

  • positive paternalism means forcing people to benefit themselves
  • negative paternalism means forcing people not to harm themselves.

The latter is much more common, I believe. Examples are anti-drug legislation, laws forcing people to wear seat belts or crash helmets etc. An example of the former are laws requiring people to contribute to a pension fund (although that case may not be strictly self-regarding since part of the motivation for such laws is the protection, not only of the future pensioner, but of his or her descendants or society in general).

seatbelts

Paternalism should therefore be distinguished from other types of coercion that aim at preventing people from harming others or forcing people to benefit others (such as laws against murder or laws imposing taxation respectively). Such non-paternalistic types of coercion focus on other-regarding consequences, whereas paternalistic coercion focuses on self-regarding consequences. Paternalism wants to limit the harm people’s actual or possible voluntary actions can do to themselves, and maximize the benefits that people’s possible but not voluntarily chosen actions can produce for themselves.

Paternalists are therefore “do-gooders” who want to maximize people’s utility, benefits, happiness, wellbeing etc. and who believe that this requires more than mutual protection.

(Other typologies of paternalism are, of course, possible: a soft form of paternalism would not intervene if people consciously and with full knowledge harm themselves, and only when self-harm results from lack of information; or would only intervene using incentives or “nudges” rather than coercion; hard paternalism would discount knowledge and intervene anyway; paternalism may be limited to the means people choose for their ends, or may also include these ends etc.).

Justifications of paternalism

Paternalists offer different reasons why they think that people, in some cases, should be prevented from engaging or forced to engage in certain actions.

  • As stated a moment ago, there may be a lack of knowledge on the part of the agent forcing the agent to unwittingly harm herself or fail to benefit herself. And this can be a lack of knowledge of different kinds:
    • First, the agent may not be aware of the harmful self-regarding consequences of a chosen or intended action, or may not be aware of the beneficial self-regarding consequences of an unchosen and unwanted action. In such cases, there are two possibilities. Either the simple delivery of information regarding the consequences – for example through education or communication – is enough to convince the agent to avoid harmful action or to choose beneficial action, and then no paternalistic action is necessary. Or this is not enough and paternalistic action is necessary. An example of the latter can be marijuana: according to some paternalists, the consequences of marijuana use are harmful, but this “information” doesn’t seem to register with users.
    • The absence of knowledge may be a deeper problem. The agent may not be aware of her true interests. Example: a terminally ill patient who wants to die may not be aware that her true interest – according to some – is respecting God’s will and God’s rules against suicide.
  • In many cases, people justify paternalism not because there’s a lack of knowledge, but because there’s a lack of “character” on the part of the agent. The agent may know very well what is and is not in her interest and what actions have beneficial or harmful consequences, but she just can’t bring herself to engage in or avoid those actions. There’s clarity about her interests and about consequences, but not the will, the courage, perseverance etc. to act correctly.

Most cases of paternalism, I guess, are of the first kind, where it is assumed that there’s a lack of continuous knowledge and a lack of conscious and lasting awareness of the consequences of certain actions, and that someone else, e.g. the state, knows better.

plato

Plato

Hence, paternalism deserves its name. Paternalists assume – much like Plato – that society is divided into two groups of people, the “fathers” and the “children”, those who know better and are more rational, and those who don’t know and can’t be counted on to take their lives into their own hands. However, paternalism goes beyond the father-child metaphor because it believes that the “children” will never fully grow up: knowledge about consequences acquired through information and education, knowledge about which actions are or are not in the best interests of people, or knowledge about how people can act to best serve their true interests will often not be enough to act in a certain way. Apart from knowledge, character can be lacking, and that’s a fault that is much more difficult to correct without continuous paternalistic force.

The temptation of paternalism

John Stuart Mill

So, all that sounds pretty awful, and yet all or most societies engage in some kind of paternalism without much public opposition. The examples given above are quite common. And indeed, some forms of paternalism are quite harmless and difficult to avoid. John Stuart Mill cites the case of a bridge that is about to collapse. The circumstances are such that only engineers are in a position to know this. Regular drivers don’t and can’t know the consequences of their actions – in this case driving across the bridge – and should therefore be prevented from acting by those who know better. This isn’t usually called paternalism, but there doesn’t seem to be a clear difference between this case and real cases of paternalism, such as laws forcing people to wear crash helmets (assuming that the reason why people don’t wear helmets is an insufficient awareness of the possible consequences), or moral rules dictating that we should try to convince our friends not to commit suicide if they are so inclined.

So, paternalism is there to stay. I don’t think there are many “hard anti-paternalists” around. Hence, as is often the case on this blog, we are faced with value pluralism and two contradicting values: in some cases it’s obviously good to protect people against themselves, but at the same time it is generally correct to respect people’s autonomy, their self-determination and their right to make their own decisions and to live according to their own reasons and motives, free from external forces.

Where’s the trade-off? I would say that the burden of proof is on those wishing to limit people’s autonomy, given the general importance of autonomy. Their case can made stronger when, for example, there’s absolutely no doubt that a certain course of action will produce serious harm to the agent. Otherwise the case for paternalistic coercion is less strong and the best we can do is simply warn people of the possible consequences. Their case can also be made stronger when medical opinion about an agent’s neurological or psychological disorders is unanimous.

The dangers of paternalism

The burden of proof is on paternalists because of the risks inherent in paternalism. We also tend to overestimate the effectiveness of paternalism. Generally, individuals are the best judges of their own needs and wants and of the means to realize them. It’s not obvious that a paternalistic class of “fathers” can have better knowledge, given the vast number of people, options and risks involved. And even if individuals make mistakes, the harm done by forcing them into a system in which they are treated like children may be greater than the harm they do to themselves when left alone. Most people value the freedom to decide for themselves and the value of this freedom can sometimes compensate the cost of self-inflicted harm. It’s also likely that mistakes make people better judges.

Does that mean that people should have the freedom to damn themselves? In most cases, yes, if that’s someone’s free and voluntary choice, made in the light of all the information available and accessible to her.

More about paternalism here. More posts in this series are here.

6 Comments

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