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According to a standard account liberalism is committed to the rejection of legal paternalism. But the fact is that paternalistic policies are common currency in most liberal democracies, and liberal governments claim or at least assume that those policies are not inimical to liberal principles. My argument in this chapter is, first, that paternalistic interventions do infringe the right to direct one’s life, and that, therefore, the scope of this right cannot be redefined to conceal the conflict. However, the fact that there is an unavoidable conflict between individual sovereignty and paternalism does not mean that paternalism is necessarily unjustifiable. Second, since the right to direct one’s life is not absolute, it can be outweighed by considerations related to an individual’s positive freedom. I will argue that the protection of an agent’s positive freedom is a permissible moral goal, and, sometimes, this goal can offset the right to direct one’s life. I acknowledge that paternalistic actions set back individuals’ autonomous choices, but I nonetheless claim that such interferences are justified because, on some occasions, positive freedom considerations outweigh the right to sovereign individual choice.
Genetic testing and gene editing are rapidly becoming – indeed, already are – consumer Genetic testing and gene editing are rapidly becoming – indeed, already are – consumer technologies that people can experiment with and apply on their own, potentially without any involvement by traditional payers and research funding agencies, professional scientists and healthcare providers, regulators, and medical product manufacturers. This chapter explores the challenges of regulating direct-to-consumer and do-it-yourself genomic technologies that disrupt the traditional funding, supply arrangements, and roles. It is widely understood that the U.S. Coordinated Framework for biotechnology regulation, even after a 2017 update, is a patchwork of old federal statutes that were never designed for some of the genetic technologies now emerging. This chapter explores four problems that are less well understood: First, consumer genetics poses a fundamental challenge, also seen in the sharing economy exemplified by ride-sharing platforms such as Uber and Lyft. This challenge is one of scale, and the need for regulators to oversee a massive number of small-scale transactions and individual actors. A second challenge is that consumer genetics forces a rethinking of the goals of regulation – specifically, how paternalistic is it appropriate for regulators to be? A third conundrum is whether top-down regulatory approaches can be effective and, if not, how to motivate bottom-up, citizen-led norm-setting and compliance. A final challenge concerns the fact that the human genome itself is, ultimately, software, and many of the consumer products for interpreting and manipulating it also are in the nature of software, yet traditional consumer safety regulators struggle when confronted with the task of regulating software. The chapter concludes that merely expanding the jurisdiction of existing regulatory bodies and granting them new tools and powers will not suffice. A more sweeping redesign of consumer safety regulation will be required.
The focus in modern bioethics on the importance of patient autonomy – with its emphasis on informed consent and patient rights – has transformed medical practice and clinical research. We analyze the concept of autonomy and distinguish two ways in which autonomy is morally important for bioethical questions. We discuss respect for autonomy and its relationship to rights before delineating a taxonomy of ways in which someone’s autonomy can be interfered with. We evaluate two justifications for interfering with someone’s actions: paternalistic justifications and prevention of harm to others. Respect for autonomy grounds the requirement to obtain consent from competent patients and research participants. We provide a detailed analysis of the conditions for valid consent. The last part of our ethical analysis discusses surrogate decision-making for those who lack competence to decide for themselves. Finally, we apply our theory to the right to refuse medical treatment and the ethics of direct-to-consumer advertising of pharmaceuticals.
GIS modeling and analysis of multispectral satellite imagery are applied to a former plantation in the British Virgin Islands (BVI), which, in 1831, became a settlement of free Africans who lived within slavery-based British colonialism. A map of the settlement represents the paternalist British government ideal for this community—an “experiment” for controlling a postemancipation peasantry—and the techniques discussed here allow clearer understanding of the way these ideals would have interacted with the physical and social landscape of the BVI had they been implemented. The residents were certainly aware of their situation, and this study does not mean to imply that they simply adopted the plan they were handed. Instead, our goal is to interrogate the implications of the plan itself. We combine least cost path (LCP), Normalized Difference Vegetation Indexes (NDVI), and other technical analyses to show the interaction of the British plan and the BVI landscape in order to describe the context in which the Kingstown community was built and maintained. Although schematic, this study quantifies at least some of the barriers the community overcame and contributes in a limited way to broader considerations of the place of land and landscape in structures of colonialism.
Is people’s willingness to implement their fairness views on a group dependent on how many in the group share their view? We designed a new experiment to answer this question. Spectator participants were asked how many other participants they believe share their view of whether it is fair to redistribute income in a work task. They were then given the option to pay two cents to implement the distribution they found fair upon a pair of participants who had completed the work task. Although spectator participants systematically overestimate how many share their fairness view, being informed about the true number does not affect their decision to implement the distribution they found fair. The results suggest that people are motivated to implement their fairness view regardless of whether their view is at odds with that of those who are affected.
In this chapter, we address some distinctively epistemic problems that algorithms pose in the context of social media and argue that in some cases that epistemic problems warrant paternalistic interventions. Our paternalistic proposal to these problems is compatible with respect for freedom and autonomy; in fact, we argue that freedom and autonomy demand some kinds of paternalistic interventions. The chapter proceeds as follows. First, we discuss an intervention that Facebook has run in hopes of demoting the spread of fake news on the site. We explain why the intervention is paternalistic and then, using the framework of this book, defend the intervention. We argue that while Facebook’s intervention is defensible, it is limited. It is an intervention that may pop some epistemic bubbles but will likely be powerless against echo chambers. We then discuss heavier-handed interventions that might be effective enough to dismantle some echo chambers, and we argue that at least some heavier-handed epistemically paternalistic interventions are permissible.
The capability approach is widely considered to be a promising alternative to welfarist approaches in welfare economics. Indeed, prominent criticism of the informational basis of utilitarianism and resource-based approaches in welfare economics and political philosophy stand at the origins of the approach. What is not straightforward is whether the capability approach can indeed overcome the problems that motivated its origins. This chapter discusses the latter issue, covering the intrinsic importance of freedom, issues of preference adaptation and the neglect of diversity linked to paternalism. Drawing both on the wide diversity of the literature on capabilities and on the axiomatic literature on freedom rankings, we show that the characteristic features of the capability approach are not enough to respect these three criteria together. We conclude that any promising non-welfarist approach will require further scrutiny of the conceptualisation of freedom, and the modalities of application of value pluralism.
Local Content and Sustainable Development in Global Energy Markets analyses the topical and contentious issue of the critical intersections between local content requirements (LCRs) and the implementation of sustainable development treaties in global energy markets including Africa, Asia, Europe, North America, Latin America, South America, Australasia and the Middle East While LCRs generally aim to boost domestic value creation and economic growth, inappropriately designed LCRs could produce negative social, human rights and environmental outcomes, and a misalignment of a country's fiscal policies and global sustainable development goals. These unintended outcomes may ultimately serve as disincentive to foreign participation in a country's energy market. This book outlines the guiding principles of a sustainable and rights-based approach – focusing on transparency, accountability, gender justice and other human rights issues – to the design, application and implementation of LCRs in global energy markets to avoid misalignments.
This paper examines paternalism as a justification for welfare reforms making benefits conditional on participation in activation programs. We clarify different types of what we denote ‘throffer paternalism’ – a paternalism conjoining an offer with a threat – and ask whether there is a good case for any of them. We argue that hard but non-perfectionistic paternalism provides the most promising defense for mandatory activation but conclude that it does not give a convincing justification for this type of welfare policy.
People often fail to make the choices that best satisfy their preferences. The design of the social environment inevitably makes some choices easier than others. According to Libertarian Paternalists, these facts justify governments nudging people towards better choices through changes to the so-called choice architecture. This is a form of means paternalism. However, the social environment affects not only people's choices or means, but also the preferences they adopt in the first place. Call this the problem of ‘preference architecture’. This article argues that preference architecture constitutes a fundamental challenge to the justificatory basis of Libertarian Paternalism. More generally, it explores when, if ever, government paternalism that influences preference formation can be justified. While Libertarian Paternalism cannot provide a satisfactory answer, the author defends a contractualist account of paternalism based on a notion of primary goods and democratic deliberation.
Prominent theories of justice conjoin the capabilities approach and a doctrine of ‘political liberalism’. The latter maintains that the exercise of state power is morally legitimate only if it is justifiable by appeal to principles that all reasonable citizens can accept, each from her own evaluative perspective. As standardly interpreted, political liberalism rules out selecting state policies on perfectionist grounds. The political perfectionist holds that it is morally mandatory for the state to promote certain activities and conditions on the ground that they are intrinsically valuable. The claim then is that reasonable citizens will differ widely in their beliefs about these intrinsic value matters, so a state that chooses its policies by appeal to perfectionist judgements will be morally illegitimate. This chapter canvasses recent debate on this issue, and suggests that the marriage of the capabilities approach and political liberalism is ill-advised. Political liberalism should be dropped, whether or not one adheres to the capabilities approach. A modest, common-sense perfectionism cohabits harmoniously with the capabilities approach.
Capability theorists disagree on how to determine, for normative purposes, which capabilities are to be treated as basic, with Martha Nussbaum and Amartya Sen taking opposite views. This chapter will scrutinize this list debate. It has two aims. First, it argues that some distinction between basic and non-basic capabilities is an inherent commitment of capability theories, but that there are many more options for responding to the capability-selection problem than a procedure of democratic deliberation (Sen) or a philosophical criterion of neo-Aristotelian flourishing (Nussbaum). A whole range of possible procedures and philosophical criteria could be combined with the capability metric. Second, it responds to a forceful challenge raised by Ian Carter, who argues that capability theorists should not endorse the selection of specific capabilities as basic (either democratically or philosophically) at all. In his view, this will always have paternalistic implications; instead he proposes that the maximization of ‘capability as such’ should be the goal. In response, I distinguish well-being-based and autonomy-based capability theories, and argue that while Carter’s challenge is valid against the former, it fails against the latter.
Drawing upon the case studies of Norfolk North and Devizes, this chapter explores the relationship between the National Government and popular Conservatism in rural, mixed-class constituencies. Through its policies of tariff protection, targeted subsidies, marketing reforms and, in due course, preparations for wartime food production, the National Government transformed British agriculture in the 1930s. This was orchestrated on behalf of the government by Walter Elliot, the ambitious and reformist agriculture minister between 1932 and 1936, who projected the policies as integral to national recovery both by means of self-sufficiency and improved public health. The chapter shows that, despite their interventionist nature, these policies were embraced by local Conservatives as demonstrable evidence of the party’s commitment to agriculture. It also shows that historical critiques centred around the political and social control allegedly wielded by the Conservative landholding interest remained a common and updated feature of Labour and Liberal politics. Under the National Government, however, Conservatives were able to combine modernity and paternalism. Government policies helped to modernise farming methods and restore profitability, and in consequence rehabilitated traditional paternalist politics through new methods of welfare provision. Whether by means of private largesse (as in the case of Sir Thomas Cook MP in Norfolk North) or public provision, the amenities and improvements championed by rural Conservatives aimed to match those already available to the urban population and to secure for the rural worker a share in the national recovery.
This chapter discusses the collective basis for communal life in early modern England, showing that contemporaries were strongly averse to division (including religious conflict). Rather, Christian social values encouraged an organic sense of community built upon reciprocity and common interest. Paternalism simultaneously reinforced the social order while providing the poor with tangible benefits. Charitable giving was underwritten by Christian social codes. The clergy and gentry had powerful social expectations made of them, especially to provide for the poor. The collective consumption of alcohol underwrote many social rituals, forms of commensality and festivity, and much of the plebeian social world was centred upon the alehouse. Rituals such as Rogationtide, along with other forms of festivity and play, articulated powerful social norms.
The COVID-19 Pandemic a stress test for clinical medicine and medical ethics, with a confluence over questions of the proportionality of resuscitation. Drawing upon his experience as a clinical ethicist during the surge in New York City during the Spring of 2020, the author considers how attitudes regarding resuscitation have evolved since the inception of do-not-resuscitate (DNR) orders decades ago. Sharing a personal narrative about a DNR quandry he encountered as a medical intern, the author considers the balance of patient rights versus clinical discretion, warning about the risk of resurgent physician paternalism dressed up in the guise of a public health crisis.
This chapter complements part 4 of Chapter 1 by engaging with and refuting several objections which may be mounted to the arguments advanced there. Those objections are considered in this chapter while making the case for an attractive interpretative theory of how conscientious exemptions should be regulated in a liberal state. A liberal state is here understood to be one committed to individual freedom and state neutrality between different conceptions of the good life. This chapter calls the interpretative theory the Liberal Model of Conscientious Exemptions. This theory has the following four defining propositions:A. The liberal state should grant a general right to conscientious exemption.B. The liberal state should refrain from passing moral judgement on the content of the beliefs which give rise to a claim for conscientious exemption.C. The liberal state should neither privilege nor disadvantage religious beliefs over non-religious ones when considering whether to grant a conscientious exemption.D. The liberal state should grant conscientious exemptions to claimants who sincerely hold a conscientious objection which would not disproportionately impact the rights of others or the public interest.The chapter defends each of the propositions in turn.
In modern times, the familial–political analogy broke down with the emergence and ascendance of liberalism. The collapse of that traditional analogy, it is contended, dissociated the two realms and required new argumentations, definitions, and justifications for the relationships and structure inside each. With the collapse of the analogy, it is argued, the traditional political meaning of the family changed and its standing as a social institution became eroded. Consequently, the political meaning of the family and its relation to justifications for the state and its authority became a fundamental challenge for modern liberal societies. The focus in this chapter is the endeavors of John Locke to define anew parental authority and political authority as unparallel phenomena
We investigate how refugee sponsors and sponsorship groups approach their responsibility to “create new Canadians.” We set the stage by reflecting on the history of Canada as an immigrant-receiving, multicultural country, as well as on the role of acculturation attitudes of host community members in establishing the integration environment for newcomers in general. We use findings from nearly 60 interviews with sponsors in the Ottawa area to outline the different approaches that sponsors take. Approaches to sponsorship fall into three general orientations: paternalistic, passive paternalistic and mutualistic. These approaches manifest in the actions that sponsors take during the sponsorship process. In our discussion, we consider the implications of these approaches for the sponsor–refugee relationship, as well as the broader project of Canadian multiculturalism. We argue that mutualistic approaches best demonstrate welcoming acculturation orientations to newcomers, and that they are an important component of supporting privately sponsored refugees to become Canadians.
The social needs of frail or isolated older people are sometimes aided by referrals to day centres in the United Kingdom. Since the late 1940s, day centres have had a role to play promoting socialisation in later life. Additionally, attendance at day centres is often open ended, with participants only leaving due to moving to a nursing home or dying. In this study, the views of those attending time-limited day centre programmes in seven day centres in Northern Ireland have been sought in relation to their thoughts about the service as well as how they feel when it ends. Seventeen participants completed diaries for the programme duration and/or engaged in an interview process. Participants reflected on the social and educational benefits of attending but also recognised impositions in the centres that impinged upon individual choices and also the length of time they could remain. This study reveals that, in order to maintain socialisation, time-limited programmes must have clear follow-on strategies for participants. Additionally, respondents’ experiences reflect that a paternalistic model of care delivery remains in place that, whilst restrictive, reveals that access to the service is more specialised and not universal. Nevertheless, should day centres wish to remain relevant, it is important that service users are fully consulted about their desires and choices within the setting.
Some accounts of the fiduciary relationship place trust and autonomy at odds with one another, so that trusting a fiduciary to act on one’s behalf reduces one’s ability to be autonomous. In this chapter, we critique this view of the fiduciary relationship (particularly bilateral instances of this relationship) using contemporary work on autonomy and ‘relational autonomy’. Theories of relational autonomy emphasize the role that interpersonal trust and social relationships play in supporting or hampering one’s ability to act autonomously. We argue that fiduciary relationships, understood through the lens of relational autonomy, can provide a means of enhancing, rather than diminishing, beneficiaries’ autonomy.