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Respectful Paternalism

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Abstract

A common objection to paternalism concerns its expressive content. Many reject paternalistic policies and actions on the ground that they arguably involve insulting expressions of disrespect toward those subjected to them. The paper challenges this view. It argues that refraining from acting paternalistically can be disrespectful. Specifically, the paper argues that there is a relevant way in which A disregards the moral worth of B if A stands idly by when B is about to act very imprudently. If true, treating others with equal respect and concern, as relational egalitarians and others rightly ask us to do, will somewhat surprisingly sometimes involve treating them paternalistically.

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Notes

  1. Joel Feinberg, Harm to Self (Oxford: Oxford University Press, 1986), p. 109; Danny Scoccia, ‘In Defense of Hard Paternalism’, Law and Philosophy 27(4) (2008): pp. 351–381, p. 358. Joe is what Alycia W. LaGuardia-LoBianco describes as a ‘deliberate self-saboteur’. According to LaGuardia-LoBianco, ‘[s]elf-saboteurs act with the goal of making themselves suffer either as the intrinsic or instrumental goal and know that their action will achieve this effect’. See, Alycia W. LaGuardia-LoBianco, ‘Self-Saboteurs and Ethical Relationships’, Social Theory and Practice 45(2): pp. 249–285, p. 256.

  2. Kristin Voigt, ‘Paternalism and Equality’, in T. Schramme (ed.), New Perspectives on Paternalism and Health Care, Library of Ethics and Applied Philosophy 35 (2015): pp. 87–100; Kristin Voigt and Gry Wester, ‘Relational Equality and Health’, Social Philosophy & Policy Foundation (2015): pp. 204–229; Richard Arneson, ‘Joel Feinberg and the Justification of Hard Paternalism’, Legal Theory 11 (2005): pp. 259–284; Richard Arneson, ‘Paternalism, Utility, and Fairness’, Revue Internationale de Philosophie 43(179) (1989): pp. 409–437; Daniel Groll, ‘Paternalism, Respect, and the Will’, Ethics 122(4) (2012): pp. 692–720; Seana Shiffrin, ‘Paternalism, Unconscionability Doctrine, and Accommodation’, Philosophy and Public Affairs 29(3) (2000): pp 205–250, p. 206; Paul Bou-Habib, ‘Compulsory Insurance without Paternalism’, Utilitas 18(3) (2006): pp. 243–263, p. 263.

  3. Elizabeth Anderson, ‘What is the Point of Equality?’, Ethics 109(2) (1999): pp. 287–337, p. 289.

  4. Ibid, p. 301.

  5. Term from Viki Pedersen and Søren Midtgaard, ‘Is Anti-Paternalism Enough?’, Political Studies 66(3) (2018): pp. 771–785.

  6. For exceptions, see Pedersen and Midtgaard, ‘Is Anti-Paternalism Enough?’, p. 780; Anne-Sofie Hojlund, ‘Mitigating Servility: Policies of Egalitarian Self-Relations’, British Journal of Political Science (2021), https://doi.org/10.1017/S0007123420000629; Anne-Sofie Hojlund, ‘What Should Egalitarian Policies Express?’, The Journal of Political Philosophy (2021), https://doi.org/10.1111/jopp.12245.

  7. Kalle Grill, ‘Anti-Paternalism as a Filter on Reasons’, in T. Schramme (ed.), New Perspectives on Paternalism and Health Care, Library of Ethics and Applied Philosophy 35 (2015): pp. 47–63, p. 47. It should be mentioned that Grill is not explicit regarding what exactly these facts consist of.

  8. Grill, ‘Anti-Paternalism as a Filter’; Peter de Marneffe, ‘Avoiding Paternalism’, Philosophy & Public Affairs 34(1) (2006): pp. 68–94, p. 69; Feinberg, Harm to Self, pp. 25–26; Pedersen and Midtgaard, ‘Is Anti-Paternalism Enough?’, p. 773.

  9. Jonathan Quong, Liberalism without Perfection (New York: Oxford University Press, 2011), p. 81; Anderson, ‘What is the point’, p. 301; Nicolas Cornell, ‘A Third Theory of Paternalism’, Michigan Law Review 113(8) (2015): pp. 1295–1336, p. 1316; George Tsai, ‘Rational Persuasion as Paternalism’, Philosophy & Public Affairs 42(1) (2014): pp. 78–112, p. 87.

  10. Stephen Darwall, Welfare and Rational Care (Princeton: Princeton University Press, 2002), pp. 14–15. The first interpretation is plausibly covered by what Darwall elsewhere describes as ‘appraisal respect’, whereas the second interpretation can be seen as an example of ‘recognition respect’. See Darwall, Stephen, ‘Two Kinds of Respect’, Ethics 88(1) (1977): pp. 36–49.

  11. For example, according to Daniel Groll, respecting a person’s will implies that it is treated as ‘structurally decisive’ in determining what to do (meaning that it silences other reasons). See Groll, ‘Paternalism, Respect, and the Will’.

  12. Darwall, Welfare and Rational Care, p. 15.

  13. Anderson, ‘What is the point’, p. 219.

  14. Carl Fox, ‘What’s special about the insult of paternalism?’ Law and Philosophy 38 (2019): pp. 313–334, p. 323.

  15. Anderson, ‘What is the point’, p. 319.

  16. Pedersen and Midtgaard, ‘Is Anti-Paternalism Enough?’, p. 771.

  17. Arneson, ‘Joel Feinberg’, p. 275.

  18. Ibid, p. 275.

  19. Arneson, ‘Paternalism, Utility, and Fairness’, p. 412.

  20. Note that Arneson’s argument hinges on the fact that paternalism is actually equality promoting. Accordingly, the argument is of no avail when bad choosers tend to be better off than prudent choosers, e.g. if being well-off has a tendency to make one more imprudent.

  21. Briefly described, the objection is that luck egalitarians will abandon individuals, who can be held adequately responsible for their imprudent activities, to severe deprivation.

  22. Pedersen and Midtgaard, ‘Is Anti-Paternalism Enough?’, p. 771.

  23. Ibid, p. 774.

  24. Voigt, ‘Paternalism and Equality’, p. 99.

  25. Anderson, ‘What is the point’, p. 289.

  26. According to Anderson, luck egalitarians must appeal to paternalistic reasons to ‘justify making mandatory the various universal social insurance programs characteristic of modern welfare states: social security, health and disability insurance’. Ibid, p. 301.

  27. Ibid.

  28. Voigt and Wester, ‘Relational Equality and Health’, pp. 225–227. Based on the work of Douglas Husak and Seana Shiffrin, Voigt and Wester expound this objection to paternalism in detail. See also Kristin Voigt, ‘Relational Equality and the Expressive Dimension of State Action’, Social Theory and Practice 44(3) (2018): pp. 437–467, pp. 461–462.

  29. Quong, Liberalism without Perfection, p. 81.

  30. Cornell, ‘A Third Theory’, p. 1316.

  31. Tsai, ‘Rational Persuasion as Paternalism’, pp. 85–89.

  32. Voigt, ‘Paternalism and Equality’, p. 97.

  33. Specifically, as Kasper Lippert-Rasmussen formulates it, Anderson’s view seems to assume the following relation between ‘treating’ and ‘expressing’: ‘X treats Y with equal concern and respect if, and only if, X treats Y on the basis of principles that express equal respect and concern’. Kasper Lippert-Rasmussen, Relational Egalitarianism: Living as Equals (Cambridge: Cambridge University Press, 2018), p. 79. However, as he points out, it is also possible to find support for an alternative point of view by Anderson. According to this, ‘one can act disrespectfully even if one does not act from a principle which expresses disrespect’. Ibid, p. 79, footnote 25. Nevertheless, if expressions of disrespect are a main characteristic of paternalistic acts and policies, paternalism seems regrettable regardless of which of the two views one adopts.

  34. Jason Hanna, In Our Best Interest: A Defense of Paternalism (Oxford: Oxford University Press, 2018), p. 68.

  35. Ibid, p. 69.

  36. Voigt, ‘Paternalism and Equality’, pp. 97–99.

  37. Note that there seems to be a relevant difference between objecting to an argument and an agent voicing an argument (even if we cannot object to an argument that is valid and consists of true premises, we might still object to an agent voicing the argument). I take the disrespect objection to be an instance of the latter, i.e. the objection is that an agent who seeks to bring about a certain distribution with appeal to paternalistic reasons must make disrespectful expressions. Here, I am inspired by Lippert-Rasmussen, Relational Egalitarianism, p. 78.

  38. Voigt and Wester, ‘Relational Equality and Health’, p. 212.

  39. Ibid.

  40. Anderson, ‘What is the point’, p. 331.

  41. Ibid, p. 330.

  42. Ibid.

  43. Ibid, p. 331.

  44. Voigt and Wester, ‘Relational Equality and Health’, p. 213.

  45. Se e.g. Anderson, ‘What is the point’, p. 312, 330. However, to the extent that a person’s moral worth is seen as something of purely impersonal value, the strength of the obligation might be relatively weak. For a detailed argument for this view, see Søren Midtgaard, ‘Non-Renounceable Rights, Paternalism and Autonomy’, Utilitas 27(3) (2015): pp. 347–364.

  46. Tsai, ‘Rational Persuasion as Paternalism’, pp. 79–80.

  47. It should be mentioned that Ben’s duty to interfere with Joe seems to be conditional on Ben not incurring unreasonably high costs in doing so.

  48. I owe this point to Søren Flinch Midtgaard.

  49. I borrow these criteria from Feinberg, Harm to Self, pp. 117–124.

  50. Gerald Dworkin, ‘Paternalism’, The Monist 56(1) (1972): pp 64–84, p. 84.

  51. Ibid, pp. 82–83. See also Julian Le Grand and Bill New, Government Paternalism: Nanny State or Helpful Friend? (Princeton & Oxford: Princeton University Press, 2015), pp. 102–103.

  52. For a relevant variant of this argument, see Bou-Habib, ‘Compulsory Insurance’, pp. 259–262.

  53. Anderson, ‘What is the point’, p. 319.

  54. Ibid.

  55. The same argument is presented in my PhD dissertation. See Viki Pedersen, The Imprudence Trilemma: Sufficiency, Non-Paternalism, and Cost-Sensitivity (Aarhus: Forlaget Politica, 2019), p. 40. The argument is inspired by Anderson’s argument to the effect that it need not be paternalistic to disallow people to waive their right to be offered assistance, see Anderson, ‘What is the point’, p. 319, 329.

  56. See also Viki Pedersen, ‘On the Anti-Paternalist Project of Reconciliation’, Utilitas 31(1) (2019): pp. 20–37.

  57. Joel Feinberg, ‘Legal Paternalism’, Canadian Journal of Philosophy 1(1) (1971): pp. 105–124, p. 118.

  58. Shiffrin, ‘Paternalism, Unconscionability Doctrine, and Accommodation’, p. 218.

  59. Ibid.

  60. See e.g. ‘Paternalism, Unconscionability Doctrine, and Accommodation’; Anderson ‘What is the point’; Bou-Habib, ‘Compulsory Insurance’.

  61. Anderson, ‘What is the point’, p. 330.

  62. Marneffe, ‘Avoiding Paternalism’, p. 79.

  63. I am indebted here to Kasper Lippert-Rasmussen.

  64. Marneffe, ‘Avoiding Paternalism’, pp. 79–80.

  65. Shiffrin, ‘Paternalism, Unconscionability Doctrine, and Accommodation’, p. 224.

  66. Hanna, In Our Best Interest, p. 67.

  67. See e.g. Fox, ‘What’s special about the insult of paternalism?’

Acknowledgements

For helpful comments, I am grateful to participants in ‘The Value of Health: New trends in public health and health equity research’ at SDU, Odense, October 4–5 2018; participants in the ‘Nordic Network in Political Theory’ in Roskilde, October 25–27 2018; participants in the ‘5th Workshop on Political Equality and Voting’ in Copenhagen, January 30–31 2000; and two anonymous referees for this journal. I thank Andreas Albertsen, Didde Boisen Andersen, Kim Angell, Paul Bou-Habib, Andreas Christiansen, Göran Duus-Otterström, Kalle Grill, Sune Lægaard, Jakob Thrane Mainz, Grethe Netland, Lasse Nielsen, Tore Vincents Olsen, Jørn Sønderholm, and James Stacey Taylor. I would also like to thank Jakob Elster and Axel Gosseries for their critical commentaries. I am especially grateful to Søren Flinch Midtgaard and Kasper Lippert-Rasmussen for helpful discussions and detailed written comments on various versions of this article.

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  1. Centre for the Experimental-Philosophical Study of Discrimination, Department of Political Science, Aarhus University, Bartholins Allé 7, 8000, Aarhus C, Denmark

    Viki Møller Lyngby Pedersen

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Pedersen, V.M.L. Respectful Paternalism. Law and Philos 40, 419–442 (2021). https://doi.org/10.1007/s10982-021-09407-9

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