Kyle van Oosterum (University of Oxford), "Paternalism and Exclusion"
Journal of Ethics and Social Philosophy, 2024
Most philosophers think that paternalism – when X interferes with Y in order to promote Y’s well-being – is generally, but not always wrong. Perhaps the only morally redeeming feature about paternalism – when it is successful – is that we would promote another person’s well-being. Other things being equal, if one can promote another person’s well-being, that consideration generates a valid reason for acting. Well, according to some philosophers, paternalism is wrong precisely because we take a person’s well-being as a reason for acting.
How does that work? It starts by recognizing that there may be certain kinds of reasons that speak about the reasons for or against acting in a particular way. Consider Ann the Banker. Ann is a banker who, exhausted after a long day of work, nevertheless has to make an important decision about some financial deal. Her tiredness is not a reason for or against making the investment. The fact that she is exhausted seems to give her a reason not to act on her best judgment of the reasons for and against making this important investment. In other words, her tiredness excludes her first-order reasons for or against doing something.
A similar move is going on in the antipaternalism literature, which I call the exclusionary strategy. There, the thought is that what it is to be an autonomous person is to have some power over the reasons others may use to justify their actions towards us. In particular, we have the power to make wellbeing-related reasons inadmissible as justifications for our action. What’s appealing about this view is the powerful intuition that pumps it – it’s no one’s business whether my well-being should be promoted.
Is there anything wrong with the exclusionary strategy? First off, you might find the claim that you have control over whether reasons play a justificatory role a bizarre one. There might be an important difference between saying these wellbeing-related reasons are about the paternalizee and claiming that these reasons are literally theirs in the way that material resources are ours. But if that’s not strange, the view is hard to formulate plausibly.
Imagine someone spontaneously decides they want to commit suicide for no apparent reason and has refused to think about his own well-being. To my mind, this is a case where it might be permissible to paternalistically interfere with them. Even if you disagree, let’s grant this for a moment. How would the exclusionary strategy proponent justify paternalistic intervention? What intuitively justifies the intervention is the well-being of the suicidal person. However, we cannot appeal to those wellbeing-related reasons since they have been excluded by the paternalizee. We also can’t appeal to reasons unrelated to the paternalizee’s well-being – how their choice affects others – for then this would not be a case of paternalism. After all, what makes paternalism paternalistic is that we justify our actions with reference to that person’s well-being.
Here’s the problem: the only thing that could morally justify this action and make it the case that we are still acting paternalistically are the very reasons that are excluded from consideration, i.e., the paternalizee’s well-being. So, these views are literally incapable of morally justifying any paternalistic intervention. This makes it hard to square with mainstream view that paternalism is generally but not always wrong – a bad result.
I think we get ourselves in a muddle when we try to exclude what are typically compelling moral reasons for action, i.e., promoting the well-being of others. My view is that we must become more philosophically sensitive to the reasons for or against paternalistic intervention and how certain facts can intensify or attenuate those reasons. Rather than excluding certain reasons, it’s about including more information in our practical moral reasoning about paternalism. For example, the significance to the person of making that self-harming choice can intensify/attenuate our reason against paternalistically interfering. We should begin to figure out the catalogue of particular considerations that speak for or against paternalism and not use the blunt tool of exclusionary reasons.