Pain research is still dominated by biomedical perspectives and the need to articulate pain in ways other than those offered by evidence based medical models is pressing. Examining closely subjective experiences of pain, this book explores the way in which pain is situated, communicated and formed in a larger cultural and social context. Dimensions of Pain explores the lived experience of pain, and questions of identity and pain, from a range of different disciplinary perspectives within the humanities and social sciences. (...) Discussing the acuity and temporality of pain, its isolating impact, the embodied expression of pain, pain and sexuality, gender and ethnicity, it also includes a cluster of three chapters discusses the phenomenon and experience of labour pains. This volume revitalizes the study of pain, offering productive ways of carefully thinking through its different aspects and exploring the positive and enriching side of world-forming pain as well as its limiting aspects. It will be of interest to academics and students interested in pain from a range of backgrounds, including philosophy, sociology, nursing, midwifery, medicine and gender studies. (shrink)

Hip hop has grown into a worldwide genre in recent decades, often being associated with issues of race and class. However, as research on ‘hip hop feminism’ in the US context demonstrates, the categories of gender and sexuality are no less fundamental. In the growing body of international hip hop research, though, questions about gender have been relatively absent, and relatively little is known about how gender norms are negotiated and challenged in hip hop in Europe. This article seeks to (...) contribute to filling this gap in the literature by exploring how women negotiate the gender norms of hip hop in the case of Sweden. To this end, rap lyrics by 12 female rap artists are analysed through poststructuralist discourse analysis. The analysis focuses on intersectionality, feminism within and beyond hip hop, as well as the possibilities and limitations of female masculinity. It is shown how the masculine norms of the genre are simultaneously resisted and resignified as many female rappers incorporate some elements commonly associated with masculinity but mobilize them in their challenging of masculine norms. In this way, complying with the genre interestingly produces a hard and explicit feminism in which ‘all sexist pigs will be slaughtered”. (shrink)

The great majority of species that lived on this earth have gone extinct. These extinctions are often explained by invoking changes in the environment, to which the species has been unable to adapt. Evolutionary suicide is an alternative explanation to such extinctions. It is an evolutionary process in which a viable population adapts in such a way that it can no longer persist. In this paper different models, where evolutionary suicide occurs are discussed, and the theory behind the phenomenon is (...) reviewed. (shrink)

Receiving information about threats to one’s health can contribute to anxiety and depression. In contemporary medical ethics there is considerable consensus that patient autonomy, or the patient’s right to know, in most cases outweighs these negative effects of information. Worry about the detrimental effects of information has, however, been voiced in relation to public health more generally. In particular, information about uncertain threats to public health, from—for example, chemicals—are said to entail social costs that have not been given due consideration. (...) This criticism implies a consequentialist argument for withholding such information from the public in their own best interest. In evaluating the argument for this kind of epistemic paternalism, the consequences of making information available must be compared to the consequences of withholding it. Consequences that should be considered include epistemic effects, psychological effects, effects on private decisions, and effects on political decisions. After giving due consideration to the possible uses of uncertain information and rebutting the claims that uncertainties imply small risks and that they are especially prone to entail misunderstandings and anxiety, it is concluded that there is a strong case against withholding of information about uncertain threats to public health. (shrink)

In this article, I challenge the widespread presumption that a child should have exactly two parents. I consider the pros and cons of various numbers of parents for the people most directly affected – the children themselves and their parents. The number of parents, as well as the ratio of parents to children, may have an impact on what resources are available, what relationships can develop between parents and children, what level of conflict can be expected in the family, as (...) well as the costs involved in parenting and the experience of parenting a child. Indirectly, there is also an effect on who will have the opportunity to be a parent, as well as on wider social issues that I mention but do not discuss. Having considered all these factors, I conclude that there is some reason to believe that three or more parents is usually better than one or two, especially if children are to have siblings, which is typically beneficial. However, these reasons are not strong enough to support a general presumption in favor of any particular number. We should therefore jettison the two‐parent presumption and make different numbers of parents more socially accepted as well as legally possible. (shrink)

The debate for and against making e-cigarettes available to smokers is to a large extent empirical. We do not know the long-term health effects of vaping and we do not know how smokers will respond to e-cigarettes over time. In addition to these empirical uncertainties, however, there are difficult moral issues to consider. One such issue is that many smokers in some sense choose to smoke. Though smoking is addictive and though many start young, it does not seem impossible to (...) plan for and implement cessation. Yet many choose not to do so and we arguably have some reason to respect this choice. I propose that liberal opposition to strict tobacco control, based on respect for choice, is mitigated when e-cigarettes are available, since they are such a close substitute. Making e-cigarettes available to smokers might therefore not only enable switching in practice, but may make tougher tobacco control more justified. Another moral issue is that making e-cigarettes widely available might induce many people to vape, who would otherwise have neither vaped nor smoked. If this is so, the price of using e-cigarettes to accelerate smoking cessation may be a long-term vaping epidemic. Since vaping is less harmful than smoking, both individuals and society will have less reason to end this epidemic and so it may endure longer than the smoking epidemic would otherwise have done. This raises further questions around the weighing of reduced harm to current smokers against increased harm to future vapers. (shrink)

In a contractual firm–stakeholder relationship the participants are expected to act according to the agreement and for mutual benefit. By acting against the agreement at the expense of the other participant, however, may result in higher individual profits within a short period of time. Building on the unlocked iterated prisoner’s dilemma (PD) setting, Scanlon’s [Scanlon, T.␣M.: 1998, What We Owe to Each Other (Belknap Press of Harvard University Press, Cambridge, Mass)] version of contractualism, and the social dilemma literature, this article (...) considers what types of behaviors should be followed by both parties in an established firm–stakeholder relationship in order to reach an outcome that is defensible both in terms of morality and viability. It is argued that a normative foundation, which advises firms and stakeholders to ground their behavior on principles that could not reasonably be rejected by others, forms a basis for moral and viable behavior that can be expressed in the form of a strategic rule that excludes defection and utilizes the option to exit in response to the other participant’s defection. Then, a set of testable propositions is developed that describe how a firm and its stakeholders can further promote moral and viable relationships. (shrink)

Conceptions of autonomy in western philosophy and ethics have often centred on self-governance and self-determination. However, a growing bulk of literature also questions such conceptions, including the understanding of the autonomous self as a self-governing independent individual that chooses, acts, and lives in accordance with her or his own values, norms, or sense of self. This article contributes to the critical interrogation of selfhood, autonomy, and autonomous decision making by combining a feminist focus on relational dimensions of selfhood and autonomy (...) with phenomenological philosophy of the embodied self as being-in-the-world. It offers a philosophical investigation of different dimensions of bodily relational autonomy by turning to phenomenological accounts of the lived body as self-reflexive. When so doing, we hope to contribute to bridging the gap that sometimes exists between discussions of autonomy in analytic moral philosophy and of freedom and facticity in phenomenological philosophy. We see this gap as unfortunate, and hold that a nuanced understanding of autonomy and autonomous decision making can be reached if these strands of philosophy are brought into dialogue. (shrink)

The revival of republicanism was meant to challenge the hegemony of liberalism in contemporary political theory on the grounds that liberals show insufficient concern with institutional protection against political misrule. This article challenges this view by showing how neorepublicanism, particularly on Philip Pettit’s formulation, demands no greater institutional protection than does political liberalism. By identifying neutrality between conceptions of the good as the constraint on institutional requirements that forces neorepublicanism into the liberal framework, the article shows that neutrality is what (...) neorepublicans must jettison to offer a tenable critique of liberalism. Only then can neorepublicans ensure greater protection against misrule by demanding that citizens participate more actively in politics. They can then also criticize liberalism for failing to appreciate the importance of such protection. (shrink)

Do we have stronger duties to assist in emergencies than in nonemergencies? According to Peter Singer and Peter Unger, we do not. Emergency situations, they suggest, merely serve to make more salient the very extensive duties to assist that we always have. This view, while theoretically simple, appears to imply that we must radically revise common-sense emergency norms. Resisting that implication, theorists like Frances Kamm, Jeremy Waldron, and Larry Temkin suggest that emergencies are indeed normatively exceptional. While their approach is (...) more in line with common-sense, however, it is theoretically less simple, and it is has proven difficult to justify the exception. In this paper we propose a model of emergencies that we call the Informal-Insurance Model, and explain how this can be used to combine theoretical simplicity with common-sense emergency norms. (shrink)

Institutions promoting republican freedom as non-domination are commonly believed to differ significantly from institutions promoting negative freedom as non-interference. Philip Pettit, the most prominent contemporary defender of this view, also maintains that these republican institutions are neutral between the different conceptions of the good that characterise a modern society. This paper shows why these two views are incompatible. By analysing the institutional requirements Pettit takes as constitutive of republican freedom, I show how they also promote negative freedom by reducing overall (...) interference. To avoid this result, republican institutions must be more restrictive and require that citizens conform to a life of political engagement. But then republican freedom will not be a neutral ideal. Rejecting negative freedom therefore means sacrificing neutrality. (shrink)

_Phenomenological insights into health issues relating to bodily self-experience, normality and deviance, self-alienation, and objectification._.

Advances in genetic diagnostics lead to more patients being diagnosed with hereditary conditions. These findings are often relevant to patients’ relatives. For example, the success of targeted cancer prevention is dependent on effective disclosure to relatives at risk. Without clear information, individuals cannot take advantage of predictive testing and preventive measures. Against this background, we argue that healthcare professionals have a duty to make actionable genetic information available to their patients’ at-risk relatives. We do not try to settle the difficult (...) question of how this duty should be balanced against other duties, such as the duty of confidentiality and a possible duty not to know one’s genetic predisposition. Instead, we argue for the importance of recognising a general responsibility towards at-risk relatives, to be discharged as well as possible within the limits set by conflicting duties and practical considerations. According to a traditional and still dominant perspective, it is the patient’s duty to inform his or her relatives, while healthcare professionals are only obliged to support their patients in discharging this duty. We argue that this perspective is a mistake and an anomaly. Healthcare professionals do not have a duty to ensure that their patients promote the health of third parties. It is often effective and desirable to engage patients in disseminating information to their relatives. However, healthcare professionals should not thereby deflect their own moral responsibility. (shrink)

This paper concerns the judgement and critique of athletic movement in moving images. Inspired by the ski crash trial case of Paltrow v. Sanderson, and by comparing different media representations of downhill skiing, the essay outlines a framework that discerns as well as connects elements of movement and images, developing the concept of the ‘diorama’ in relation to Deleuze’s notion of the diagram and Kant’s idea of critique. Thus, moving images featuring elite alpine skier Mikaela Shiffrin, fictional character James Bond, (...) and an official skiing game for the international ski federation (World Cup Ski Racing, FIS) figure as comparative material to the animation that played a central role in the celebrity trial. Diorama and diagram are posited on a continuum to assess when and how judgement takes place in each of the exhibits. The essay concludes by discussing how the judging of athletic movement in moving images contributed to Paltrow winning the case, and theoretically by connecting this finding to dioramas and diagrams as tools apt for a framework aiming at the critique of athletic movement in moving images. (shrink)

It is generally agreed upon that Grice's causal theory of perception describes a necessary condition for perception. It does not describe sufficient conditions, however, since there are entities in causal chains that we do not perceive and not all causal chains yield perceptions. One strategy for overcoming these problems is that of strengthening the notion of causality. Another is that of specifying the criteria according to which perceptual experiences should match the way the world is. Finally, one can also try (...) to provide sufficient conditions by elaborating on the content of perceptual experiences. These different strategies are considered in this paper, with the conclusion that none of them is successful. However, a careful examination of their problems points towards the general solution that we outline at the end. (shrink)

Aggregating individuals’ consistent attitudes might produce inconsistent collective attitudes. Some groups therefore need the capacity to form attitudes that are irreducible to those of their members. Such groups, group-agent realists argue, are agents in control of their own attitude formation. In this paper, however, I show how group-agent realism overlooks the important fact that groups consist of strategically interacting agents. Only by eliminating group agency from our social explanations can we see how individuals vote strategically to gain control of their (...) groups and produce collective attitudes we cannot make sense of if we treat groups as agents. (shrink)

The existence of a firm can be seen as a necessary condition for the existence of stakeholders. However, in the stakeholder literature, the firm has remained a relatively underdeveloped and fuzzy construct. In this essay, we examine how the firm has been conceptualized (explicitly or implicitly) in earlier research and suggest that, at least in stakeholder thinking, the firm can be considered as having an emergent nature. We elaborate this idea by building on the resent philosophical discussions of emergence and, (...) as a result, propose the emergentist stakeholder model of the firm. (shrink)

In discussions concerning intersubjectivity the notion of expression has come to play a part of increasing significance. Expression shifts our point of departure away from subjectivity as something mysterious hidden within the body to subjectivity as altogether embodied and embedded in the world. In this article I engage writings by Maurice Merleau-Ponty to argue that expression is essentially something that happens in a communicative space in between self and other while at the same time giving rise to both. I show (...) how locating expression in a shared space between self and other is a way of emphasizing that self and other are not only expressive of selfhood, but are also expressed by one another and emerge in relation to one another. I point to this understanding of expression as a way of recognizing that there is both a fundamental reciprocity and asymmetry between self and other. (shrink)

Public reason liberals expect individuals to have justificatory reasons for their views of certain political issues. This paper considers how groups can, and whether they should, give collective public reasons for their political decisions. A problem is that aggregating individuals’ consistent judgments on reasons and a decision can produce inconsistent collective judgments. The group will then fail to give a reason for its decision. The paper considers various solutions to this problem and defends a deliberative procedure by showing how it (...) incentivizes information sharing and leads to outcomes most acceptable to the group members. (shrink)

The essays in this provocative collection survey and assess institutional arrangements that offer possible alternatives to capitalism as it exists today. The point of departure agreed upon by the contributors is that on the one hand, capitalism produces unemployment, a lack of autonomy in the workplace, and massive income inequalities; while on the other, central socialist planning is characterized by underemployment, inefficiency, and bureaucracy. In Part I of the volume, various alternatives are proposed: profit-sharing systems, capitalism combined with some central (...) planning, worker-owned firms in a market economy into a centrally planned economy, as has occurred recently in Hungary. Part II provides a theoretical analysis and assessment of these systems. This book is the first to cover such a wide range of subjects as central planning, market socialism, and profit sharing. It will prove indispensable to political and social scientists, and economists. (shrink)

Papers in philosophical bioethics often discuss unrealistic scenarios and defend controversial views. Why is that, and what is this kind of work good for? My aim in the first part of this paper is to specify how philosophical bioethics relates to other types of work in bioethics, and to explain the role of the unrealistic scenarios and the controversial views. In the second part, I propose three strategies for doing research in philosophical bioethics that makes a valuable contribution to the (...) bioethics community at large. (shrink)

This essay concerns the place of e-sport in the history of sport. E-sport is construed as an entity in this corpus, by seeking out historical counterparts that display similar forms of play and organisation. Thus, ancient Roman games are identified as an early instance of what could be called public gaming, i.e. competitive digital games in a public setting. Two recent philosophical statements regarding the history of sport furnish the point of departure of the analysis: Steven Connor's historicising of the (...) term sport, and Heather Reid's treatise of virtue in the games and athletics of antiquity. The varying content of sport in its course through time is discussed foremost in relation to how the human and nonhuman elements have been organised. In order to settle the role of public gaming in the history of sport, two aspects of Roman games are highlighted to 'fabricate' its legacy in the history of e-sport: Pollice Verso and simulations. It is concluded that the way Roman games ha... (shrink)

Several DNA-damage detection and repair mechanisms have evolved to repair double-strand breaks induced by mutagens. Later in evolutionary history, DNA single- and double-strand cuts made possible immune diversity by V(D)J recombination and recombination at meiosis. Such cuts are induced endogenously and are highly regulated and controlled. In meiosis, DNA cuts are essential for the initiation of homologous recombination, and for the formation of joint molecule and crossovers. Many proteins that function during somatic DNA-damage detection and repair are also active during (...) homologous recombination. However, their meiotic functions may be altered from their somatic roles through localization, posttranslational modifications and/or interactions with meiosis-specific proteins. Presumably, somatic repair functions and meiotic recombination diverged during evolution, resulting in adaptations specific to sexual reproduction. BioEssays 27:795–808, 2005. © 2005 Wiley Periodicals, Inc. (shrink)

The philosophical debate on paternalism is conducted as if the property of being paternalistic should be attributed to actions. Actions are typically deemed to be paternalistic if they amount to some kind of interference with a person and if the rationale for the action is the good of the person interfered with. This focus on actions obscures the normative issues involved. In particular, it makes it hard to provide an analysis of the traditional liberal resistance to paternalism. Given the fact (...) that actions most often have mixed rationales, it is not clear how we should categorize and evaluate interfering actions for which only part of the rationale is the good of the person. The preferable solution is to attribute the property of being paternalistic not to actions, but to compounds of reasons and actions. The framework of action–reasons provides the tools for distinguishing where exactly paternalism lies in the complex web of reasons and actions. (shrink)

In this chapter, we ask three questions about pedophilia: Is it immoral to be a pedophile? Is it immoral for pedophiles to seek out sexual contact with children? Is it immoral for pedophiles to satisfy their sexual preferences by using computer-generated graphics, sex dolls, and/or sex robots that mimic children? We argue that it is not immoral to be a pedophile, it is immoral for pedophiles to seek out sexual contact with children because of the expected harm to children, and (...) it is morally permissible for pedophiles to satisfy their sexual preferences in ways that do not involve any real children. (shrink)

A number of ethical frameworks have been proposed to support decision-making in public health and the evaluation of public health policy and practice. This is encouraging, since ethical considerations are of paramount importance in health policy. However, these frameworks have various deficiencies, in part because they incorporate substantial ethical positions. In this article, we discuss and criticise a framework developed by James Childress and Ruth Bernheim, which we consider to be the state of the art in the field. Their framework (...) distinguishes aims, such as the promotion of public health, from constraints on the pursuit of those aims, such as the requirement to avoid limitations to liberty, or the requirement to be impartial. We show how this structure creates both theoretical and practical problems. We then go on to present and defend a more practical framework, one that is neutral in avoiding precommitment to particular values and how they ought to be weighted. We believe ethics is at the very heart of such weightings and our framework is developed to reflect this belief. It is therefore both pluralist and value-based. We compare our new framework to Childress and Bernheim’s and outline its advantages. It is justified by its impetus to consider a wide range of alternatives and its tendency to direct decisions towards the best alternatives, as well as by the information provided by the ranking of alternatives and transparent explication of the judgements that motivate this ranking. The new framework presented should be useful to decision-makers in public health, as well as being a means to stimulate further reflection on the role of ethics in public health. (shrink)

When people talk about anarchism, what they have in mind is typically political anarchism, that is, the view that there should be no state. As the philosopher and anarchism scholar David Miller observes, however, anarchism itself is a more general view, namely the view that there should be no rulers. Miller writes that “although the state is the most distinctive object of anarchist attack, it is by no means the only object. Any institution which, like the state, appears to anarchists (...) coercive, punitive, exploitative or destructive is condemned in the same way”—including, for example, religious institutions, schools, or economic systems (Miller 1984: 8). In this sense, one can be an anarchist about different things. Relationship anarchy is anarchism about personal relationships. -/- Several thinkers in the anarchist tradition have held views on personal relationships (e.g., Godwin 1793; Bakunin 1866; Goldman 1910). In what follows, however, our focus is not on the general issue of anarchist views on relationships, but on the ideas of the contemporary movement of self-identifying relationship anarchists. -/- The ideas of relationship anarchy in this sense—hereafter RA—have been developed in queer and countercultural communities over the last two decades. Rather than focusing primarily on mechanisms of political power, RA theorists have been concerned with understanding and challenging the power dynamics at play in close personal relationships. Andie Nordgren, the movement’s central, founding theorist, describes RA as a radical commitment “to avoid defining relationships by attempts to exercise power over each other” (Nordgren 2018). -/- Our aim is to give a concise presentation and defense of RA. We will approach RA as a theory in applied ethics—in particular, as a theory in sexual ethics and relationship ethics—and relate it to ongoing debates in these areas. We, the authors, are both queer men with a background in countercultures where RA is widely practiced and discussed. One of us is an activist working on trans- and sex workers’ rights (Sørlie), the other is a philosophy professor (Moen). Although we make several claims about the scope, content, and justification of RA, we do not claim to speak with any special authority on the issue. Moreover, many of the points that we make here, while not attributable to a specific source, are not original to us, but are the result of several years of fruitful discussion with others in the RA community. -/- We start by considering the cases where, from an RA perspective, current mainstream relationship norms are too restrictive. Then we turn to the cases where current norms are too permissive. Our views on what counts as “mainstream” relationship norms are, no doubt, influenced by the fact that we are writing from a Scandinavian perspective. -/- We then proceed to consider the relationship between RA and polyamory. We argue that RA is compatible with some, but not all, forms of polyamorous practice. We also argue that, from an RA perspective, the increasingly popular term “consensual non-monogamy” is a misleading term that should be avoided. In the conclusion, we explain how RA, as a position in applied ethics, can be justified within consequentialist, deontological, and virtue ethical frameworks alike. -/- We have restricted our scope, in what follows, to chosen relationships between adults. Thus, we are not dealing with, for example, kinship relationships into which one is born, nor relationships between adults and minors. Although many issues and arguments deserve to be explored in greater depth than we can do here, we hope, nevertheless, to be able to convey the main nature and thrust of RA. (shrink)

According to group-agent realism, treating groups as agents with their own intentional states, irreducible to those of the group members, helps us explain and predict the groups’ behavior. This pap...

In the debate on how we ought to define political freedom, some definitions are criticized for implying that no one can ever be free to perform any action. In this paper, I show how the possibility of freedom depends on a definition that finds an appropriate balance between absence of interference and protection against interference. To assess the possibility of different conceptions of freedom, I consider the trade-offs they make between these two dimensions. I find that pure negative freedom is (...) clearly possible. Republican freedom might also be possible, though its protection requirement is too vague for a definitive verdict. Finally, the recently proposed ‘freedom as independence’ is impossible since it is an attempt to avoid the unavoidable trade-off. (shrink)

Can groups really be agents or is group agency just a fiction? Christian List and Philip Pettit argue influentially for group-agent realism by showing how certain groups form and act on attitudes in ways they take to be unexplainable at the level of the individual agents constituting them. Group agency is therefore considered not a fiction or a metaphor but a reality we must account for in explanations of certain social phenomena. In this paper, I challenge this defence of group-agent (...) realism by showing how it is undermined by individual-level analysis of how individuals interact within groups. While group agency can be a useful fiction, real agents are at the individual level, not the collective level. (shrink)

Contemporary population ethics is dominated by views that aggregate by summing, whether of well-being or of some construct based on well-being. In contrast, average well-being is generally considered axiologically irrelevant. To many of us, however, the number of future people does not seem important, as long as it is sufficient to enable rich and varied life experiences, and as long as the population continues throughout time. It therefore seems relatively plausible to aggregate future well-being by averaging. In particular, it seems (...) plausible to value high average well-being at any particular time, and to do so for all future times. I present a time-sensitive version of the Average View that underpins such axiological intuitions. I also address a series of issues and objections that confront such a view. (shrink)

In this paper I seek to answer two interrelated questions about pleasures and pains: (i) The question of unity: Do all pleasures share a single quality that accounts for why these, and only these, are pleasures, and do all pains share a single quality that accounts for why these, and only these, are pains? (ii) The question of commensurability: Are all pleasures and pains rankable on a single, quantitative hedonic scale? I argue that our intuitions draw us in opposing directions: (...) On the one hand, pleasures and pains seem unified and commensurable; on the other hand, they do not. I further argue that neither intuition can be abandoned, and examine three different paths to reconciliation. The first two are response theory and split experience theory. Both of these, I argue, are unsuccessful. A third path, however—which I label “dimensionalism” —succeeds. Dimensionalism is the theory that pleasure and pain have the ontological status as opposite sides of a hedonic dimension along which experiences vary. This view has earlier been suggested by C. D. Broad, Karl Duncker, Shelly Kagan, and John Searle, but it has not been worked out in detail. In this paper I work out the dimensionalist view in some detail, defend it, and explain how it solves the problem of the unity and commensurability of pleasures and pains. (shrink)

Lifelong smokers lose on average a decade of life vis-à-vis non-smokers. Globally, tobacco causes about 5–6 million deaths annually. One billion tobacco-related deaths are predicted for the 21st century, with about half occurring before the age of 70. In this paper, we consider a complete ban on the sale of cigarettes and find that such a ban, if effective, would be justified. As with many policy decisions, the argument for such a ban requires a weighing of the pros and cons (...) and how they impact on different individuals, both current and future. The weightiest factor supporting a ban, we argue, is the often substantial well-being losses many individuals suffer because of smoking. These harms, moreover, disproportionally affect the disadvantaged. The potential gains in well-being and equality, we argue, outweigh the limits a ban places on individuals’ freedom, its failure to respect some individuals’ autonomous choice and the likelihood that it may, in individual cases, reduce well-being. (shrink)

I first distinguish four types of objection to paternalism and argue that only one – the principled objection – amounts to a substantive and distinct normative doctrine. I then argue that this doctrine should be understood as preventing certain facts from playing the role of reasons they would otherwise play. I explain how this filter approach makes antipaternalism independent of several philosophical controversies: On the role reasons play, on what reasons there are, and on how reasons are related to values. (...) I go on to contrast the filter approach with the competing and dominant action-focused approach, which understands objections to paternalism in terms of paternalistic action, behavior, law, policy and the like. Seana Shiffrin and Peter de Marneffe are singled out as prominent recent proponents of this approach. By engaging with their definitions of paternalism, I explain how the action-focused approach makes antipaternalism dependent on the sorting of actions into paternalistic and nonpaternalistic according to what reasons support them. Because one and the same action can be supported by many different reasons, and by different sorts of reasons, such sorting is very difficult. The upshot is that antipaternalism on the action-focused account fails to provide the precise normative implications of the filter approach that I favor. (shrink)

Paternalism means, roughly, benevolent interference: benevolent because it aims at promoting or protecting a person’s good; interference because it restricts his liberty without his consent. The paternalist believes herself superior in that she can secure some benefit for the person that he himself will not secure. Paternalism is opposed by the liberal tradition, at least when it targets sufficiently voluntary behavior. In legal contexts, policies may be paternalistic for some and not for others, forcing trade-offs. In medical contexts, paternalism can (...) be an open or hidden aspect of the relationship between caregiver and patient. (shrink)