The Problems of Paternalism

Dissertation, Brown University (1981)

This dissertation is composed of four chapters. In the first I discuss the concept of paternalism. I state and analyze a definition of 'paternalism' which provides a coherent and illuminating scheme of classification for discussing the moral problems normally associated with acts of paternalism. I then compare this definition with alternative definitions and argue that it is superior. ;In the second chapter I show why paternalism is morally objectionable. My position is that paternalism limits autonomy and that we must understand why autonomy is valuable in order to understand why paternalism is morally objectionable. I argue that autonomy is valuable partly because it is a constituent of individual and social welfare. But I also argue that autonomy has moral worth which is independent of its contingent relation to welfare. The bulk of the chapter is devoted to explaining why autonomy has moral worth. ;The third chapter is a discussion of the concept of individual welfare. I discuss four conceptions of welfare: a "material" conception which maintains that there are things which are intrinsically good or intrinsically bad for persons; several versions of a happiness theory; a rational desire theory; and perfectionism. I argue that the rational desire theory is the best of these. ;In the fourth chapter I discuss the problem of justifying paternalism. I argue that it can be justified in particular cases, and I discuss two conflicting principles which could be the principles which justify paternalism. They are a utilitarian principle and what I call a "libertarian" principle. I argue that each principle justifies paternalism in only a narrow range of cases and that they may be extensionally equivalent. However, they appear to justify paternalism for different reasons. I argue that the libertarian principle appears to justify paternalism for the rights reasons but that more work is needed to confirm this
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