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Paternalism, Liberal Theory, and Suicide
Published online by Cambridge University Press: 01 January 2020
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A principle of paternalism must be able to answer three questions. Who are the persons who are the proper object of paternalism? Which actions should we prevent persons from doing or induce them to perform? What should our goals be when acting paternalistically toward these persons? A satisfactory principle will also be reasonably precise in distinguishing appropriate from inappropriate instances of paternalism, and it will be comprehensive, speaking to most (if not all) potential cases, including suicide. My purpose is not to reach a conclusion about the acceptability of paternalistic restrictions on suicide. Rather, because such a conclusion will follow from the way in which a principle of paternalism is formulated, I want to examine several liberal attempts at formulation and the theoretical background underlying these attempts.
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References
1 Feinberg, Joel ‘Legal Paternalism; Canadian Journal of Philosophy, 1 (1971) 105-24;CrossRefGoogle Scholar Social Philosophy (Englewood Cliffs: Prentice-Hall 1973) 45-52
2 Feinberg Social Philosophy, 46
3 Ibid. See also Alan Ryan: ‘ … the liberal dilemma is that it is very hard to formulate any principle which will moderate [mediate] antipaternalism in such cases [heroin] without weakening it elsewhere’ U.S. Mill [London: Routledge and Kegan Paul 19741 149).
4 Of course, much use of alcohol (and, these days, cigarettes) has other-regarding effects. Feinberg is only discussing the Justifiability of paternalism with respect to the use of alcohol that is predominantly self-regarding. I do agree with Feinberg that a distinction can be drawn between acts which are only self.hurtful (self– regarding) and acts which cause harm to others (other–regarding). See ‘legal Paternalism: p. 106, fn. 2, and Ten, C.L. ‘Mill on Self-Regarding Actions,' Philosophy, 43 (1968) 29–37.CrossRefGoogle Scholar In some cases the arguments over the regulation of suicide may be seen as arguments over the correct way to divide self from other-regarding actions.
5 Hart, H.I.A. Law, Libterty, and Morality (Stanford, CA: Stanford University Press 1963) 30–34Google Scholar
6 Ibid., 33
7 Ibid. (italics added). Do not make too much out of Hart's use of the word ‘victims.' He is speaking about voluntary euthanasia (these persons are not victims in the literal sense), which is a form of suicide and can be purely self-regarding.
8 This liberal ingredient is advanced in Mill's On Liberty (New York: Bobbs– Merrill. The Library of Liberal Arts 1956). See also Alan Ryan:’ … in any tolerably advanced society, no-one knows better than I what I want. It is a distrust of expertise about ends that is common to liberal thought ('Mr. McCloskey on Mill's Liberalism,’ Political Quarterly, 14 [1964) 259).
9 See Hobhouse, L.T. Liberalism (New York: Oxford University Press 1964; originally 1911) 60-1, 76.Google Scholar But note that the liberal can only defend suicide done by a rational person on the grounds that such a person knows best what she wants; the argument based on the development of character apparently allows interference with suicide attempts.
10 The idealist also has a triumvirate of core doctrines. (1) The denial of the autonomy of empirical desires, (2) the claim that ends as well as means can be evaluated as rational/irrational - or at least that ends can be evaluated in some substantive way or another, and (3) the doctrine of positive freedom (being free means more than being unhindered by obstacles).
11 A variant of Mill's example (On Liberty, 117).
12 Feinberg, Social Philosophy, 49ff. At least for this reason Feinberg is wrong in thinking that his version of paternalism ‘could be accepted even by Mill’ (p. 50).
13 Ibid., 49-50
14 See Mill, On Liberty, 13.Google Scholar
15 Bernard Gert claims that ‘the desire to be killed’ is irrational: see The Moral Rules (New York: Harper and Row 1973) 37.
16 Marxists who claim that no woman would become a prostitute unless economically coerced are making this sort of statement. Becoming a prostitute counts necessarily as an expression of involuntariness.
17 Category v is difficult. A person coerced by others into murdering another per– son is not for that reason ‘paternalistically’ excused from being charged with the crime and subsequently punished. But the inclusion of this category is one way for the liberal to Justify paternalistic welfare, unemployment and minimum– wage laws. Extreme poverty (caused by ‘other persons’ in the sense of the opera– lion of the economy) can be viewed as a force undermining voluntariness (see Hobhouse, Liberalism, 50Google Scholar).
18 Mill, On Liberty, 117Google Scholar
19 See the prolific writing of Szasz, Thomas including The Myth of Mental Illness (New York: Harper and Row 1961)Google Scholar and The Manufacture of Madness (New York: Harper and Row 1970).
20 Gibson, Mary ‘Rationality,’ Philosophy and Public Affairs, 6 (1977) 193–225,Google Scholar especially p. 212
21 These formulas can be found in Rawls’ discussion of paternalism. He uses his theory of the primary goods (what any person wants whatever else she wants) to give substance to formula (2). See A Theory of Justice (Cambridge: Harvard University Press 1971) 248-50.
22 This example is a modification of one of Gibson's.
23 Dworkin, Gerald ‘Paternalism: in Wasserstrom, R.A. ed., Morality and the Law (Belmont, CA: Wadsworth 1971) 107–126Google Scholar
24 Ibid., 119 (italics added). Rawls, too, writes in the indicative mood: ‘We must be able to argue that with the development … of his rational powers the individual in question will accept our decision on his behalf and agree with us that we did the best thing for him’ (A Theory of Justice, 249; italics added).
25 This point is neatly ignored by the reassuring television commercial for KoolAid: 'You loved it as a child; you trust it as a mother.'
26 Rawls does escape this charge, however, but at the cost of indefinitely postponing the empirical determination of the boundary. The empirical determination could be done in the context of a society already governed by his two principles; this would guarantee (on his view) that the Judgments made by the adult the child has become are largely independent and autonomous. In her paper ‘justifying Paternalism’ (Canadian Journal of Philosophy, 7 [1977] 133-45), Rosemary Carter claims (correctly, I think) that if paternalistic interference is ‘causally sufficient to guarantee the subsequent consent of the subject' (p. 136), then that interference is not Justified. However, she condones a great deal of paternalism when children are the subjects (p. 141), without realizing that in many of these cases the child's subsequent approval (or consent), upon reaching adulthood, has been manufactured by that earlier paternalism. For a discussion of ‘ex post facto consent,’ see my ‘Deception in .Social Science Research: Is Informed Consent Possible?', The Hastings Center Report, 8 (1978) 40-6, and Donald Van De Veer, ‘Paternalism and Subsequent Consent,’ Canadian Journal of Philosophy, 9 (1979), 631-42.