Paternalism in Philosophy: Conceptions and Justifications

Should a physician be responsible for the harm suffered by her patient if the patient refuses a certain treatment because he did not want to hear, accept, or believe the information given by the doctor? To what degree is the doctor obliged or allowed to convince, persuade, or coerce the patient into having or not having a certain therapy? We face similar, sometimes less but sometimes more dramatic questions about the interference of family, friends, strangers, and public officials in our life almost every day. Instances of both personal paternalism (between parent and child, doctor and patient) and legal paternalism (between legislators and citizens, judges and parties) abound. The latter ranges from the mandatory waiting time before marriage through safety regulations requiring motorcyclists to use crash helmets and drivers to use seat belts to the prohibition of certain forms of euthanasia, the criminalization of drug use, or the irrelevance of the victim’s consent to mutilation and homicide in criminal law. Intuitively we tend to call many kinds of interference and regulation paternalistic but among the numerous ways modern laws regulate our life, paternalism is a relatively specific phenomenon. We should beware of the indiscriminate use of the term for any interference with freedom of choice.