Autonomy and Paternalism

Abstract

Paternalism has generally been thought of as forcible or coercive interference with a person's liberty of action which is (believed to be) justified because it will prevent harm to that person's welfare interests or the like. Opposition to paternalistic interference with adults, whether it involves the intervention of the state (legal paternalism) or another adult individual, has usually been based on a concern to preserve human autonomy or self-determination. More strictly it is opposition to so-called ‘strong’ paternalism - interventions to protect or benefit a person despite the person's informed voluntary consent to the contrary- which has been grounded on such a commitment to self-determination. ‘Weak’ paternalism involves interference where there is (or is believed to be) a defect in the decision-making capacities of the person interfered with (or to ascertain whether the person's behaviour is fully reflective). It is claimed to be justifiable insofar as consent to the interference would be forthcoming were these capacities restored.

Empowerment in mainstream psychology: Legitimacy, obstacles, and possibilities.

“…Many so-called "benevolent" interventions to help the disadvantaged have infringed upon their sense of self-respect and effectively curtailed tiieir aspirations for self-determination (Gaylin, Glasser, Marcus, 8c Rothman, 1981). Among applied ethicists, Young (1982) contends that "opposition to paternalistic interference with adults, whether it involves the intervention of the state (legal paternalism) or anodicr adult individual, has usually been based on a concern to preserve human autonomy or self-determination" (1982, p. 47). The many converging critiques on paternalism coalesced to create alternate, empowering strategies (Boytc & Riessman, 1986;Rappaport, 1981Rappaport, , 1987Swift, 1984).…”

Paternalism and democracy

“…''24 Joel Feinberg, John Hodson and Jefffie Murphy agree with Carter here, 25 as does John Young, who goes on to characterize paternalism not only as an interference with, but also as a violation of, individual liberty. 26 The interesting thing about this definition is that it encompasses both too little and too much. On the one hand, it ignores the context of paternalisfic choice-making -or, in other words, the relationships of domination and inequality that exist between a paternalist and those subject to paternalistic treatment.…”