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Part of the book series: The International Library of Bioethics ((ILB,volume 90))

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Abstract

Writers have devoted too little attention to the question of the appropriate limits of the state. There seems to be a tacit assumption that wise, well-meaning statesmen will translate philosophers’ insights into good policy. I suggest that it is more likely to find that government leaders in large nations are narcissistic, power-obsessed, and corrupt. The necessity for protecting children’s needs must balanced against the need to maintain the integrity of private spaces against the sorts of governments that are likely to wield authority. I propose seven principles that undergird this balance, and that will be reified in the State Intervention Test in the next chapter. These principles are family primacy, pluralism, political realism, negotiation, limitation of government scope, diffusion of government power, and sufficientarianism. Essentially, I seek a political process with constitutional guarantees of liberty. My vision derives from a contemporary movement in political theory known as political realism. Needs must ultimately be determined politically, and are reified through a political process as guarantees of minimum fulfillment of important interests. The idea that the state should provide such a floor is called sufficientarianism. The levels of sufficiency are established through a modus vivendi. There is no non-controversial principled justification, so I use sentiment to justify my political realist solution. First, it is based on compassion, and possibly solidarity. Second, it encompasses the notion of self-insurance; any of us may fall below a sufficient level without the state providing a floor. Finally, the existence of a social net promotes the legitimacy of societal institutions, including the state, thus promoting social harmony and order.

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Notes

  1. 1.

    A state is a geographically based entity with the power to enact and enforce laws and regulations. The United States, Texas, and Houston are states under this definition. A government is the organization (institutions and their officials) that wields state power.

  2. 2.

    The Dark Triad consists of narcissism, Machiavellianism, and psychopathy.

  3. 3.

    Including gains for the government official, her family and friends, her reelection prospects, and those interests that are of narrow benefit to the government official’s constituents but which do not promote the public good.

  4. 4.

    However, American jurisdictions are is not required to offer such protections (DeShaney v. Winnebago County Dept. of Social Servs., 489 US 189, Supreme Court, 1989).

  5. 5.

    This covers outpatient costs in the United States funding system for the elderly. It is funded partly by the government and partly through income-based premiums paid by recipients.

  6. 6.

    A scarce resource is defined as one not present in sufficient quantities to satisfy the desire for that resource.

  7. 7.

    A QALY, or Quality-Adjusted Life Year, is “a measure of the state of health of a person or group in which the benefits, in terms of length of life, are adjusted to reflect the quality of life. One quality-adjusted life year (QALY) is equal to 1 year of life in perfect health. QALYs are calculated by estimating the years of life remaining for a patient following a particular treatment or intervention and weighting each year with a quality-of-life score (on a 0 to 1 scale). It is often measured in terms of the person’s ability to carry out the activities of daily life, and freedom from pain and mental disturbance (NICE 2001).

  8. 8.

    The Oath of Maimonides was actually composed by Marcus Herz in 1783, almost 600 years after the death of Maimonides.

  9. 9.

    If provision of sufficient quantities of any currency is impossible because there are insufficient resources (or for some other reason), there will arise a new modus vivendi that redefines the level of sufficiency. We cannot, for example, expect parents to provide adequate housing for their children if a hurricane has just leveled their city. Government must then define what parents must do to avoid liability for neglect.

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Jacobs, A.J. (2022). Political Considerations in a Liberal Pluralist State. In: Assigning Responsibility for Children’s Health When Parents and Authorities Disagree: Whose Child?. The International Library of Bioethics, vol 90. Springer, Cham. https://doi.org/10.1007/978-3-030-87698-2_6

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