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Part of the book series: Library of Ethics and Applied Philosophy ((LOET,volume 35))

Abstract

Paternalistic interventions restrict individuals’ liberty or autonomy so as to guide their decisions towards options that are more beneficial for them than the ones they would choose in the absence of such interventions. Although some philosophers have emphasised that there is a case for justifiable paternalism in certain circumstances, much of contemporary moral and political philosophy works from a strong presumption against paternalistic interventions. However, Richard Arneson has argued that there are egalitarian reasons that support the case for paternalism: paternalistic interventions can protect poor decision-makers from making ‘bad’ choices, thus preventing inequalities between them and those with better decision-making skills. This paper seeks to clarify and advance our understanding of the egalitarian argument for paternalism. Arneson’s argument adds an important and often neglected dimension to the debate about paternalism but also raises a number of questions about equality, paternalism and the relationship between the two.

This work was first presented at the ‘New perspectives on medical paternalism’ workshop at the University of Hamburg in March 2012 and benefited greatly from the comments received. I would also like to thank Kalle Grill and Thomas Schramme for their helpful comments on an earlier draft.

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Notes

  1. 1.

    In Jefford et al.’s (2005) study with Australian oncologists, the most commonly voiced concerns about giving patients information about unsubsidised drugs were about causing the patient and their family distress and mentioning a drug to patients even though they probably wouldn’t be able to afford it.

  2. 2.

    Note that strictly speaking we are dealing with impure paternalism here, where third parties are restricted in their liberties so as to protect other agents from making ‘bad’ choices.

  3. 3.

    On the relationship between the distributive and relational views, see also Schemmel (2012). The possible implications of the relational approach for questions surrounding health are considered in Voigt and Wester (forthcoming).

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Correspondence to Kristin Voigt .

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Voigt, K. (2015). Paternalism and Equality. In: Schramme, T. (eds) New Perspectives on Paternalism and Health Care. Library of Ethics and Applied Philosophy, vol 35. Springer, Cham. https://doi.org/10.1007/978-3-319-17960-5_6

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