Earlier this year, 3000 bikers staged a protest in Los Angeles against a California law that goes into effect in January requiring motorcyclists to wear helmets. Bikers sought to overturn the measure, arguing for freedom of choice. One biker said that helmets would mess up his spiked, "rock 'n roll" hairdo. Some bikers, followers of the Sikh Dharma religion, claimed that they couldn't wear helmets because helmets would interfere with the turbans worn to symbolize their faith. Supporters of the law argue that it will protect cyclists from serious injuries. Bikers are outraged, maintaining that their freedom of choice is being denied.
At issue in the controversy over the helmet law is the problem of paternalism. Paternalism can be defined as interfering with a person's freedom for his or her own good. The word calls to mind the image of a father ("pater" in Latin) who makes decisions for his children rather than letting them make their own decisions, on the grounds that "father knows best." The principle of paternalism underlies a wide range of laws, practices, and actions„ a physician who decides what is best for a patient, a sign prohibiting swimming without a lifeguard on duty, laws against voluntary euthanasia, laws restricting the use of heroine, cocaine, marijuana and other drugs, compulsory retirement savings plans, and mandatory seat belt laws„all designed to protect our interests, whether we like it or not.
While paternalistic practices are relatively common, are they morally acceptable? Paternalism involves a conflict of two important values: 1) the value we place on the freedom of persons to make their own choices about how they will lead their lives, and 2) the value we place on promoting and protecting the well being of others. When people freely choose to act in ways that seem contrary to their own well being, the question of whether we are justified in interfering with their affairs, the problem of paternalism arises.
Most people would agree that paternalism is justified when dealing with a person whose freedom of choice is seriously impaired or limited, be it due to coercion, a person's limited cognitive capacities, ignorance of the facts, the effects of a disease such as Alzheimer's, or the influence of drugs. For example, paternalism is sometimes warranted when dealing with children, who lack the emotional and cognitive capacity to always know what is in their best interest. We may alsp be justified in temporarily interfering with a person action to determine whether that person is, in fact, actin voluntarily, is appraised of the facts, and is otherwise competent, before allowing him or her to proceed.
But apart from cases involving serious incompetence or other limitations, is paternalism justified? Consider the hang glider who refuses to wear safety devices because "it interferes with the sensation of flying like bird," or the smoker who believes that the pleasure derived from smoking compensates for the years of life loss as a result.
Some moral philosophers hold that a competent person's freely made decision should never be over ridden, even for that person's own good. The classic case against paternalism was voiced by John Stuart Mill, nineteenth century British philosopher, who wrote:
. . . the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant. He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because in the opinion of others, to do so would be wise, or even right.... The only part of the conduct of anyone, for which he is amenable to society, is that which concerns others. In the part which merely concerns himself, his independence is of right, absolute, over himself. Over his own body-mind, the individual is sovereign.
For Mill and his followers, freedom is essential for the development of each person's individuality, the attainment of truth, and the development of new and more enriching lifestyles. It is, therefore, a most fundamental social value. Persons must be left free to make their own choices about how they will lead their lives, even if these choices are considered reckless, stupid, or otherwise "bad" choices by others. Moreover, the ability to make choices that promote our well-being is a capacity one acquires and improves only through practice.
Also, according to this view, individuals are the best judges of their own interests and so should be left free to pursue them. Mill writes: "With respect to his own feelings and circumstances, the most ordinary man or woman has means of knowledge immeasurably surpassing those that can be possessed by any one else.... He is the man most interested in his own well-being." If I, from my privileged standpoint, can't be trusted to determine what's in my best interest, that judgment certainly can't be trusted to someone else from a less privileged standpoint.
From another perspective, paternalism is objectionable because it violates what the philosopher Immanuel Kant called the equal "dignity" of all human beings. Respect for human dignity implies respect for people's ability to think and choose for themselves. Paternalism, however, imposes choices based on what someone else thinks is good for a person. People who are interfered with are not treated as equals capable of making their own choices, Kant claims, but are treated as means to someone else's view of what their choices should be, "like immature children unable to distinguish between what is truly useful or harmful to them." Nevertheless, many philosophers believe that paternalism can sometimes be justified. According to some philosophers, restricting a person's freedom is warranted when such interference maximizes benefits and minimizes harm to a person. Freedom may be an important value, but it is not the only value. There may be situations in which the costs to a person's freedom are trivial compared to other values, such as happiness or health, that might be gained by restricting that freedom. Mandatory seat belt laws, for example, entail a loss of freedom that is minor compared to the lives saved and the injuries prevented by such laws. Some philosophers claim that paternalism is justified only when it is aimed at protecting or promoting a person's freedom. For example, nineteenth century prohibitions against selling oneself into slavery restricted a person's freedom in the short run, but resulted in greater freedom in the long run.
Others challenge Mill's claim that because individuals are the best judge of their own interests, others ought not to interfere, pointing out that some people lack good judgment when it comes to their best interests. For example, people with low self-esteem or people who have been abused as children may not have a true sense of who they are and who they can bc and tend toward self-destructive choices. In such cases, others may be better judges of what will promote their good.
Paternalism may also be warranted in situations in which, because of our shortsightedness, impulsiveness, or carelessness, we would want to have our freedom restricted, especially when dangerous and irreversible consequences are involved. Not all of our decisions are considered, careful decisions that take into account our long-run welfare. A motorcyclist who refuses to wear a helmet will be more likely to wear one after an accident. Here paternalism is justified to protect a person's future self from the shortsighted or foolish choices of his or her earlier self.
Finally, some philosophers have argued that because we are social beings, all of our choices directly or indirectly affect others, and when our choices would harm others, it is legitimate to interfere. People who are injured as a result of their foolish or risky behaviors not only cause harm to themselves but, because persons are connected to one another, inevitably also impose emotional and financial costs on others. Consequently, these philosophers have argued that paternalism might always be morally justified.
Henry David Thoreau once remarked:
"[If] . . . a man was coming to my house with the conscious design of doing me good, I should run for my life." The issues raised by paternalism arc important ones, with implications for many of our public and private practices. They call on us to recognize the fine line between care and concern for the well-being of others and respect for persons as people of their own choosing and creators of their own destinies.
Further reading:
Brock, Dan, "Paternalism and Autonomy," Ethics, Vol. 98 (April 1988), pp. 550-565.
Kleinig, John, Paternalism (Totowa, NJ: Rowman and Allanheld, 1984).
Mill, John Stuart, On Liberty, edited by Currin V. Shields (New York: Liberal Arts Press, 1956).
Sartorius, Rolf, ed., Paternalism (Minneapolis, MN: University of Minnesota Press, 1983).
VanDeVeer, Donald, Paternalistic Intervention: The Moral Bounds of Benevolence (Princeton, NJ: Princeton University Press, 1986).
This article was originally published in Issues in Ethics - V. 5, N. 2 Fall 1991