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Added by: Carl Fox
Abstract: In this paper, I argue that a definition of paternalism must meet certain methodological constraints. Given the failings of descriptivist and normatively charged definitions of paternalism, I argue that we have good reason to pursue a normatively neutral definition. Archard's 1990 definition is one such account. It is for this reason that I return to Archard's account with a critical eye. I argue that Archard's account is extensionally inadequate, failing to capture some cases which are clear instances of paternalism. I refine each of his three conditions, ultimately providing an improved definition of paternalistic interference. This revised definition meets specific methodological constraints, offering a definition that is both neutral between anti- and pro-paternalistic intuitions, but that also explains why paternalism is normatively significant. Specifically, this definition captures the conflict between interfering with an individual's choices and treating the individual benevolently, without making paternalism permissible or impermissible by definition.Begon, Jessica. Paternalism2016, Analysis 76(3): 355-373.-
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Added by: Carl Fox
Summary: Analysis review article of recent work on the topic of paternalism. Discusses different ways in which the term is defined, reviews the debate between 'paternalists' and 'anti-paternalists', and presents soft paternalism.Comment: Could be used as an introductory reading to the topic of paternalism, or a further reading to provide a comprehensive background to recent work in the area.
Corrigan, Oonagh. Empty Ethics: The Problem with Informed Consent2003, Sociology of Health & Illness, 25 (3): 768-792.-
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Added by: Rochelle DuFord
Abstract: Informed consent is increasingly heralded as an ethical panacea, a tool to counter autocratic and paternalistic medical practices. Debate about the implementation of informed consent is constricted and polarised, centring on the right of individuals to be fully informed and to freely choose versus an autocratic, paternalistic practice that negates individual choice. A bioethical framework, based on a principle-led form of reductive/deductive reasoning, dominates the current model of informed consent. Such a model tends to abstract the process of consent from its clinical and social setting. By fleshing out the social process involved when patients and healthy volunteer subjects consent to take part in clinical drug trials, this paper attempts to address the problem arising from the current 'empty ethics' model. My arguments are substantiated by qualitative interview data drawn from a study I conducted on the process of consent as experienced by participants in clinical drug trials.Comment: This text is a clear critique of the use of informed consent as a medical-ethical panacea (it could be taught alongside O'neill's "Paternalism and Partial Autonomy" for a more accessible and applied look at the problem of informed consent). It would be useful as a contrast at the end of a unit on informed consent for medical treatment or a unit on clinical research ethics. It is especially good for use in a biomedical ethics or research ethics course aimed at students interested in the health professions.
Conly, Sarah. One Child: Do We Have a Right to More?2016, Oxford: Oxford University Press.-
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Added by: Rochelle DuFord
Summary: A compelling argument for the morality of limitations on procreation in lessening the harmful environmental effects of unchecked population. We live in a world where a burgeoning global population has started to have a major and destructive environmental impact. The results, including climate change and the struggle for limited resources, appear to be inevitable aspects of a difficult future. Mandatory population control might be a possible last resort to combat this problem, but is also a potentially immoral and undesirable violation of human rights. Since so many view procreation as an essential component of the right to personal happiness and autonomy, the dominant view remains that the government does not have the right to impose these restrictions on its own citizens, for the sake of future people who have yet to exist. Sarah Conly is first to make the contentious argument that not only is it wrong to have more than one child in the face of such concerns, we do not even retain the right to do so. In One Child, Conly argues that autonomy and personal rights are not unlimited, especially if one's body may cause harm to anyone, and that the government has a moral obligation to protect both current and future citizens. Conly gives readers a thought-provoking and accessible exposure to the problem of population growth and develops a credible view of what our moral obligations really are, to generations present and future.Comment: This book would be an excellent resource for an upper-division course on population ethics, ethcs of reproduction, autonomy, or human rights. It would also serves as a good overview of positions in population ethics or as a supplement to a class on environmental ethics and future generations.
Etieyibo, Edwin. The Case of Competancy and Informed Consent2013, Journal of Clinical Research and Bioethics, 4 (2): 1-4.-
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Added by: Rochelle DuFord
Abstract: Patient competence is an essential element of every doctor-patient relationship. In this paper I provide a case report involving an older Korean man in a Hawaiian hospital who refused treatment on the basis of mistaken facts or beliefs about his doctors and treatment. I discuss the case as it relates to competency and extends it to informed consent, autonomy and paternalism. I suggest and argue firstly, that the older Korean man is not fully competent, and secondly, that if he is not fully competent, then soft and weak paternalism may be justified in his case and in cases similar to his.Comment: This text presents an introduction to the relationship between competance, informed consent, and autonomy in medical contexts through the use of a case study. As such, it would be a good text for an introductory course in health care ethics or biomedical ethics within a unit on autonomy or culturally-specific applications of medical ethical principles.
Allen, Anita. 22 Atmospherics: Abortion Law and Philosophy2004, In Francis J. Mootz (ed.), On Philosophy in American Law. Cambridge University Press 184-
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Added by: Simon Fokt
Abstract: In 1934, Karl N. Llewellyn published a lively essay trumpeting the dawn of legal realism, "On Philosophy in American Law." The charm of his defective little piece is its style and audacity. A philosopher might be seduced into reading Llewellyn’s essay by its title; but one soon learns that by "philosophy" Llewellyn only meant "atmosphere". His concerns were the "general approaches" taken by practitioners, who may not even be aware of having general approaches. Llewellyn paired an anemic concept of philosophy with a pumped-up conception of law. Llewellyn’s "law" included anything that reflects the "ways of the law guild at large" - judges, legislators, regulators, and enforcers. Llewellyn argued that the legal philosophies implicit in American legal practice had been natural law, positivism and realism, each adopted in response to felt needs of a time. We must reckon with many other implicit "philosophies" to understand the workings of the law guild, not the least of which has been racism. Others, maternalism and paternalism, my foci here, persist in American law, despite women’s progress toward equality. Both maternalism and paternalism were strikingly present in a recent decision of the U.S. Supreme Court, Gonzales v. Carhart, upholding the federal Partial-Birth Abortion Ban Act.Comment: This article offers a good way to relate practical legal problems with philosophical issues, giving the students a very direct way to see the relevance of ethics. It can inspire discussions on paternalism and its relations with global justice. Note that the article does not define the following terms which are important to understand the material: Natural law, Positivism, Realism, Atmosphere/atmospherics, Paternalism, Maternalism. Due to its focus on legal issues, the text can be better suited as further reading, or as a core reading in classes focused on applied ethics and law (following Diversifying Syllabi).
Tsai, George. Rational Persuasion as Paternalism2014, Philosophy and Public Affairs 42(1): 78-112.-
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Added by: Carl Fox
Content: Tsai argues that offering another agent reasons can sometimes count as paternalism when it is motivated by distrust of the other's agency, conveys this lack of confidence, and intervenes in the target's sphere of agency.Comment: Best suited as further or specialised reading on paternalism and agency.
O'Neill, Onora. Some limits of informed consent2003, Journal of Medical Ethics 29 (1):4-7-
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Added by: Simon Fokt
Abstract: Many accounts of informed consent in medical ethics claim that it is valuable because it supports individual autonomy. Unfortunately there are many distinct conceptions of individual autonomy, and their ethical importance varies. A better reason for taking informed consent seriously is that it provides assurance that patients and others are neither deceived nor coerced. Present debates about the relative importance of generic and specific consent (particularly in the use of human tissues for research and in secondary studies) do not address this issue squarely. Consent is a propositional attitude, so intransitive: complete, wholly specific consent is an illusion. Since the point of consent procedures is to limit deception and coercion, they should be designed to give patients and others control over the amount of information they receive and opportunity to rescind consent already given.Comment: A great introductory text offering a short overview of the problems related to consent. The point regarding the intransitivity of consent is likely to inspire interesting discussions. As the paper is quite short, it can easily be used in conjunction with other texts.
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Bullock, Emma. A Normatively Neutral Definition of Paternalism
2015, Philosophical Quarterly 65(258): 1-21.
Comment: This paper updates Archard's attempt to provide a normatively neutral account of paternalism, and would be a good further reading for any topic touching on paternalism.