A pervasive theme throughout the topics of the class was the idea of the value of life and how individuals and society should potentially value, judge and affect individual options and choices. Oftentimes, a significant factor in many of these discussions is the question of paternalism: Whether individuals can be wrong in their decisions of their own good and whether it is societies’ right or even duty to “correct” such wrongness, potentially by restricting the individuals’ freedoms. Most people agree on paternalistic arguments for various issues, such as slavery or child labor, while greatly disagreeing on other issues, such as drug use or euthanasia. But what determines the strength or validity of paternalistic arguments? While most authors we read evaluated paternalistic arguments based on a calculus of the harm prevented versus freedom restricted from a utilitarian perspective, I’d like to use the concept of insurance policies to focus on the probabilistic aspects of paternalism.
In “Paternalism,” Gerald Dworkin dissects arguments regarding paternalism in very great detail. Going forward, it is important to note that Dworkin isolates the paternalistic argument from other potential justifications of positions that may seem paternalistic. In particular, “pure” paternalism concerns only the restriction of an individual’s freedom when the potential harm is done to the individual itself, while other cases “can always be justified on non-paternalistic grounds, i.e. in terms of preventing harm to others” (Dworkin 244). We should also exclude “slippery-slope” arguments in which individual choices collectively result in harming others (e.g. unionization).
After a lengthy discussion of John Stuart Mill’s argument of “liberty above everything,” which dismisses most justifications of paternalism, Dworkin successfully generalizes Mill’s one exception for paternalistic intervention (on the grounds of preservation of future liberty) toward the general framework through which we shall evaluate paternalistic arguments: “Future-oriented consent” (248). Paternalism derives its validity solely from its ultimate advancement of the individual’s choices and values. Once again, it is crucial to note that we do not consider preventing individuals from harming themselves because we consider it a bad decision, but because we believe that in some future, the individual, assuming full moral rationality, will realize it is a bad decision (and presumably be thankful). When intervening, the paternalist has to, with the burden of proof, strongly believe that he is able to truly act according to the individual’s preferences and values and fully consider the severity of the bad decision (like irrevocability of liberty).
Dworkin very briefly and tangentially mentions a nonetheless very interesting analogy that helps us evaluate the strength of paternalistic intervention: Paternalism as an insurance policy protects us against the potentially catastrophic downside of making a truly bad decision for the recurring cost of restricted freedom (250). Consistently, factors that determine a good insurance policy should induce good paternalistic intervention. A good insurance policy has the lowest possible premium (in restricted freedom) for the highest possible claim value (of severity of harm prevented), but most importantly, is personalized towards one’s risk profile (the chance of the individual making a regrettable decision). There simply is no single best insurance policy for everyone. Furthermore, we have to point out one important distinction Dworkin’s analogy suffers from: The insurer (society) has little incentive to collect the premium and actually forces the claim upon the insured (the individual) as part of the contract. Hence, the difficulty of quantifying the chance of a regrettable decision becomes further complicated with the need for insured’s confidence or trust in the insurer to reliably predict the regrettable decision.
Consider the discussion of paternalistic arguments in the case of suicide: Paternalistic interventions are heavily dependent on the chance of individuals choosing to commit a suicide they would (hypothetically) regret as well as on our (society's) ability to correctly gauge the individual’s moral agency specifically in such cases. When we consider it permissible for a parent to intervene his child or a mental facility intervene its depressive patient, what we are really saying is that we have strong confidence in them and their experience to reliably detect possible regret. Conversely, a strong paternalistic argument assumes that society respects the death wish of the terminally ill if it is truly according to their utilitarian preferences. Consequently, our relatively strong agreement on the perception of moral agency in cases of depression or terminal illness and how it relates to empirical evidence, as well as the relative experience by the paternalist supports the strength of the paternalistic argument in this case, not necessarily the (ultimate) severity of the downside.
Correspondingly, the strength of the paternalistic argument in the case of drug use is weakened by the great lack of consensus on society’s ability to detect individuals’ making a regrettable decision when using drugs. Flat out prohibition ignores probabilistic factors of moral agency or addictiveness of many drugs, which seems to be overreaching and a poor indicator of predicting regrettable decisions. Opposition to the relatively high drinking age in the United States is equally cemented in the associated low trust in the lawmakers who overestimate their confidence in detecting individuals’ regret, especially considering its high prevalence and importance in common culture. That trust is further corroded by hypocrisy as evidenced in the fact that the last three US presidents admitted to cannabis consumption . A more sensible policy based on paternalistic principles would be active education and discouragement, but the opportunity for mature individuals to responsibly consume drugs by providing sensible regulation and rehabilitation services when (possible) regret is much clearer. Once again, relativity in experience between the paternalist and the individual is what regulates the strength of the argument. For example, it is stronger when concerns prohibiting drugs to children, but not to presumably fully mature moral agents.
In conclusion, by exemplifying the use of the insurance policy analogy as a way to evaluate paternalism in the cases of euthanasia and drug use, I have been able to show that our individual risk profiles and trust in the paternalist largely account for the validity of paternalistic arguments. You cannot evaluate utility decisions involving false-positives without probabilistic analysis, as evidenced in the case of paternalism. Many philosophical discussions assume full moral rationality, but we know empirically that this is not appropriate in reality. Hence, the strength is ultimately decided by our personal view of robustness of moral agency and human rationality in moral edge cases. That difference in risk profiles is largely explained by psychological disparities: insecure, undisciplined, regretful, self-conscious, trusting people are more likely; confident, self-righteous, narcissistic and paranoid people less likely to support paternalistic policy. Empirically, society’s tendency toward more individualism and individual responsibility will naturally reduce the strength of paternalistic arguments, as evidenced by the decline of paternalistic policies around the world, such as the liberalization of euthanasia, as well as the marijuana legalization efforts by many governments. Beyond the scope of this paper, we could continue extending the insurance policy analogy: When can/have to choose our insurance policy (society) according to our risk profiles? Do we actively sign it or is it implied? Since there seems to be a baseline of cases in which most people, if not all, support paternalistic intervention (remember slavery), is there such thing as a minimum required insurance policy that everyone should be protected under? Can a society offer more than one insurance policy? What if our risk profile is too inconsistent with our societies’ predominant insurance policy?. Ultimately, the insurance policy analogy highlights the frequently overlooked probabilistic aspects of any cost-benefit calculation and can hence help us evaluate utilitarian discussions more comprehensively by improving our often poor understanding of quantitative arguments.