Paternalism Author(s): N. Fotion Reviewed work(s): Source: Ethics, Vol. 89, No. 2 (Jan., 1979), pp.

191-198 Published by: The University of Chicago Press Stable URL: http://www.jstor.org/stable/2380029 . Accessed: 20/12/2011 13:23
Your use of the JSTOR archive indicates your acceptance of the Terms & Conditions of Use, available at . http://www.jstor.org/page/info/about/policies/terms.jsp JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.

The University of Chicago Press is collaborating with JSTOR to digitize, preserve and extend access to Ethics.

http://www.jstor.org

PATERNALI SM

N. Fotion
Emory University

The best way to understand "paternalism" is to view it as a concept, based upon an analogy, in competition with other concepts, most of which are also based upon analogies. The analogy to which the concept of paternalism draws our attention is concerned, quite obviously, with the special family relationship of father to child. A state, organization, or even an individual is said to be acting paternalistically with respect to another state, organization, or individual when it is acting as a father acts with respect to his child or his children. However one might feel about a paternalistic arrangement for this or that situation, the fact remains that this social and/or political arrangement of people represents a real option among several others. Actually some of the other options overlap paternalism, and each other, to a degree, but several of them differ enough from the others to deserve special attention. One such option is suggested by the analogy to a contractor. A popular version of this option has the state operating much like a business firm which makes agreements with individuals or groups of individuals to provide certain services in return for fees or taxes. In addition to the paternalistic and the contractor options, a third is suggested by the analogy of the master-slave relationship. If the state is viewed as the master, then the people as slaves are seen as acting on behalf of the master. A fourth option reverses the situation somewhat by viewing the state as the servant of the people. Here the people are viewed as basically knowing what they want and thus as able to order their servant to perform whatever services they desire. A fifth option views the state as if it were composed of people who are in conversation with one another. With this democratic option, the people of the society or group gather together to discuss what is to be done much as people do when they wish to make plans for a picnic. The presupposition here is that there is no state hierarchy, or only a minimal one, apart from the assembly of people.
?

1979 by The Universityof Chicago. 0014-1704/79/8902-0005$00.75 191

192 Ethics
Other analogies come to mind at this point. The state can be seen as a representative of the people much as a lawyer or a business manager represents a person, or as a counselor who issues advisories to the people but, by and large, leaves the decisions up to them. Finally, the state can be viewed as a dominating "friend" or an unpleasant mother-in-law who, in the end, we would all rather not have around. This list of options for social organization is, of course, not intended to be exhaustive. Nor is it being suggested that there is a one-to-one correlation between a certain option and some real state or some specific theory about political organization. No doubt, with almost all cases, several of these options, and perhaps others as well, will be needed to characterize a particular state such as the United States, or a particular theory of the state such as Plato's. Nonetheless, identifying even these options helps to dramatize how paternalism is like and also unlike other ways of organizing the state and other social organizations and thus helps to give us insights into the concept of paternalism. For instance, paternalism differs from the master-slave model or analogy in that the former identifies the subjects as the recipients of intended favor while the latter identifies the state and/or its rulers as the primary beneficiaries. This is the case even though both analogies imply that the locus of agency is with the ruler, with the former implying strongly that the ruler or state is more mature, intelligent, knowing, experienced, and/or wise and the latter only suggesting that the ruler possesses some or all of these attributes. Another difference between the two views of the state and its relationship with the poeple is that there is no suggestion in the master-slave model that changes in the relationship may be forthcoming. Indeed, the implication is that the master will always play his role, and the slave will always play his. In contrast, the paternalistic model leaves open the possibility, and often encourages the expectation, that in time the "children" of the state may mature, and the state's father role will therefore alter, perhaps to something like that of a retired grandfather. A comparison of the paternalistic with the servant's model helps to dramatize still other aspects of the concept of paternalism. With respect to the latter, politicians are always claiming to be servants of the people, and civil servants sometimes say "I am your humble servant" or "I am here to serve you." To be sure, one can hardly suppress the feeling of being patronized upon hearing such things, since "humble servants" are never the powerful figures that many state officials, in fact, are. Nonetheless, if we are to take the model of the state and its officials as servants seriously, it should be noted that, like the paternalistic model, the state's actions are intended to benefit the people, but, unlike that model, the state's initiative is significantly reduced. A servant might take the initiative to act on his own, but he would do so presumably only if he knew his master well enough to anticipate his wishes. In most cases, the servant's and thus the state's role would be seen more in terms of instrumentality than of agency.

193 Discussion
This suggests another difference between the paternalistic and servant models. Since the servant acts instrumentally to satisfy the wishes of his master, and presumably since his master knows what he wants, the servant can be assessed and even be replaced by his master (the people). In a fundamental sense, neither of these options is appropriate in a paternalistic setting. To be sure, as has already been suggested, the paternalistic model allows for the state to "retire" eventually, but it does not, as the servant model does, allow for replacement at any moment the servant fails to deliver whatever service has been asked for by the people. In some respects, the representative model is similar to the servant model. Not only is the representative supposed to act on behalf of those he represents, but he can, like the servant, be assessed by them and, if need be, be replaced. The crucial difference is, of course, that the representative often has some professional status; and insofar as he does, he knows certain things of which his client is unaware. The person represented may in some sense know what he wants from his representative; but in another sense, the representative, because of his expertise in law, technology, history, and so on, may be said to be in a stronger position to assert his own initiative than would the humble servant. Indeed, the representative model suggests an uneasy balance of initiative which is not found in the servant model, or, for that matter, in the paternalistic model. The representative model or analogy differs from the paternalistic in another important way. The latter draws our attention, as the former does not, to the family setting. In this regard, the paternalistic model differs radically from the other models referred to thus far. With most, there is not even the hint that the relationship is that of a friend or comrade, let alone of the most intimate blood relationship. Given, then, this radical difference between the paternalistic model and all the rest, it is interesting to ask, Just what is accomplished when one invokes the family-based paternalistic model as against any of the rest?
II

Before answering this question, it is important to enunciate a principle which is applicable when an analogy is being presented and which I will call the principle of complete implication. When someone says that the state is acting with respect to its citizens as a father is acting (or should act) with respect to his children, he means "acting just exactly as." He means "acting just exactly as," since if he presents the analogy without any explanations, as he would if he simply were to make the accusation, "But that is paternalism," we, as listeners, would have no recourse but to understand him as saying that the likeness is complete. He could, of course, say "Except for x, this is paternalism" or "Just insofar as it leads toy, this policy is paternalistic." Such disclaimers would then excuse him from being committed to all of the things implied by the analogy. But if he failed to issue such disclaimers, or if such disclaimers were not already built into the linguistic

194

Ethics

context, his analogy would be subject to some criticism, as least if we found one feature present in the father-child relationship which was absent in the state-citizen relationship (and vice versa). If now the principle of complete implication is applied to the paternalistic model, the father must be taken not only as acting in ways which imply he is wiser, more informed, and stronger (as well as acting in the interest of the child), but acting in the child's interests in ways which are derived from the close family relationship of father to child. As a father, the father hovers over the child, as it were, anticipating those outside dangers which he has some control over, satisfying the child's needs whenever possible, and, if necessary, preventing the child from harming himself. In the latter case, should the child persist in engaging in activities which will harm him, the father may be forced to deter or even punish him. It would be a mistake, however, to see the father's role exclusively in terms of depriving the child of its freedom and administering punishment. Daddy's role is neither exclusively nor primarily that of a benevolent policeman or enforcer. Analogously, it would be misleading at best, and just plain wrong at worst, to treat the concept of paternalism when applied to the state or any social institution as one closely akin to an enforcer. Perhaps if most philosophers took the analogy on which the concept of paternalism is based seriously, as I have been trying to do in this essay, this point would be obvious. Perhaps also if paternalism were not discussed, as it often is, in the context of Mill's problem in On Liberty,the temptation to see the concept of paternalism primarily in terms of the concept of coercion would be lessened. Mill's problem, it will be recalled, is concerned with what could be called coercive paternalism. Granting some limited exceptions, Mill says that the state has no right to act coercively in those situations where a citizen is not harming others but is harming himself. I am not concerned here to discuss the nature or the merits of Mill's views. I am, however, concerned when the concept of paternalism is viewed by a variety of writers in terms of the notion of coerciveness.' A government, as a part of its policy of pater1. Gerald Dworkin, in his article "Paternalism" (reprinted in Philosophyof Law, ed. J. Feinberg and H. Gross [Encino, Calif.: Dickenson Publishing Co., 1975], but appearing originally in Morality and the Law, ed. R. Wassertrom [Belmont, Calif.: Wadsworth Publishing Co., 1971]), says, "By paternalism I shall understand roughly the interference with a person's liberty of action justified by reasons referring exclusively to the welfare, good, happiness, needs, interests or values of the person being coerced" (p. 1975). Although in his "Legal Paternalism" (Canadian Journal of Philosophy 1, no. 1 [September 1971]: 105-24) J. Feinberg is content to tell us that "the principle of legal paternalism justifies state coercion to protect individuals from self-inflicted harm . . ." and does not define his key concept, there is no suggestion in this article that it could be defined without coercion representing a necessary condition of the definition. Hart, in Law, Libertyand Morality (Stanford, Calif.: Stanford University Press, 1963), is somewhat more explicit in speaking of
paternalism as a policy of ". . . the protection of people against themselves . . ." (p.

31). Martin Golding, in his Philosophyof Law (Englewood Cliffs, N.J.: Prentice-Hall,

195 Discussion
nalism, can act coercively; but paternalism in government includes much more than mandating, for instance, that motorcycle drivers must wear helmets (even supposing for the moment that not wearing helmets when accidents occur only causes injury to the driver, and supposing also that most drivers object to the helmets). It also includes "forcing" them to do things which they themselves want done (e.g., saving for retirement) and, in addition, providing services which the people need and want but, for some reason or other, are unable to provide for themselves (e.g., housing, jobs, food stamps, medical care). The fact is that some philosophers have given paternalism a far worse reputation than it deserves by associating it with coercion by definition and in effect confusing it with coercive paternalism. All this is not to say that this concept's generally bad reputation is not well deserved. Even if the state acts affectionately toward its citizens, it is not likely that these citizens will consciously take kindly (it may be another matter on the unconscious level) to being thought of as children. Further, the family setting in the paternalistic model implies that the state has rights, as our father substitute, to an intimate knowledge of our actions, attitudes, and beliefs. As good as the state's intentions might be in exercising these rights, it is difficult to imagine how the citizen's own rights to privacy could be respected and maintained in such a paternalistic setting.2
Inc., 1975), discusses the limits of law (chapter 3) and paternalism almost wholly with the framework of Mill's problem and coercion. John Rawls, in his A Theoryof Justice (Cambridge, Mass.: Harvard University Press, 1971) evidently also thinks of paternalism primarily (exclusively?) in coercive terms, for in speaking of acting paternalistically with respect to someone he says: "We must be able to argue that with the development or the recovery of his rational powers the individual in question will accept our decision on his behalf and agree with us that we did the best thing for him" (p. 249). Whether these definitions or characterizations of paternalism by philosophers in terms of coercion are thought of by them as "descriptive" or stipulative matters little to the point I am making: namely, that paternalism does not entail coercion among nonphilosophers. 2. Even though they are concerned to broaden the definition of paternalism so that coercion is not tied analytically to paternalism, Bernard Gert and Charles M. Culver ("Paternalistic Behavior," Philosophyand Public Affairs 6, no. 1 [Fall 1976]:
45-57) do not help matters much in this regard since for them ". . . an action is not

paternalistic unless the person whom A intends to benefit is also the person toward whom A breaks a moral rule" (p. 51). Thus, if the other conditions of their definition are satisfied, an action could be labeled paternalistic if it involved deception or deprivation of opportunity rather than coercion. The problem here is that their definition is still too narrow. Providing services to one's children involves no violation of a moral rule. Our use of paternalism is guided by the analogy of acting as a father does to his child, and the argument is that, just as a father does not necessarily act coercively, so he does not necessarily act to violate some (prima facie) moral rule. I might add that I am not analyzing what they call "paternal behavior" (which does not involve violating a moral rule) as distinct from "paternalistic behavior." I am concerned with the latter and insist that their definition of that concept is wrong insofar as it includes in it some mention of moral rule violation.

196

E thics

Bad as things are, then, it only makes matters worse for the concept to define it narrowly-and persuasively, I am tempted to say-in terms of coercion. Aside from making paternalism a more pejorative concept than it need be, notice one other effect of defining it in terms of coercion (i.e., in terms of Mill's problem). Noncoercive policies of the government (free abortion service on demand, to give another example), which I have been arguing are paternalistic on an application of the principle of complete implication, cannot be classified as paternalistic under the narrower definition. If one favors these policies it would be convenient, to say the least, to accept the narrower definition, thereby freeing these favored policies from carrying the burden of the paternalistic label.

There is perhaps one other model which should be explored in seeking a better understanding of paternalism by contrasting it with those models which are competitive with it, namely, one I will call the iatristic model. This model is suggested by talk such as "treating the economy," "healthy economy," "welfare programs," "sick society," "cancer of communism," and "opiate of the people"; and the implication is, of course, that those in charge of the state act like doctors and the people and their institutions are to be treated like patients. Some of the contrasts between paternalism and iatrocism are obvious. With iatrocism, the setting is again taken away from the family, with the aim of governmental action being more to make the people well than to guide them affectionately through a maturing process. Less obvious is that, from the point of view of the citizen, it is more palatable to be thought of as ill than childish. Further, from the standpoint of the governmental officials, the iatristic model is more satisfying than is the paternalistic model, since "professionalism" can now characterize one's status and "surgical precision" one's insightful actions in dealing with the economy or some other aspect of the social setting. In spite of these and other differences, there are some major similarities between the two models. With both, the people are supposedly the recipients of attention, and with both the initiative rests strongly with the ruler, even to the point where both will condone coercion. With both, however, the state's actions are not limited to coercion, and with both a change of status of the people is presupposed. With iatrocism the change is a return to good health, while with paternalism it is a maturing to adulthood; although with the former the change may be temporary, with the latter it is permanent. One other similarity should be mentioned, since it is difficult at times know whether a policy of the government is best characterized as iatristic to or paternalistic. If the sickness the society suffers from is viewed as being mental rather than physical, as it would be if its people were thought of as

197 Discussion
having been drugged or brainwashed, then the government might be tempted to play an even more dominating role than it would otherwise. This role would be comparable to that of a father raising a small child. In both cases the people would be treated or handled in a way which would put little or no premium on their own judgments.
IV

Having analyzed the concept of paternalism in very general terms against the backdrop of other political models, it is appropriate, in closing, to give a somewhat more specific analysis of that concept. It is clear from what has been said that a necessary condition of acting paternalistically is that the "father" (whether it be the state, an institution, or an individual) is acting with the intent of benefiting the "child" (some other state, institution, or individual). It is, however, not a necessary condition that the father act coercively. He may, that is, act coercively or not. But putting it this way makes it clear that in rejecting the narrower definition of paternalism so as to include noncoercive actions, one is not adding a new condition to the definition but literally throwing an old one away. This means that unless at least one condition other than acting to benefit the child is added to a proposed definition or elucidation of paternalism that concept will be too broad instead of too narrow, since it will apply practically to everything the state does. Now I think that several conditions need to be added as either being necessary or optionally needed to give an adequate analysis of paternalism. One which is most needed, however, is suggested by the point that change is built into the paternalism model. The child, if it is normal, can in time become able to do the things the father did for it in the past. This particular kind of change within the father-child relationship suggests that when the paternalistic model is applied to governments, institutions, etc., it is applicable only to those limited classes of actions which the child could, in principle, learn to perform for itself. Providing police and military protection for the citizens on this analysis would not fall under the aegis of the paternalistic model, since one could not expect a person on his own ever to provide these services for himself. Nor would most regulatory functions of the state be classed as paternalistic. Regulating drug, chemical, and food manufacturers and the like would not be classified as paternalistic since, again, these practices require expertise, resources, and time far beyond the range of an individual's capabilities. In contrast, providing food stamps for an individual or group would be paternalistic, since it is at least possible for that individual (or group)to become able to do the providing for himself. This condition, then, of having the state act on behalf of its citizens in the areas in which they themselves could have acted replaces coercion as a necessary condition of paternalism and indicates as well the intended limited scope or the relatively minor explanatory power of that concept. That

198 Ethics
scope is probably as wide as is the iatristic model, but certainly not as wide as, for example, the contract model, which can easily accommodate the police and military functions of the state, as well as most of its regulatory ones. As a "minor" among the concepts in the arena of political philosophy, the argument has been that paternalism needs to be protected against the abuses of those who have identified it mistakenly with coercive paternalism and against the neglect of those who have generally misunderstood how paternalism and other closely related concepts like iatrocism operate.