In medicine and in life there are cases for and against paternalism. I agree with the author Alan Goldman. Nevertheless, adults should be allowed choices. In America, patients have "The Patient's Bill of Rights" that gives patients the rights like privacy and confidentiality, involvement in their treatment, right to refuse, continuity of care, etc. The best judge of a patient's interests can only be the patient themselves, if they are informed -- they know their values and beliefs.
The invoking of paternalism in the example of ignorance when Dick desires to board a New York train but almost boards a Boston train instead certainly warrants coercing in most cases since this is what the subject initially desired. However, did it not deny him the right to possible learn from a mistake? Jane, in contrast, not donning a motocycle helmet, does not warrant paternalism; She should have the right to wear or not to wear a helmet, as an adult -- whether it shortens her life or not, it is her choice. Maybe she wants to "live in the moment." The "minor nuisance" can make a big difference in the thrill and enjoyment of riding a motorcycle as well as visibility.
Is minimizing the risk to health and life the real reasons for paternalistic laws? What about peoples choices to smoke, or their choice whether or not to wear a seat belt while driving?
Recently, the actor, John Travolta had his son, Jett, die from hitting his head while experiencing seizures from Kawasaki disease. Mr. Travolta is a member of the Church of Scientology. It is believed that this church does not condone the use of medications which possibly could have prevented Jett from having seizures. Jett was 16 years old when he died. Should the doctors have intervened in this case?
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I will say two things:
ReplyDelete1. It's granted that a smoker has the freedom to smoke. At the same time, I think it is true that everybody has the right to healthy living. A smoker's freedom to smoke must be respected; but so must the right to healthy living of non-smokers. Thus, smoking in public areas is justifiably banned, for it violates the right to healthy living of non-smokers. Personal freedom or desires shouldn't violate the rights of others.
Now, the interesting question, I think, is whether the law that bans smoking in public areas is paternalistic for non-smokers.
2. You wrote that "However, did it not deny him the right to possible learn from a mistake".
ReplyDeleteI am not too sure whether there is such a right to learn from a mistake. Right and duty often go hand in hand. For instance, one of arguments against euthanasia is that a someone's having the "right to die" implies that somebody else has the "duty to kill", and that it is wrong to impose such a duty on doctors who must perform euthanasia.
If we posit that there is a right to learn from a mistake, then it can be argued that we must also posit something like, say, a duty to teach from mistakes--that seems bizarre. For one thing, who would have such a duty?
As a side note, I think that not all rights are inviolable. The right to learn from a mistake, the right to excitement by not wearing a helmet, if there are such rights at all, must constitute a category of defeasible rights. The alleged examples of paternalism that you cite may involve defeasible rights as opposed to inviolable rights. Such cases of paternalism may be justified given good reasons.
lebenswelt,
ReplyDeleteI'm not sure there's a general right to make a mistake either, and I agree that most, if not all rights will be defeasible or non-absolute), but I find it strange that you think a right to die implies someone else's duty to kill.
It's true that rights and duties go hand in hand, or correlate to one another, but I would have thought that the correlative duties to a right to die would include, primarily, duties for others to refrain from interfering with the right-holder's suicide or voluntary euthanasia--not necessarily to actively bring about his or her death.
Similarly, if I have a right to learn from my mistakes, the correlative duty for others wouldn't be the positive duty to 'teach' me, but merely the negative duty to refrain from interfering (perhaps so that I may learn, but other reasons are conceivable). Consider parents who refuse to allow their son or daughter to date until he or she reaches legal adulthood, out of fear that the youngster will make mistakes.
Even if the parents are justified in some paternalism--for example, setting a curfew in order to cut down on opportunities for unsafe sex--isn't part of the value in allowing people to date before they reach adulthood that they learn to navigate romantic relationships through trial and error?
Perhaps parents have a duty to allow this kind of romantic autonomy, and perhaps not. But if they do, what's wrong with construing at least one aspect of the correlative right as a 'right to learn from one's mistakes?'
I'm confused as to why Goldman makes such a distinction between the two examples: Dick almost boarding the wrong train and Jane not wearing a helmet. As the author points out, both subjects initially desired something--Dick wants to go to New York, and Jane does not want to be seriously injured for trivial reasons.
ReplyDeleteGoldman says that Dick is ignorant, but isn't Jane ignorant too? And in direct conflict with her desire to be seriously injured? I agree that there are many other factors that contribute to not wearing a helmet, but the same can be said for boarding the train. Who knows, Dick may get a thrill out of spontaneity, showing up in the wrong place and having to figure out a new way to reach his desired destination.
It's tough for me to draw the line where paternalism is justified. Even, like the instructicator say, with parents. If we believe we have a right to learn from our mistakes, then it seems that parent don't even have paternalistic authority over their children. But then again, there is something to be said for learning from other people's mistakes (like seeing the hardship of a teen pregnancy) and then setting a curfew for your children. It's a tough situation and I'm not sure I even know where I stand on the issue.
There is great difficulty in attempting to define when paternalism is morally justified. There must exist certain cases when paternalism IS justified, just as there must exist cases when it IS Not morally justified. But in attempting to create generic rules or guidelines that a medical professional could fall back on in order to justify their case for paternalism, is this just an extension of the rule utilitarian versus act utilitarian argument? I do not remember my Mill that well, however could such “rule paternalism” and “act paternalism” exist?
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