PATERNALISTIC INTERVENTIONS

As I suggested earlier, paternalistic intervention involves a conflict between the risk hierarchies of a benefactor and an intended beneficiary. So paternalistic intervention is is based on the supposition that a benefactor's cost/benefit analysis (at least sometimes) trumps the assessment of a targeted beneficiary AND that the intervention will, in fact, leave the beneficiary "better off." Being made "better off" could mean either an unwanted benefit or an unwanted lessening or removal of a harm. The lessening or removal of a harm could mean either reducing the probability of its occurance or reducing its magnitude. Moreover, justified paternalistic intervention implies empirical evidence that the intended intervention, will in fact, leave the beneficiary "better off" in either the long-run or short run. So the question is whether a beneficiary will (in fact) be better off or not as the result of a given paternalistic intervention.

In assessing whether a beneficiary will be better off or not must take into account the full range of known costs and benefits. Paternalistic intervention invariably requires the use of coercive force, which is often an under-valued cost. The degree of coercive force is, obviously, contingent upon the degree of resistence offered by the intended beneficiary. Sometimes beneficiaries are relatively submissive and make a calculated decision to submit to the benefactor: "It's not worth fighting over!" When the beneficiary offers resistance intervention requires more coercive force. So some interventions require high degrees of physical coercion and inflict greater or lesser injuries on the beneficiary: black eyes, bruises, broken bones etc. Sometimes injuries result, not only from the interdiction process, but also from subduing the resistant beneficiary long enough to provide the benefit. Sometimes the interventions themselves inflict costs, which are euphemistically described as "side-effects. Most anti-psychotic drugs turn out to have serious long-term and short-term side effects, including suicidal thoughts, sexual dysfunction, and loss of energy etc. Thus the overall "redounding good" of any intervention must take into account the amount of coercive force required to get the job done and the side-effects of the intervention itself.

With the benefit of 20/20 hindsight, let's take a look at a few of classic large group paternalistic interventions. In the nineteenth century psychiatrists believed that the mentally ill were "better off" locked up in a mental hospital where they could be bled and force-fed emetics and purgatives. In hindsight, we know that those were unjustified interventions. In the mid-twentieth century, psychiatrists believed that electro-shock therapy and lobotomies left patients better off than bloodletting, emetics, and purgatives. Today we have a long list of modern drugs that have been proven to be either unsafe, ineffective, or both: DES, Fen Fen etc.

So despite the dismal record of well-meaning paternalistic interventions, and despite the fact that most interventions benefit the benefactors (and third parties), why do we accept paternalism as a social practice. I believe we all have a biological predisposition to submit to group-based authority, even when there is little evidence to suggest that authoritative interventions are any more reliable than anyone else. In other words, we blindly submit to group-based authority and rarely question it. This is probably a remnant of our Pleistocene hunter-gatherer brain. Therefore, it is very difficult for us to question socially-designated authorities. The social processes that we employ to manufacture experts is intriguing. Just think about how we ceremoniously bestow these "experts" with credentials: advanced degrees, licenses, etc.

Pure and Impure Paternalism

Let’s begin with a fundamental distinction between pure and impure forms of paternalism. Paternalistic intervention is an intentional act of beneficence where a benefactor violates the liberty of a beneficiary in order to provide an unwanted benefit. Beneficiaries and benefactors can be either individuals or groups. Within group-based paternalism, we can also differentiate between governmental paternalism (state paternalism) and non-governmental paternalism. Under state paternalism government acts as the benefactor by exercising the coercive power of government via regulations and taxation. For now let’s focus on group-based state paternalism.

Pure state paternalism is where the group whose liberty is being violated is identical to the group that may benefit (seat belt laws). Impure paternalism is when the group whose liberty is violated is larger than the group that is targeted for benefit. (laws that restrict access to sudafed)

Another feature of state paternalism is that it often benefits the benefactor and/or third parties, and therefore, masks conflict of interest and corporate welfare. Most paternalistic laws are initiated by providers. In modern societies, acts of pure paternalism are extremely rare. After all, in the “real world” of state paternalism, politically well-connected third parties almost always benefit such as: daycare centers, beauty salons, tatoo parlors, mental institutions, drug companies, psychologists, and psychiatrists. Seat belt laws benefit the engineers and manufacturers that produce seat belts. Drug laws benefit the alcohol industry and criminal organizations. (Admittedly, this is an empirical observation. If I'm wrong, please correct me!)

Now what can we say about those intended paternalistic benefits? Well, the fact of the matter is that many (if not most) paternalistic interventions enforced by the state, benefit the providers much more than the targeted beneficiaries. Do you really believe that laws that restrict access to marijuana protect anyone other than pharmaceutical companies, local police departments, and the employees of the Drug Enforcement Agency? (Another empirical observation!) As a modest proposal, let me suggest that justified paternalism requires that beneficiaries actually benefit from their loss of liberty. Libertarians tend to be highly critical of state paternalism because it rarely benefits intended beneficiaries and almost always masks corporate welfare. I’ll try to develop this theme in subsequent blog entries.

Paternalistic Intervention: Part 1

My friend Bill inspired me to clarify my thoughts on the libertarian stance toward paternalism. The word “paternalism” is rooted in the Latin noun “pater,” or father. Today, the word paternalism signifies an act of intervention whereby one party, a well-meaning “benefactor,” violates the liberty of another person(s), a “beneficiary,” in order to provide an unwanted benefit. Benefits can be classified either something generally considered to be good, or the removal of something bad, a harm. The overwhelming majority of paternalistic interventions involve the removal of harms. Therefore, many (if not most) acts of paternalism seek to limit risk-taking by intended beneficiaries.

First of all, two parties are involved in paternalistic interventions: a beneficiary and a benefactor. So let’s break down this dyadic relationship a bit more. Beneficiaries and benefactors can be either individuals (individual paternalism) or groups of individuals (group paternalism). One important for of group paternalism is “state paternalism.” Examples of state paternalism include seat belt laws, drug laws, etc.

Paternalism involves the imposition of an unwanted benefit by a benefactor. On the face of it, this sounds absurd. After all, human beings tend to want benefits and not want harms. So the idea of an unwanted benefit seems irrational. That’s why RATIONALITY plays a key role in justifying paternalistic intervention. But in the real world, benefits and harms are subject to a certain degree of social construction. Thus rationality and social control tend to often overlap. We believe that there are some risks that are irrational. Why would any rational person choose to: kill one’ self, take mind altering recreational drugs, live homelessly out on the streets, refuse chemotherapy, not wear seat belts when driving etc. So the concepts of both rationality and HARM are central to paternalism.

But paternalism is only morally problematic in a social structure that places value on both PERSONAL LIBERTY and BENEFICENCE. Conversely, in cultures that place little or no value on personal liberty, or routinely value beneficence over liberty, paternalism is not regarded as problematic. Indeed, many cultures defer decision-making to husbands, parents, religious leaders, and/or government. However, in most of the Western world, especially, the United States and Europe, personal liberty has at least some value, and therefore, the violation of one’s liberty requires moral justification.

Insofar as paternalistic intervention violates the will of an intended beneficiary, it requires the benefactor to employ a certain degree of COERCIVE FORCE. Here the presumption is that if you do not want the benefit that is being offered, but you do not pose any resistant force to its imposition, it is not paternalistic because no coercive force was required.

And finally, we can explore the nature of interventions. Since all interventions involve costs and benefits, the underlying feature of paternalism is that the benefits offered by intervening outweigh the costs for not intervening. Call it REDOUNDING GOOD. Thus, there seems to be an empirical component involved in paternalistic intervention: either the intended beneficiary will, in fact, benefit from the intervention or they will not.

So we’ve established that there are five dimensions to paternalistic intervention:

1.) The presence or risk of an identifiable HARM.

2.) The value of PERSONAL LIBERTY and BENEFICENCE and the underlying assumption that individuals ought to be able to take at least some risks without being subjected to well-meaning benefactors.

3.) The RATIONALITY of the intended beneficiary and benefactor and/or the risks involved.

4.) The use of COERCIVE FORCE by benefactors

5.) The assessment of costs and benefits, or REDOUNDING GOOD of the intervention.

I’ll explore each of these dimensions in detail in subsequent blog entries.