Against Autonomy: Justifying Coercive Paternalism

I understand the impulse with this book. Too much good regulation is opposed under the rubric of concern about preserving "autonomy" when the only autonomy at stake is the freedom of the powerful to manipulate the less powerful. But I think the appropriate response is to acknowledge that inequality not to pitch out the value of autonomy as such. That will never be accepted by a broader audience because Americans feel so strongly about the preservation of perceived autonomy. And there are very real dangers from embracing the notion that government or some panel of experts know best (even if they do) because it blasts through what may be an important limitation on government. I wanted to like this book but I did not. It seemed to avoid some of the hard questions about what to do when it is not at all obvious from any perspective what is best for people.

This book was really interesting. I bought it for a class, and the product arrived on time which was great.The book is about coercive paternalism, and it definitely brought some interesting discussions within my study group. It's not really my style, and I thought it was one of the more bland political theories that I've read, but definitely worth the read.

Great Read!

First, despite my disagreement with the book, I am glad Sarah Conly has written it. Philosophy thrives on people's willingness to make controversial cases that can spur good dialogue. This book is a well-articulated (even if philosophically problematic) argument for 'coercive paternalism' by government - the ability of government to coerce us in cases where (one could argue) it is 'our own good.' To be clear, the author is not arguing for totalitarianism (briefly, because her views is that government will not enforce what we should value, but create legislation that help us realize values we actually do hold but often fail to actualize). Nor is she trying to make a case (that she finds uncontroversial) about whether government should be able to coerce us for OTHERS' good like speed limits, where speeding may kill innocents). Her focus is those more controversial cases where government may restrict, say, what foods we are allowed to eat or how much debt we can legally accumulate, because it will help us flourish later.Conly first takes on the idea of autonomy itself: why do Western philosophers find it to be so valuable, such that we'd rather respect autonomy than help people actually live well? (Is it really better to respect autonomy by letting others drink themselves to death than to try and keep them alive by limiting their ability to buy alcohol?) Conly takes primary aim at John Stuart Mill's defense of liberty, arguing against Mill's idea that autonomy derives much of its value by allowing people to be heterodox and not have to conform to public opinion or authority. Conly points out that few of us actually use our autonomy to actually buck (rather than conform to) public opinion, and many people really do find too much autonomy to be a chore (as in the dieter who wishes they did not have to face the temptation of the donut). While this is the part of the book I most enjoyed, there are two flaws: first, Conly really only deals with Mill's defenses of autonomy (rather than approaches grounded in deontology or virtue ethics). Second, even if people use their autonomy to conform to the group, or some do find autonomy to be a chore, it is still not clear to me that this is an argument AGAINST having choice at all. (Maybe people need to toughen up and learn to deal with the burden of choice. And just because people will use choice to go with the group, that doesn't mean we shouldn't have autonomy to live that way if we choose.)Next, Conly deals with the possibility of "abuse and misuse" by government. I find this section to be thin, and Conly's views on the nature of government and their decision making processes to be excessively optimistic. When she talks of coercive legislation being imposed, it is almost always "by society" rather than by government officials. She refers to government abuses as "errors" as if bad legislation (that not wholly motivated by the common good) is the deviation from the rule. To keep this part of the review short, I (in the vain of public-choicers like James Buchahan) believe that any policy which won't be just unless instituted by a government of angels isn't one we should give to governments. After all, Conly's argument that coercive paternalism can be justified MUST come with an argument that, therefore, we should give governments the power to write such legislation, and this means that they will be the judges of whether their legislation is reasonable (yes, because we live in a republic, not an Athenian democracy). So, if you are not comfortable with the worst congresspeople and presidents you can imagine able to write such legislation, this should be a large chink in Conly's case.Conly's next chapter is about whether coercive paternalism is unjust because it punishes unjustly or incurs on privacy. On the latter, she is somewhat convincing; she acknowledges that privacy may be a problem, but insists that coercive legislation can often be written in a way that minimizes privacy. (Instead of weighing us in to make sure we are eating healthy, we can just outlaw certain bad foods.) She also writes (much less convincingly) that since government is acting in our best interest with their coercive legislation, incursion on privacy is not such a bad thing.Conly is a utilitarian of sorts who, at all turns, argues that the justice of coercive legislation must be determined on a case-by-case basis, an honest assessment of costs and benefits. My main problem here is that a huge cost of coercive paternalism that Conly doesn't really address is the cost of enforcing laws outlawing transactions between willing participants, none of which wish to report the matter to the police. Part of why the drug war is so costly comes from the fact that neither dealers nor users have any incentive to report drug sales to the police (unless it is that of their competitors). Thus, governments spend oodles of time and money trying to monitor what transactors try hard to keep hidden. And, by extension, governments have to fight costly `wars' trying to quash black markets that thrive in proportion to how `black' they are! HUGE cost.Lastly, Conly tries to appeal to our intuitions in order to argue the intuitive legitimacy of some coercive legislation. We acknowledge that John may stop Rebecca from drinking antifreeze she thinks is KoolAid but John knows is not. Okay, but that is not really the kind of analogy that reflects what Conly is arguing. A better analogy to what Conly argues in the book would be my taking away your donut because I judge you to be too obese, or your taking $50 from me because you don't think I am putting away enough money for the future. In both of THESE cases, I think, intuition DOES NOT support Conly, but these are precisely the kinds of coercion she finds justified when government does them. (Here, I find Michael Huemer's  The Problem of Political Authority: An Examination of the Right to Coerce and the Duty to Obey  to be particularly instructive. Why, he asks, do we allow governments to do things we would recognize as unjust if done by private actors?)Anyhow, despite the problems I think exist, I did enjoy reading Conly's controversial case. I hope that those who think they will disagree with her case read her book because her well-articulated case provides a valuable way to think through why we value autonomy, why autonomy is more valuable than a person's long-term well-being, and how far government should be allowed to go in coercing us "for our own good."

Sara Conly responds to almost all of the complaints in the reviews that are posted as I write this. Her view is not totalitarianism. Her view is also not elitist. And it is not undemocratic. The reality is, that even Conly's proposal were enacted, it might actually result in LESS policies, overall, than we currently have (in the US). A careful reading of Conly's book shows that her proposal is actually rather modest and thoroughly sensitive to revision (in light of empirical evidence). So in the end, it might be that, given Conly's insistence weighing both the costs and the benefits of any given coercively paternalistic policies, Conly would recommend very few coercively paternalistic policies -- possible fewer than the number that currently exist! Further, if a coercively paternalistic policy is established and there are unforeseen negative consequences that outweigh the benefits of the policy, then Conly's own view entails rescinding the policy. So the worries expressed in all of these complaints are unnecessary.As I see it, the major worry I have with Conly's proposal is that it burdens those who do not need paternalistic policies to thrive. Conly bases the need for paternalistic policies on the fact that, on average, most people will not thrive if left to their own devices. However, there will surely be outliers and exceptions to this rule, although few. These people who can thrive without a certain paternalistic policy imposed on them might feel that such paternalism is unjust. I think Conly could respond by saying that well-being is not so isolated. Even if a few people are unnecessarily inconvenienced by a paternalistic that they, personally, do not need, they will benefit from the policy so long as MOST people need the policy. They will benefit because there will be less of a collective burden from irrational choices and behaviors (e.g., the reduced cost of health care after imposing paternalistic policies that make it more difficult to make poor health choices). So, even if some people do not need paternalistic policies to thrive as an individual, they might need paternalistic policies to thrive in a community of people who, for the most part, DO need such paternalistic policies to thrive (and to relieve the public of their poor decision-making).

This is a well written book that provides a very useful case against unfettered Autonomy. Autonomy requires that the decision-maker is competent and Professor Conly demonstrates that in many instances the individual lack the information and expertise needed to make decisions that will achieve their own goals. This is her case for restriction on individual autonomy. She notes that the state cannot be trusted and therefore great care needs to be taken when allowing the state to over rule individual autonomy, but she points out that we already allow this (e.g. taxation) so that the argument is one of degree and that absolute claims on behalf of autonomy are unhelpful.Her arguments can also be applied in the case of "patient autonomy", in that "informed consent" is largely an illusion, because the patient lacks the experience, knowledge and expertise to make an rational decision. The patient is completely dependent on the clinician for the information and even then cannot really interpret its meaning.In summary her the case against autonomy is that the individual sometimes lack the ability to make decision that conform to their own goals. She does not claim that the state should be permitted to dictate the individual's gaols, only that the state many intervene in the rare cases where the individual needs help to achieve their own goals.

Excellently written. And eminently readable.