The harm principle, personal identity and identity-relative paternalism

Journal of Medical Ethics 49 (6):393-402 (2023)
  Copy   BIBTEX

Abstract

Is it ethical for doctors or courts to prevent patients from making choices that will cause significant harm to themselves in the future? According to an important liberal principle the only justification for infringing the liberty of an individual is to prevent harm to others; harm to the self does not suffice.In this paper, I explore Derek Parfit’s arguments that blur the sharp line between harm to self and others. I analyse cases of treatment refusal by capacitous patients and describe different forms of paternalism arising from a reductionist view of personal identity. I outline an Identity Relative Paternalistic Intervention Principle for determining when we should disallow refusal of treatment where the harm will be accrued by a future self, and consider objections including vagueness and non-identity.Identity relative paternalism does not always justify intervention to prevent harm to future selves. However, there is a stronger ethical case for doing so than is often recognised.

Other Versions

No versions found

Links

PhilArchive



    Upload a copy of this work     Papers currently archived: 103,486

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

Medical choices and changing selves.Rebecca Dresser - 2023 - Journal of Medical Ethics 49 (6):403-403.
Identity-relative paternalism is internally incoherent.Eli Garrett Schantz - 2023 - Journal of Medical Ethics 49 (6):404-405.
Identity-Relative Paternalism and Allowing Harm to Others.David Birks - 2023 - Journal of Medical Ethics 49 (6):411-412.
On Justifying Legal Paternalism.Ernesto Garzón Valdés - 1990 - Ratio Juris 3 (s1):173-184.
Implications of identity-relative paternalism.Dominic Wilkinson - 2023 - Journal of Medical Ethics 49 (6):417-418.
Paternalism, with and without identity.Ben Saunders - 2023 - Journal of Medical Ethics 49 (6):409-410.
The harm principle.Nils Holtug - 2002 - Ethical Theory and Moral Practice 5 (4):357-389.

Analytics

Added to PP
2023-01-29

Downloads
49 (#476,215)

6 months
12 (#239,387)

Historical graph of downloads
How can I increase my downloads?

Author's Profile

Dominic Wilkinson
Oxford University

Citations of this work

Medical choices and changing selves.Rebecca Dresser - 2023 - Journal of Medical Ethics 49 (6):403-403.
Paternalism, with and without identity.Ben Saunders - 2023 - Journal of Medical Ethics 49 (6):409-410.
Future Selves, Paternalism and Our Rational Powers.Kyle van Oosterum - forthcoming - Inquiry: An Interdisciplinary Journal of Philosophy.

View all 12 citations / Add more citations

References found in this work

What You Can't Expect When You're Expecting'.L. A. Paul - 2015 - Res Philosophica 92 (2):1-23.
The Methods of Ethics.Henry Sidgwick - 1903 - International Journal of Ethics 13 (2):251-254.
Advance directives and the personal identity problem.Allen Buchanan - 1988 - Philosophy and Public Affairs 17 (4):277-302.
Reformulating Mill’s Harm Principle.Ben Saunders - 2016 - Mind 125 (500):1005-1032.

View all 15 references / Add more references