In this paper, I investigate intergroup relations between natives and asylum seekers during the European refugee crisis, and contribute to the reemerging methodological debate on the measurement of stereotypes and prejudices as individual and collective constructs. Drawing on data from the Norwegian Citizen Panel, I examined how Norwegians stereotyped asylum seekers at the height of the refugee crisis and the emotional prejudices asylum seekers as a group elicited. By experimentally manipulating the survey question format, I examined whether and (...) how stereotypes and emotional prejudices toward asylum-seekers differed depending on their measurement as individual or collective constructs. A subset of respondents had reception centers for asylum-seekers established in their local community during the crisis. These participants reported their behaviors toward the asylum seekers in their neighborhood. In this subsample, I investigated how individual facilitating and harming intergroup behavior was related to individual and collective conceptualizations of stereotypes and prejudices. The results showed that both low warmth and low competence stereotypes, as well as negative emotions toward asylum seekers, were rated as stronger when measured as collective as compared to individual-level constructs. In the individual condition, respondents reported feeling more admiration and sympathy than respondents in the collective condition attributed to others. Individual stereotypes and prejudices correlated systematically with individual facilitating and harming intergroup behaviors. The perception that others hold more negative stereotypes of asylum seekers, and the perceived anger and fear of others, did correlated with individual harming behaviors. Perceptions of others’ anxiety correlated negatively with facilitating behaviors. Implications and future directions for the conceptualization and measurement of stereotypes and emotional prejudices are discussed. (shrink)

Although Glowacki proposed that peace developed from the relatively recent advent of intergroup norms and tolerance for out-group members, we submit that (a) positive intergroup relations developed from a psychology grounded in the regulation of intragroup relations, (b) the “default” intergroup orientation is uncertainty, and (c) positive intergroup relations likely existed early in our evolutionary history.

Focusing on one of the most studied dimensions of Social Psychology, i.e., intergroup relations, this study analyzes its discursive accomplishment in a specific group-based intervention, i.e., the talk and work of an Italian group home, i.e., a small alternative care facility hosting a group of out-of-home children. Particularly, we focused on the fictionally called “Nuns’ Home,” a group home previously investigated for its ethnocentric bias, and its intergroup relations with “inside” and “outside” groups, such as schools, (...) biological families, and social services. By combining a qualitative and quantitative approach in analyzing one audio-recorded ethnographic interview with the whole team of professionals, we aimed at accounting for the multitude of internal and external stakeholders that participants refer to, analyzing the discursive accomplishment of ingroup and outgroup in talk-in-interaction and investigating ingroup bias and group qualification. To do so, we detected social categorization markers and qualifying devices that participants rely on when referring to groups. Results show that, among the numerous groups recognized, participants co-construct intergroup relations and ingroup bias implying negative assessment over external groups. Being different from traditional laboratory studies illustrating substantial contraposition between ingroup and outgroup, our qualitative analysis reveals the multitude of groups by which the ingroup is formed and their internal fragmentation. To conclude, we discussed the implications of qualitatively studying intergroup relations in group homes and indicated future lines of research. (shrink)

First published in 2001. Routledge is an imprint of Taylor & Francis, an informa company.

Dixon et al. suggest that the psychological literature on intergroup relations should shift from theorizing to A focus on social change exposes the importance of psychological theories involving collective phenomena like social norms and institutions. Individuals' attitudes and emotions may follow, rather than cause, changes in social norms and institutional arrangements.

Moral foundations theory has provided an account of the moral values that underscore different cultural and political ideologies, and these moral values of harm, fairness, loyalty, authority, and purity can help to explain differences in political and cultural ideologies; however, the extent to which moral foundations relate to strong social ideologies, intergroup processes and threat perceptions is still underdeveloped. To explore this relationship, we conducted two studies. In Study 1, we considered how the moral foundations predicted strong social ideologies (...) such as authoritarianism and social dominance orientation as well as attitudes toward immigrants. Here, we demonstrated that more endorsement of individualizing moral foundations was related to less negative intergroup attitudes, which was mediated by SDO, and that more endorsement of binding moral foundations was related to more negative attitudes, which was mediated by RWA. Crucially, further analyses also suggested the importance of threat perceptions as an underlying explanatory variable. Study 2 replicated these findings and extended them by measuring attitudes toward a different group reflecting an ethnic minority in the United States, and by testing the ordering of variables while also replicating and confirming the threat effects. These studies have important implications for using MFT to understand strong ideologies, intergroup relations, and threat perceptions. (shrink)

Today’s urban schools provide a unique intergroup context in which the students vary not only by race/ethnicity but also by the relative representation of their racial/ethnic groups. In two studies, we examined how this diversity aligns with intersectionality and multiple identities perspectives to affect the power and status associated with each group to shape intergroup dynamics. Study 1 focused on the perception of intergroup bias to investigate how perceived presence of same-race/ethnicity peers affects middle school students’ intersectional (...) intergroup attitudes based on race/ethnicity, gender, and sexual orientation. Middle school students were randomly assigned to view Facebook-like profiles of peers that varied by gender, race/ethnicity, and sexual orientation and offered their first impressions as a way to assess various domains of intergroup attitudes. The perceived presence of same-race/ethnicity peers influenced intersectional intergroup attitudes, however, differentially so depending on stereotypes, prejudice, and behavioral tendencies. Study 2 focused on the experience of intergroup bias and simultaneously examined race, gender, and weight discrimination and its consequences among middle school students. Using latent profile analysis, five profiles of youth based on the pattern of perceived discrimination due to gender, race/ethnicity, and weight were identified. Being African American, Latinx, and male with a high body mass index and few same-race/ethnicity peers at school predicted membership in a race profile, whereas being White or Asian with high BMI and more same-race/ethnicity peers predicted membership in a weight profile. Perceiving oneself as gender atypical was associated with all discrimination profiles. (shrink)

Psychological interest in Meritocracy as an important social norm regulating most of the western democratic societies has significantly increased over the years. However, the way Meritocracy has been conceptualized and operationalized in experimental studies has advanced in significant ways. As a result, a variety of paradigms arose to understand the social consequences of Meritocracy for intergroup relations; in particular, to understand the adverse consequences of Meritocracy for disadvantaged group members. The present research seeks to understand whether there is (...) strong support for the idea that (manipulated) Meritocracy disproportionally affects members of low status groups, and also to understand which specific components of this norm have been successfully manipulated and to what consequences. And this is particularly important given the recent call for greater transparency in how the success of experimental manipulations is reported. Thus, we carried out a systematic review examining the content of different prime tasks, summarizing prime manipulation checks’ effectiveness, and analyzing whether priming Meritocracy leads to less favorable orientations toward low status groups. Results across 33 studies revealed that despite the existing differences in the components highlighted, the salience of any of the Meritocracy dimensions facilitates the use of internal causal attributions, negative evaluations and stereotyping towards low status groups, affecting negatively decisions involving low-status group members, particularly in specific domains, as organizational contexts. These results carry both practical and theoretical implications for future research on the role of Meritocracy in intergroup settings. (shrink)

The target article offers a game-theoretical analysis of primitive intergroup aggression (i.e., raiding) and discusses difficulties in achieving peace. We argue the analysis does not capture the actual strategy space, missing out “do-nothing.” Experimental evidence robustly shows people prefer doing nothing against out-group members over cooperating with/attacking them. Thus, the target article overestimates the likelihood of intergroup aggression.

The focus on negative attitudes toward other groups has led to a dichotomy between the prejudice reduction and the collective action approach. To solve the resulting problems identified by Dixon et al., we suggest analyzing the psychological processes underlying the construction of relationships between own and other groups.

In this paper I look at various ways that interpersonal and social relations can be seen as required for autonomy. I then consider cases where those dynamics might play out or not in potentially paternalistic situations. In particular, I consider cases of especially vulnerable persons who are attempting to reconstruct a sense of practical identity required for their autonomy and need the potential paternalist’s aid in doing so. I then draw out the implications for standard liberal principles of (...) paternalism, specifically in clinical or therapeutic situations. The picture of potential paternalism that emerges here is much more of a dynamic, interpersonal scenario rather than a case of two separate individuals making decisions independent of each other. (shrink)

Relational conceptions of autonomy attempt to take into account the social aspects of autonomous agency. Those views that incorporate not merely causally, but constitutively necessary relational conditions, incorporate a condition that has the form: A necessary condition for autonomous agency is that the agent stands in social relations S. I argue that any account that incorporates such a condition cannot play one of autonomy’s key normative roles: identifying those agents who ought to be protected from paternalistic intervention. I (...) argue, against objections from Oshana, that there are good reasons for maintaining the notion of autonomy in this role, and thus that such relational conceptions should not be accepted. This rejection goes beyond that from John Christman, which holds only for those relational conditions which are value-laden. (shrink)

Previous research has found that news coverage on immigration is often biased in negative ways and that it inspires the formation of negative attitudes towards immigrants. However, academic research about this link between news consumption and attitudes towards immigrants among adolescents remains limited. The current study aims to test this association from a media-exposure and intergroup-contact perspective using survey data from 875 adolescents in Flanders, Belgium. The findings show that only television news consumption, thus no other types of news (...) consumption, was associated with adolescents’ attitudes towards immigrants. Intergroup contact within the friend group, outside the school context, was linked to more positive attitudes. This study nuances earlier findings that news consumption predicts attitudes towards immigrants. Implications for future research are discussed. (shrink)

Sport-related neurotrauma annually affects millions of athletes worldwide. The return-to-play protocol (RTP) is the dominant strategy adopted by sports leagues and organizations to manage one type of sport-related neurotrauma: concussions. RTPs establish guidelines for when athletes with concussions are to be removed from competition or practice, and when they can return. RTPs are intended to be neuroprotective, and to protect athletes from some of the harms of sport-related concussions, but there is athlete resistance to and noncompliance with RTPs. This prompts (...) consideration of whether RTPs, as employed in adult, professional sports, are paternalistic, and if they are, whether they are objectionably so. If RTPs are uniquely effective at protecting current or future athlete autonomy, they might be justified by paternalism. I conclude that RTPs are paternalistic in their effects, but are not adequately justified, and thus they are objectionable. (shrink)

The concept of paternalism is intricately tied to the concept of autonomy. It is commonly assumed that when paternalistic interventions are wrong, they are wrong because they impede individuals’ autonomy. Our aim in this paper is to show that the recent shift towards conceiving of autonomy relationally highlights a separate conceptual space for a nonpaternalistic kind of interpersonal intervention termed maternalism. We argue that maternalism makes a twofold contribution to the debate over the ethics of interpersonal action and decision-making. (...) Descriptively, it captures common experiences that, while not unusual in everyday life, are largely absent from the present discussion. Normatively, it describes a type of intervention with justification conditions distinct from the standard framework of paternalism. We explicate these contributions by describing six key differences between maternalism and paternalism, and conclude by anticipating and responding to potential objections. (shrink)

Relational egalitarianism is a theory of justice according to which people must relate as equals. However, not just any inegalitarian relation is unjust, i.e., the fact that parents do not relate as equals to their children is not unjust. Whereas an adult treating another adult paternalistically is objectionable from the point of view of relational egalitarianism, parent-child paternalism is not. What may explain this difference in judgment? I refer to this as the Puzzle. I discuss four justifications of the Puzzle (...) and argue that none of them is satisfactory. In the final part of the paper, I discuss where this leaves relational egalitarianism as a theory of justice. (shrink)

This study addresses race and ethnic relations from the standpoint of Schutzian phenomenological social psychology. It shows how this approach, by focusing on intersubjectivity and the construction of self and identity, both yields an intimate look at race and reveals the critical thrust, hence, political relevance, of phenomenology.

Existential threat lies at the heart of intergroup conflict, but the literature on existential concerns lacks clear conceptualization and integration. To address this problem, we offer a new conceptualization and measurement of existential threat. We establish the reliability and validity of our measure, and to illustrate its utility, we examine whether different existential threats underlie the association between political ideology and support for specific political policies. Study 1 (N = 798) established the construct validity of the scale, and revealed (...) four distinct existential threats: personal death, physical collective annihilation, symbolic collective annihilation, and past victimization. Study 2 (N = 424) confirmed the 4-factor structure, and the convergent and discriminant validity of the scale. Study 3 (N = 170) revealed that the association between a hawkish political ideology and support for hardline policies was mediated by past victimization, whereas the association between a dovish political ideology and conciliatory policies was mediated by concerns over collective symbolic annihilation. Study 4 (N = 503) conceptually replicated the pattern of findings found in Study 3, and showed that at times of conflict, physical collective annihilation concerns also mediate the relationship between hawkish ideologies and support for hardline policies. In both Studies 3 and 4, when controlling for other threats, personal death did not play a significant role. These results underscore the need to consider the multidimensional nature of existential threat, especially in the context of political conflict. (shrink)

The current study strives to examine the determinants of employee innovative work behavior and job performance. Therefore, an integrated research model is developed with the help of paternalistic leadership style and job embeddedness theory to investigate employee behavior toward innovative work behavior. The research model is extended with the moderating effect of environmental dynamism between the relationship of innovative work behavior and employee job performance. Data were collected from 411 employees working in small medium enterprises. For inferential analysis, the (...) structural equation modeling technique is used. Results of the structural equation modeling revealed that altogether paternalistic leadership style and factors underpinning job embeddedness theory have explained 52.1% of the variance in employee innovate work behavior. The findings of this research suggest that managers and policy makers should focus on benevolent leadership, moral leadership, and on-the-job embeddedness to boost employee job performance and innovative work behavior. (shrink)

Is it allowable for your government, or anyone else, to influence or coerce you 'for your own sake'? This is a question about paternalism, or interference with a person's liberty or autonomy with the intention of promoting their good or averting harm, which has created considerable controversy at least since John Stuart Mill's On Liberty. Mill famously decried paternalism of any kind, whether carried out by private individuals or the state. In this volume of new essays, leading moral, political and (...) legal philosophers address how to define paternalism, its justification, and the implications for public policy, professional ethics and criminal law. So-called 'libertarian' or non-coercive paternalism receives considerable attention. The discussion addresses the nature of freedom and autonomy and the relation of individuals to law, policy and the state. The volume will interest a wide range of readers in political philosophy, public policy and the philosophy of law. (shrink)

Whereas many evolutionary models emphasize within-group cooperation or between-group competition in explaining human large-scale cooperation, recent work highlights a critical role for intergroup cooperation in human adaptation. Here we investigate intergroup cooperation in the domain of shotgun hunting in northern Republic of the Congo. In the Congo Basin broadly, forest foragers maintain relationships with neighboring farmers based on systems of exchange regulated by norms and institutions such as fictive kinship. In this study, we examine how relationships between Yambe (...) farmers and BaYaka foragers support stable intergroup cooperation in the domain of shotgun hunting. In the study village, shotgun hunting is based on a specialization-based exchange wherein Yambe farmers contribute shotguns and access to markets to buy cartridges and sell meat while BaYaka foragers contribute their specialized forest knowledge and skill. To understand how costs and benefits are distributed, we conducted structured interviews with 77 BaYaka hunters and 15 Yambe gun owners and accompanied hunters on nine hunting trips. We found that hunts are organized in a conventional manner within a fictive kinship structure, consistent with the presence of intercultural mechanisms to stabilize cooperation. However, because bushmeat demand is high, gun owners can gain significant cash profit, while compensating hunters only with cigarettes, alcohol, and a traditional hunter’s portion of meat. To level payoffs, hunters strategically hide kills or cartridges from gun owners to feed their own families. Our results illustrate how each group prioritizes different currencies (e.g., cash, meat, family, intergroup relations) and provide insights into how intergroup cooperation is stabilized in this setting. The example of this long-standing intergroup cooperative system is discussed in terms of its contemporary entwinement with logging, the bushmeat trade, and growing market intersection. (shrink)

Is reducing large-scale intergroup conflict the business of corporations? Although large corporations can use their power and prominence to reduce intergroup conflict in society, it is unclear to what extent stakeholders support corporate Intergroup Responsibility. Study 1 showed that support for CIR correlates in theoretically meaningful ways with relevant economic, social, and moral attitudes, including fair market ideology, consumer support for corporate social responsibility, social dominance orientation, symbolic racism, and moral foundations. Studies 2 and 3 employed experimental (...) designs to test the hypothesis that business leaders who advocate for intergroup tolerance boost perceptions of corporations and their leaders as moral, just, and fair, which in turn, increases stakeholders’ support for CIR. We found support for this hypothesis across two highly publicized and contentious events related to racial conflict in the U.S.: The White supremacy rally in Charlottesville and the federal government’s announcement about the planned rescinding of the Deferred Action for Childhood Arrivals immigration policy. Specifically, exposing participants to real-world tweets by CEOs who advocated intergroup tolerance following these events increased participants’ support for CIR. This effect was mediated by heightened perceptions of corporations and their leaders as moral, just, and fair. Taken together, these findings enhance our understanding of the factors that shape stakeholders’ reactions to CIR; highlight intergroup conflict as an emerging arena for CSR; and illustrate the power of ethical intergroup leadership. (shrink)

Intergroup and long-distance relationships are both central features of human social life, but because intergroup relationships are emphasized in the literature, long-distance relationships are often overlooked. Here, we make the case that intergroup and long-distance relationships should be studied as distinct, albeit related, features of human sociality. First, we review the functions of both kinds of relationship: while both can be conduits for difficult-to-access resources, intergroup relationships can reduce intergroup conflict whereas long-distance relationships are especially (...) effective at buffering widespread resource shortfalls. Second, to illustrate the importance of distinguishing the two relationship types, we present a case study from rural Bolivia. Combining ethnography and two different experimental techniques, we find that the importance of intergroup relationships—and the salience of group membership itself—varies across populations and across methods. Although ethnography revealed that participants often rely on long-distance relationships for resource access, we were unable to capture participant preferences for these relationships with a forced-choice technique. Taken together, our review and empirical data highlight that (1) intergroup and long-distance relationships can have different functions and can be more or less important in different contexts and (2) validating experimental field data with ethnography is crucial for work on human sociality. We close by outlining future directions for research on long-distance relationships in humans. (shrink)

Good corporate governance requires that managers promote shareholder interests but it cannot be assumed they will act in this manner. Though this is an observation most managers would acknowledge, many argue they should be free of external regulatory intervention because regulations designed to protect shareholders are necessarily a form of paternalism that take from shareholders decisions that are rightly theirs to make. We question this perspective by showing that regulations founded on paternalist principles are compatible with a liberal economy and (...) social relations. We identify when a paternal approach to decision making is justified and add substance to our argument by responding to claims that the Principles of Good Governance1 promulgated by the Australian Stock Exchange (ASX) are an unacceptable infringement on managers’ right to govern their enterprises because they are supposedly paternalist. We reject this argument and suggest that while the current ASX principles are not paternalistic there is a case for ensuring shareholder protection is informed by paternalist principles. (shrink)

Several authors have recently advocated a so-called new case for paternalism, according to which empirical findings from distinct decision sciences provide compelling reasons in favour of paternalistic interference. In their view, the available behavioural and neuro-psychological findings enable paternalists to address traditional anti-paternalistic objections and reliably enhance the well-being of their target agents. In this paper, I combine insights from decision-making research, moral philosophy and evidence-based policy evaluation to assess the merits of this case. In particular, I articulate (...) and defend three complementary arguments that, I claim, challenge even the best available calls for such case. In doing so, I identify the main justificatory challenges faced by the new paternalists and explicate the implications of these challenges for the ongoing philosophical debate about the justifiability of paternalistic interference. (shrink)

Donald VanDeVeer probes the moral complexities of the question: under what conditions is it permissible to intervene invasively in the lives of competent persons--for example, by deception, force, or coercive threat--for their own good? In a work with broad significance for law, public policy, professional-client relations, and private interactions, he presents a theory of an autonomy-respecting" paternalism. Originally published in 1986. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished (...) backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)

Many scholars think that women are sentenced more leniently than men because judges are paternalistic toward women. In this article, I suggest that paternalism is a multilayered concept and that it is important to distinguish between judicial concerns for protecting women and those for protecting children and families. To learn what factors judges consider in sentencing and whether these differ for men and women defendants, I interviewed 20 men and 3 women judges in two state criminal courts. I learned (...) that the primary objects of judicial protection were not women, but children, and men's and women's economic support or care for families. However, there was a labor hierarchy in the judges' minds in that they believed that care giving was more important than wage earning for the maintenance of families. Interactive influences among the defendant's gender, familial status, race or ethnicity, and the nature of the offense charged are discussed. (shrink)

BackgroundPsychiatric staff members have the power to decide the options that frame encounters with patients. Intentional as well as unintentional framing can have a crucial impact on patients’ opportunities to be heard and participate in the process. We identified three dominant ethical perspectives in the normative medical ethics literature concerning how doctors and other staff members should frame interactions in relation to patients; paternalism, autonomy and reciprocity. The aim of this study was to describe and analyse statements describing real work (...) situations and ethical reflections made by staff members in relation to three central perspectives in medical ethics; paternalism, autonomy and reciprocity.MethodsAll staff members involved with patients in seven adult psychiatric and six child and adolescent psychiatric clinics were given the opportunity to freely describe ethical considerations in their work by keeping an ethical diary over the course of one week and 173 persons handed in their diaries. Qualitative theory-guided content analysis was used to provide a description of staff encounters with patients and in what way these encounters were consistent with, or contrary to, the three perspectives.ResultsThe majority of the statements could be attributed to the perspective of paternalism and several to autonomy. Only a few statements could be attributed to reciprocity, most of which concerned staff members acting contrary to the perspective. The result is presented as three perspectives containing eight values.•Paternalism; 1) promoting and restoring the health of the patient, 2) providing good care and 3) assuming responsibility.•Autonomy; 1) respecting the patient’s right to self-determination and information, 2) respecting the patient’s integrity and 3) protecting human rights.•Reciprocity; 1) involving patients in the planning and implementation of their care and 2) building trust between staff and patients.ConclusionsPaternalism clearly appeared to be the dominant perspective among the participants, but there was also awareness of patients’ right to autonomy. Despite a normative trend towards reciprocity in psychiatry throughout the Western world, identifying it proved difficult in this study. This should be borne in mind by clinics when considering the need for ethical education, training and supervision. (shrink)

Most anti-paternalists claim that informed and competent self-regarding choices are protected by autonomy, while ill-informed or impaired self-regarding choices are not. Joel Feinberg, among many others, argues that we can in this way distinguish impermissible “hard” paternalism from permissible “soft” paternalism. I argue that this view confronts two related problems in its treatment of ill-informed decision-makers. First, it faces a dilemma when applied to decision-makers who are responsible for their ignorance: it either permits too much, or else too little, intervention (...) to satisfy its proponents. Second, the most promising rationales in favor of the view ignore the distinction between an agent’s voluntarily bringing about some state of affairs, on the one hand, and an agent’s voluntarily assuming a risk, on the other. I conclude that a decision-maker’s ignorance is irrelevant to the permissibility of intervention on her behalf. If it is permissible to intervene in a given ill-informed choice, it would be permissible to intervene in an otherwise similar but informed choice, at least provided that intervention would produce similar benefits in both cases. This shows that we should sometimes accept straightforwardly paternalistic rationales. (shrink)

A common objection to paternalism concerns its expressive content. Many reject paternalistic policies and actions on the ground that they arguably involve insulting expressions of disrespect toward those subjected to them. The paper challenges this view. It argues that refraining from acting paternalistically can be disrespectful. Specifically, the paper argues that there is a relevant way in which A disregards the moral worth of B if A stands idly by when B is about to act very imprudently. If true, (...) treating others with equal respect and concern, as relational egalitarians and others rightly ask us to do, will somewhat surprisingly sometimes involve treating them paternalistically. (shrink)

Paternalism is a frequent source of anxiety and scholarly enquiry within public health. This article examines debate in the UK from the 1950s to the early 1980s about two quintessentially paternalistic laws: those making it compulsory to use a motorcycle helmet, and a car seatbelt. This kind of historical analysis, looking at change over time and the circumstances that prevent or enable such change, draws attention to two significant features: the contingent nature of that which is perceived as (...) class='Hi'>paternalistic and therefore objectionable, and the wide range of arguments that can be marshalled for and against. It suggests that paternalism became a particularly disruptive accusation in the UK of the 1970s in relation to seatbelts, thanks to the population that would be affected and the wider socio-political context. It also suggests that arguments about the social cost of death and injury on the roads, along with overt acceptance that some element of paternalism could be acceptable, proved influential—as was the sense of inevitability that 10 years of regular debate helped to create. (shrink)

BackgroundPatient autonomy is a fundamental, yet challenging, principle of professional medical ethics. The idea that individual patients should have the freedom to make choices about their lives, including medical matters, has become increasingly prominent in current literature. However, this has not always been the case, especially in communist countries where paternalistic attitudes have been interwoven into all relationships including medical ones. Patients’ expectations and the role of the doctor in the patient-physician relationship are changing. Croatia, as a transitional country, (...) is currently undergoing this particular process.MethodsQualitative research was conducted by means of six focus group discussions held in the years 2012 and 2013 in Croatia. Focus groups were held separately with each of the following: first year and final year medical students, physicians engaged in medical ethics education, physicians practicing in a clinical hospital, family medicine residents and individuals representing patients with chronic disease. This research specifically addresses issues related to patient autonomy, in particular, the principles of truth telling, confidentiality, and informed consent. All focus group discussions were audio taped and then transcribed verbatim and systematized according to acknowledged qualitative analysis methods.Results and discussionPatient autonomy is much more than a simple notion defined as the patient’s right to make treatment decisions independently. It has to be understood in context of the broader socio-cultural setting. At present, both patients and medical doctors in Croatia are increasingly appreciating the importance of promoting the principle of autonomy in medical decision-making. However, the current views of medical students, physicians and patients reveal inconsistencies.Conclusions Knowing how to respect the various facets of patients’ autonomy should be part of physician’s professional duties, and also be reflected in his or her core clinical competencies. For this reason greater importance should be dedicated to patient autonomy issues in medical education in Croatia. (shrink)

In patient centred care, shared decision making is a central feature and widely referred to as a norm for patient centred medical consultation. However, it is far from clear how to distinguish SDM from standard models and ideals for medical decision making, such as paternalism and patient choice, and e.g., whether paternalism and patient choice can involve a greater degree of the sort of sharing involved in SDM and still retain their essential features. In the article, different versions of SDM (...) are explored, versions compatible with paternalism and patient choice as well as versions that go beyond these traditional decision making models. Whenever SDM is discussed or introduced it is of importance to be clear over which of these different versions are being pursued, since they connect to basic values and ideals of health care in different ways. It is further argued that we have reason to pursue versions of SDM involving, what is called, a high level dynamics in medical decision-making. This leaves four alternative models to choose between depending on how we balance between the values of patient best interest, patient autonomy, and an effective decision in terms of patient compliance or adherence: Shared Rational Deliberative Patient Choice, Shared Rational Deliberative Paternalism, Shared Rational Deliberative Joint Decision, and Professionally Driven Best Interest Compromise. In relation to these models it is argued that we ideally should use the Shared Rational Deliberative Joint Decision model. However, when the patient and professional fail to reach consensus we will have reason to pursue the Professionally Driven Best Interest Compromise model since this will best harmonise between the different values at stake: patient best interest, patient autonomy, patient adherence and a continued care relationship. (shrink)

Identity-Relative Paternalism, as defended by Wilkinson, holds that paternalistic intervention is justified to prevent an individual from doing to their future selves (where there are weakened prudential unity relations between the current and future self) what it would be justified to prevent them from doing to others.1 Wilkinson, drawing on the work of Parfit and others, defends the notion of Identity-Relative Paternalism from a series of objections. I argue here, however, that Wilkinson overlooks a significant problem for Identity-Relative (...) Paternalism—namely, that it yields unactionable and self-contradictory results when applied to choices where both options present potential harms to future selves. (shrink)

We also critique the myopic focus on prejudice reduction, but we do not support the call for a reconceptualization of prejudice. Redefining key psychological constructs is unproductive. Also, we point to interpersonal dynamics in cross-group interaction as a key mechanism in the prejudice reduction/collective action paradox and point to solutions involving intrapersonal/interpersonal processes, as well as broader structural intergroup relations.

Positive intergroup contact and cross-group friendships are known to have numerous benefits for intergroup relations in diverse schools. However, children do not always spontaneously engage in cross-group friendships, choosing rather to spend time with their ingroup peers. Several factors have previously been identified that influence children’s confidence in contact and subsequent development of cross-group friendships, including perceived intergroup similarity and reconciliation of intergroup differences. However, inducing perceived similarity may pose a threat to the person’s social (...) identity and increase the need for distinctiveness. Therefore, it remains unclear how one should manipulate perceived similarity and group boundaries when designing interventions that prepare school children for successful contact. Moreover, eliminating perceived group boundaries need not lead to the generalization of improved attitudes towards the outgroup. An optimal balance of inclusion and differentiation between the groups should be determined so as to make way for beneficial cross-group friendships. Based on a literature review, we provide recommendations for designing prejudice reduction interventions in schools from the perspective of intergroup similarity. (shrink)

Many discussions of J. S. Mill's concept of liberty focus too narrowly on On Liberty and fail to acknowledge that his treatment of related issues elsewhere may modify its leading doctrines. Mill and Paternalism demonstrates how a contextual reading suggests that in Principles of Political Economy, and also his writings on Ireland, India and on domestic issues like land reform, Mill proposed a substantially more interventionist account of the state than On Liberty seems to imply. This helps to explain Mill's (...) sympathies for socialism after 1848, as well as his Malthusianism and feminism, which, in conjunction with Harriet Taylor's views, are central to his later discussions of the family and marriage. Feminism, indeed, is shown to provide the answer to the problem which most agitated Mill, overpopulation. Thus Gregory Claeys sheds new lights on many of Mill's overarching preoccupations, including the theory of liberty at the heart of On Liberty. (shrink)

Many believe that paternalism is less wrong in intimate relationships. In this paper, we argue that this view cannot be justified by appeal to (i) beneficence, (ii) shared projects, (iii) vulnerability, (iv) epistemic access, (v) expressivism, or (vi) autonomy as nonalienation. We finally provide an error theory for why many may have believed that paternalism is less wrong in intimate relations.

Medical paternalism has long been a common medical practice. However, patient autonomy in healthcare has been recently adopted by doctors and patients alike. This study explored whether doctors and patients in a tertiary care hospital in Saudi Arabia preferred autonomy or paternalism in shared decision‐making. A total of 118 participants (51 patients requiring total knee replacement, owing to stages 3–4 of osteoarthritis, and 67 doctors) from the Eastern province, Saudi Arabia. responded to a 17‐question category‐based questionnaire involving four scales of (...) autonomy. Descriptive statistics and chi‐square test results revealed that in this hospital, patients preferred a paternalistic approach toward their medical care along with a full disclosure of the risks related to surgical procedures. We recommend health education regarding the specific autonomy subscales (doctor knows best, patient should decide, right to non‐participation, and obligatory risk information), and the implementation of protocols that protect patients' rights and enhance personal autonomy. (shrink)

This paper challenges the two aims of Michael Cholbi’s Rational Will View (RWV) which are to (1) offer an account of why paternalism is presumptively or pro tanto wrong and (2) relate the relative wrongness of paternalistic interventions to the rational powers that such interventions target (Sections 1 and 2). Some of a paternalizee’s choices harm their future selves in ways that would be wrong if they were done to others. I claim this challenges Cholbi’s second aim (2) because (...) the cases his account deems particularly wrong turn out to be not to be as wrongful as expected (Section 3). When this second aim is challenged, it has knock-on effects on the capacity of the RWV to discern which cases of paternalism are generally more wrongful than others, which undermines Cholbi’s first aim (1). I consider responses on behalf of Cholbi’s view but conclude that the account is insufficient on its own to vindicate its two aims (Section 4). Finally, I draw on recent work that adopts ideas from the practical reasoning literature to help determine paternalism’s wrongness (Section 5). I argue this helps Cholbi’s view withstand my objections, but we must remain skeptical of why interceding with rational powers is particularly wrong. (shrink)

In this paper, I argue against the commonly held view that paternalism is all things considered wrong when it interferes with a person’s autonomy. I begin by noting that the plausibility of this view rests on the assumption that there is a morally relevant difference in the normative reasons concerning an intervention in a person’s self-regarding actions and an intervention in his other-regarding actions. I demonstrate that this assumption cannot be grounded by wellbeing reasons, and that autonomy-based reasons of non-interference (...) also cannot adequately explain the difference. Following this, I propose that the difference in the reasons related to an intervention in a person’s self-regarding actions and an intervention in his other-regarding actions can be explained by the value of holding a person responsible for his choices. Nonetheless, this does not result in paternalistic behavior that interferes with autonomy being all things considered wrong. Instead, I show that the reason to hold a person responsible for a diminution of his wellbeing does not necessarily defeat the wellbeing reasons that count in favor of paternalistic behavior. (shrink)

Dominic Wilkinson’s defence of identity-relative paternalism raises many important issues that are well worth considering. In this short paper, I will argue that there could be two important differences between the first-party and third-party cases that Wilkinson discusses, namely, a difference in associative duties and how the decision relates to the decision maker’s own autonomous life. This could mean that identity-relative paternalism is impermissible in a greater number of cases than he suggests.

Receiving information about threats to one’s health can contribute to anxiety and depression. In contemporary medical ethics there is considerable consensus that patient autonomy, or the patient’s right to know, in most cases outweighs these negative effects of information. Worry about the detrimental effects of information has, however, been voiced in relation to public health more generally. In particular, information about uncertain threats to public health, from—for example, chemicals—are said to entail social costs that have not been given due consideration. (...) This criticism implies a consequentialist argument for withholding such information from the public in their own best interest. In evaluating the argument for this kind of epistemic paternalism, the consequences of making information available must be compared to the consequences of withholding it. Consequences that should be considered include epistemic effects, psychological effects, effects on private decisions, and effects on political decisions. After giving due consideration to the possible uses of uncertain information and rebutting the claims that uncertainties imply small risks and that they are especially prone to entail misunderstandings and anxiety, it is concluded that there is a strong case against withholding of information about uncertain threats to public health. (shrink)