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A Reexamination of Hard Paternalism

Posted: 14 Feb 2001  

Thaddeus Mason Pope

Mitchell Hamline School of Law; Queensland University of Technology - Australian Health Law Research Center; Saint Georges University; Alden March Bioethics Institute

Date Written: September 22, 2000


Autonomy, the preeminent value in bioethics since the 1970s, has come under increasing attack in recent years. One outcome of this attack is that many bioethicists now recognize that the presumption in favor of autonomy can be rebutted for hard paternalistic reasons, at least under some circumstances. Unfortunately, bioethicists have failed to specify those circumstances.

Yet, this failure is understandable. There is a conceptual obstacle to establishing systematic criteria for the justifiability of hard paternalism: there is no adequate definition of hard paternalism. If we aren't clear about which acts are correctly described as hard paternalistic acts, then we cannot coherently morally assess hard paternalism.

In this paper, I address this problem, offering a comprehensive definition of hard paternalism. Specifically, I argue that six factors must be considered. (1) Presently, hard paternalism is typically defined only in terms of whether the subject's conduct is substantially autonomous. Thus, if the subject acts substantially free from cognitive and volitional defects, then interference with her action is hard paternalism. But hard paternalism must also be defined in terms of: (2) the identity of the paternalistic agent and the agent's relationship to the subject, (3) the motive of the paternalistic agent in restricting the subject, (4) the manner in which the agent restricts the subject, (5) the nature of the subject's restricted conduct, and (6) the importance of the restricted conduct to the subject.

Keywords: autonomy, paternalism, bioethics

JEL Classification: I18, K10, K32

Suggested Citation

Pope, Thaddeus Mason, A Reexamination of Hard Paternalism (September 22, 2000). Available at SSRN:

Thaddeus Mason Pope (Contact Author)

Mitchell Hamline School of Law ( email )

875 Summit Avenue
Room 320
Saint Paul, MN 55105
United States
651-695-7661 (Phone)


Queensland University of Technology - Australian Health Law Research Center ( email )

2 George Street
Brisbane, Queensland 4000

Saint Georges University ( email )

West Indies


Alden March Bioethics Institute ( email )

47 New Scotland Ave
MC 153
Albany, NY 12208
United States


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