Social Theory and Practice

Volume 41, Issue 4, October 2015

Preference, Choice, and (Libertarian) Paternalism

Torbjörn Tännsjö
Pages 716-733

Context-Dependent Preferences and the Right to Forgo Life-Saving Treatments

A member of Jehovah’s Witnesses agreed to receive blood when alone, but rejected it once the elders were present. She insisted that the elders should stay, they were allowed to do so, and she bled to death. Was it all right to allow her to have the elders present when she made her final decision? Was it all right to allow her to bleed to death? It was, according to an anti-paternalist principle, which I have earlier defended on purely utilitarian grounds. The thrust of the present argument is that the principle stands even in cases with context-sensitive preferences. However, my utilitarian argument to this effect must now rely on something other than J.S. Mill’s standard presumption that in most cases the individual makes the right choices for herself. A reference to the general trust in the system of healthcare is essential to the utilitarian defense of the anti-paternalistic principle.