This is going to be my last substantive post for the week. Huge thanks to Thomas and the broader Flickers community for the opportunity, it’s been a blast!
I started this week’s blogging with a problem for certain hierarchical theories of autonomy. If we are only autonomous when our desires/actions align with some higher order attitude, then it looks like paternalism will be less prevalent, and consent much harder to come by, than typically thought. Akrasia is a paradigm example of the kind of mismatch between higher and lower order attitudes that hierarchical theories will treat as non-autonomous. Yet we typically think it’s paternalistic to intervene in akratic actions, and that (absent other considerations) akratically given consent is still valid.
The theory I’ve been sketching over the course of the week can avoid this problem. Decisions, I claim, have authority of their own, even when they fail to align with other elements of the agent’s psychology. This provides a simple and straightforward explanation of the connection between autonomy, paternalism, and consent. It does, however, raise difficulties of its own. It’s those difficulties I’ll be focusing on today.
In my last post I talked about the problem of manipulation. To recap, the problem is that if the agent’s values, beliefs, decisions etc are merely the product of manipulation, the agent shouldn’t be considered autonomous with respect to them. My solution was to note that such agents would have low autonomy because many of their values, beliefs, decisions etc would clash with other of their core attitudes: for instance, a policy of only treating as reasons considerations that are true. What’s distinctive about this solution is that it doesn’t deny the authority of the values, decisions etc that are the product of manipulation; it just suggests that their presence lowers the agent’s autonomy because they clash with other elements. It’s this continued authority that needs to be accounted for when thinking about consent and paternalism.
Both consent and paternalism are responsive to the authority of the agent’s decision: consent is only valid if the agent has the authority to grant it through her decision; more straightforwardly, paternalism is wrong because the agent’s decision to act has authority. When an agent is otherwise competent, informed, and free from coercion, we typically take decisions to consent and to act to be authoritative. We do this even when the agent is deciding akratically, suggesting that those decisions don’t need to be fully autonomous in order to be authoritative. What, though, if the agent’s decision to consent/act is the product of manipulation?
It might be tempting to say that, for whatever reason, the agent’s decision cannot have authority if it is the product of manipulation. That’s the temptation I’m hoping to resist. That doesn’t mean, though, that I think manipulated consent is fully valid; or that intervening in manipulated action is fully paternalistic. The reason is that, while the agent’s decision has authority, so too do the rest of her values, policies, etc.
Most of us, I suspect, have some kind of standards concerning when our decisions should be granted authority, even if not fully articulated. For instance, I don’t think my drunken decision to send an angry email should be respected; if someone’s in a position to stop me, they should. I do, however, think my drunken decision to eat a kebab on the way home should be respected; how dare anyone presume to tell me what to eat! I’ll call such standards policies (even though they don’t neatly fit with what Bratman calls self-governing policies). They are policies concerning the authority I take my decision to have, under certain conditions.
In order to head off a potential misunderstanding at the outset: I am not suggesting that these policies trump the decisions themselves; that because I have a policy denying authority to certain decision, those decisions then lack authority. Instead, I am suggesting that these policies have authority alongside the decisions themselves. If we then make one of these decisions, we have placed ourselves (and others) in a bind – there is nothing we can do, or that they can do, that will fully preserve and respect our autonomy. Whatever happens, some element with authority has been overridden.
What should we say, then, about consent and paternalism under conditions of manipulation? Exactly the same thing, I think, that we should say about consent and paternalism when the agent is akratic. In each case, the agent’s decision retains authority – to prevent her from following through would be to frustrate/disrespect her autonomy. However, the agent’s policies also have authority – if she has a policy denying the authority of an akratic or manipulated decision (in the relevant circumstances) then granting her consent, or failing to intervene in her action, will also frustrate/disrespect her autonomy.
When we’re deciding whether to intervene, or whether consent has been validly given, I don’t think it’s helpful to focus on whether or not the agent’s decision is autonomous. I think it’s more fruitful (and more accurate) to ask how we can respond so as to best preserve/respect the agent’s autonomy, acknowledging all the while that whatever we do will involve some costs: some aspect of the agent’s autonomy will be frustrated.
Why is this fruitful? A key reason, I think, is that it brings to our attention an analog of what Judith Jarvis Thomson calls ‘moral remainder’. If we assume that the manipulated agent’s decision has no authority, then there is no autonomy-related harm done to her if we override that decision, or refuse to grant her consent. On my approach, by contrast, we are forced to acknowledge the ways we are – albeit justifiably – overriding something that actually has authority. In thinking about how we engage with agents at the margins, such as the mentally ill, I think this sensitivity has much to recommend it.