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Comment on Levy's ‘Forced to be free? Increasing patient autonomy by constraining it’
  1. Jan Narveson
  1. Correspondence to Professor Jan Narveson, Department of Philosophy, and Department of Political Science, University of Waterloo, 57 Young Street West, Waterloo, ON, Canada N2L 2Z4; jnarveso{at}

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The general thrust of Neil Levy's paper is that a certain amount of paternalism should be viewed as compatible with liberalism.1 I am not quite convinced that what he is defending is properly paternalism. In addition, I am not entirely sure what his proposal is. Here are a few comments about several points in the paper.

1. A possibly small question is worth raising when Levy says, ‘That is, the state may not interfere with individuals’ actions, even to promote their own conception of the good. This claim is typically justified on epistemic grounds: individuals are best placed to judge for themselves how to pursue their conception of the good.’

But I don't think that this is quite the right picture, though admittedly, it has often been suggested by liberals. Still: if it's a matter of ‘epistemic’ grounds, then that implies that there is something out there to be known, so that the question is, how do we go about knowing it? But this way of putting it is misleading. For liberalism says that whenever anybody, B,  other than the individual we are considering, say A, claims that what is good for A is something ‘out there’—something that can strongly contradict what A thinks for his own case—then that outsider has no authority to override A's preference. This isn't epistemic—it's a moral position.

If we were to talk of ‘epistemic’ here, presumably what is known in this case is how the individual …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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