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Implications of identity-relative paternalism
  1. Dominic Wilkinson1,2,3,4
  1. 1 Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
  2. 2 Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
  3. 3 Centre for Biomedical Ethics, National University of Singapore Yong Loo Lin School of Medicine, Singapore
  4. 4 Newborn Care, Oxford University Hospitals NHS Foudnation Trust, Oxford, UK
  1. Correspondence to Professor Dominic Wilkinson, University of Oxford and John Radcliffe Hospital, Oxford OX3 9DU, UK; dominic.wilkinson{at}

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I am grateful to the commentators for their thoughtful engagement with my paper.1 I am unable in this short response to reply to all of the important questions raised. Instead, I will focus on the practical application of identity-relative paternalism. Some commentators felt that this novel concept would yield implausible implications,2 others that it would have no impact because of uncertainty,3 or because existing ethical principles would yield the same conclusion.4

In the paper, I proposed the following principle:

Identity-relative paternalistic intervention: Individuals should be prevented from doing to 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.

What sorts of intervention might fit under this principle? Garstman et al give the example of living kidney donation.2 They imagined ‘Beth’, who altruistically decides to donate a kidney to a third party. Beth’s decision would mean that a future BethT2 would be deprived of a kidney, be at risk of immediate perioperative complications and would be at (somewhat) higher risk of long-term health complications including renal failure. But they argue that we would be justified in preventing someone from inflicting such harms on a third party (eg, we should stop someone from stealing a kidney). Hence, they claim that identity relative paternalism would rule …

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  • Funding This research was funded in whole, or in part, by the Wellcome Trust [203132/Z/16/Z]. The funders had no role in the preparation of this manuscript or the decision to submit for publication.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.