PT  - JOURNAL ARTICLE
AU  - Jonathan Pugh
TI  - Coercive paternalism and back-door perfectionism
AID  - 10.1136/medethics-2013-101556
DP  - 2014 May 01
TA  - Journal of Medical Ethics
PG  - 350--351
VI  - 40
IP  - 5
4099  - http://jme.bmj.com/content/40/5/350.short
4100  - http://jme.bmj.com/content/40/5/350.full
SO  - J Med Ethics2014 May 01; 40
AB  - In this response piece, I argue that the ‘coercive paternalism’ that Sarah Conly endorses in her book Against Autonomy veers towards a back-door perfectionism. Although Conly points out that coercive paternalism does not mandate the imposition of alien values upon us in the same way that perfectionism does, I argue that coercive paternalism might yet impose an alien weighting of our own values; this, I suggest, means that coercive paternalism remains perfectionist in spirit, if not in letter. I go on to concede to Conly that coercive paternalism might be warranted in preventing actions that threaten health and that are only carried out on the basis of cognitive error. However, I conclude by claiming that we must take great care about what we presume that people are consuming only on the basis of cognitive error. More specifically, I suggest that it is crucial that we avoid defining our terms in such a manner that it becomes impossible for agents to choose some action that poses a risk to their health without them being accused of making a cognitive error in weighing their values in that way.