Respect for autonomy: deciding what is good for oneself

Paternalistic interference in autonomous decisions is typically impermissible. This has several explanations, among which is a view I call the agent-constitution of the good: that the autonomous agent not only knows what is best for herself, but determines what is best for herself through her desires, goals and so on (her aims). For instance, it might seem that if an autonomous person does choose not to take insulin for her diabetes, then not only is it inappropriate to force treatment upon her, it is also not in her best interest to take insulin. Here I argue that agent-constitution, though appealing, is false. In fact, autonomous agents can be mistaken about their good, even when it seems to depend only upon their aims. Agent-constitution appears true only because we typically fail to notice constraints on a person's good in private, self-regarding decisions where paternalism might be considered.