Paternalistic Interventions with the Gravely Disabled

Abstract

Interfering in the affairs of the gravely disabled has received attention in areas such as philosophy, theology, law, politics, and sociology. For such persons to be declared incompetent and have guardians appointed to care for them, a balancing is required of the right to personal freedom against the right to care. When consideration is given to the underlying principles of autonomy and beneficence, a case can be made for weak paternalistic interventions with persons of diminished capacity who are clearly endangered and in whom the conduct involved is substantially nonvoluntary. Examples are given of beneficial results occurring in persons with alcohol dependence or alcohol-related brain damage on whom a paternalistic intervention involving financial management was imposed with the aim of seeing that basic needs were met and that spending on alcohol was not excessive.