This essay begins with the assumption that a liberal political morality is grounded upon two core ideals one, that the freedom to shape one's own life in accordance with one's reasonable beliefs about the good is constitutive of the ideal human life; and two, that the state ought to be in the business of securing this life-shaping freedom for its citizens. I argue that the endorsement of these ideals has perfectionist implications for a political morality. My central claim is that if the liberal state is committed to securing its citizens' life-shaping freedom, then it must actively and intentionally promote a definitive ideal of human flourishing. Accordingly, a liberal political morality is perfectionist insofar as it promotes an ideal of human flourishing; it is liberal insofar as that ideal is a distinctively liberal one. My argument proceeds in four stages. In Chapter II, I argue that a liberal political morality cannot remain neutral in the way that many liberals claim it must be. The consequence of this is that a liberal morality must be grounded upon a non-neutral moral ideal. In Chapter III, I argue that this non-neutral ideal must take citizens' positive liberty or what I am calling their life-shaping capabilities €”seriously if it is to achieve its end of securing its citizens' life-shaping freedom. In Chapter IV, I present a theoretical framework intended to support the perfectionist element of my account. To do this, I propose a capabilities approach to well-being, which enables us to determine which capabilities are necessary for life-shaping freedom. In Chapter V, I address the inevitable worry that the state's enforcement of perfectionist political principles is likely to unjustifiably infringe upon its citizens'€™ freedom. To alleviate this concern, I argue that any paternalistic interference justified by a capabilities approach actually enhances citizens' long-term freedom by preventing them from permanently forfeiting the necessary conditions of their freedom. Once this obstacle has been overcome, we will be free to embrace the perfectionist implications of our commitment to life-shaping freedom.

The purpose of this thesis is to compare the paternalistic implications of two opposing political theories: neutrality and perfectionism. Neutrality holds that the state must not appeal to conceptions of the good as the justification for its decisions. Perfectionism rejects this constraint. Applied to paternalism, perfectionism makes it permissible for the state to appeal to a conception of the good when it acts paternalistically, that is, interferes with a person for his own good. Neutrality requires that paternalism must instead be guided by considerations that are in some sense neutral between various conceptions of the good. Perfectionism supports forcing people into worthwhile conceptions of the good. It provides motivation for a wider range of paternalistic policies than neutrality does. A number of perfectionist strategies for resisting this conclusion are examined. The first is to appeal to the value of autonomy as a component of well-being. Paternalism, some perfectionists argue, undermines the value of living an autonomous life. I try to show how various arguments for the value of autonomy, even if accepted, fail to rule out a wide range of paternalistic policies. A second strategy is to appeal to the endorsement constraint. According to this, a person's well-being cannot be advanced by forcing her into activities that she does not endorse as valuable. I argue that the endorsement constraint is not plausible in its strong form, and that whilst a weaker form is plausible, it allows a wide range of paternalism. A number of other strategies, such as appealing to the value of activity, claiming that many worthwhile activities require people to approach them with the right intentions for those activities to be for their own good, and that paternalism undermines trust in the government are examined and criticised. These difficulties do not mean that perfectionism should be rejected. But they do support setting aside conceptions of the good when the state acts paternalistically, whilst not necessarily ruling out perfectionism in non-paternalistic state action. This conclusion is strengthened in two ways. First, by taking Rawlsian contractualism as a method of elucidating neutrality, it is shown that neutrality supports a plausible principle of paternalism. Second, a number of recent attempts to set out necessary conditions for justified paternalism, such as that liberty must be balanced against wellbeing, that the consent of the patemalised is needed, and that the conduct must be nonvoluntary, are examined. The arguments for these conditions all suggest that neutrality is a necessary condition for justified paternalism. The conclusion of the thesis is two-fold. A conclusion about the neutralityperfectionist debate is that neutrality is required for paternalistic state action whilst perfectionism may be acceptable in the non-paternalistic sphere. A conclusion about state paternalism is that it is justified only if guided by neutral considerations.

Föreliggande studie avser att öka förståelsen för hur boendepersonal ser på och arbetar medbrukarinflytande för personer med psykiska funktionsnedsättningar. För att kunna göra detta formulerades tre forskningsfrågor, vilka avser att undersöka boendepersonals syn på syftet med brukarinflytande, deras upplevelse av hur de kan främja respektive hindra förutsättningar för brukarinflytande samt vilken påverkan brukarinflytande kan ha på deras arbete. För att kunna besvara studiens frågeställningar har fem kvalitativa intervjuer genomförts med personal på boenden för personer med psykiska funktionsnedsättningar. Studien har vidare analyserats utifrån följande teoretiska utgångspunkter; det relationella maktperspektivet, Franzéns makttriangel, den professionella makten och brukarrollen, handlingsutrymme samt paternalism och empowerment. Resultatet visar att brukarinflytande har en föränderlig karaktär och varierar i utformning och styrka beroende på kontext och brukarens personliga förutsättningar. Det framkommer flera argument för brukarinflytande. Vissa syftar till att öka brukarnas empowerment och främja deras återhämtning, dessa kan i hög grad kopplas till olika kategorier av brukare. Andra syften gynnar verksamheten och boendepersonal. Resultatet visar vidare att inte heller arbetet med brukarinflytande är helt okomplicerat. I detta arbete återfinns flera hindrande faktorer och aktörer på olika nivåer. Hindren påverkar vidare hur boendepersonal kan använda sin professionella makt och sitt handlingsutrymme i arbetet med brukarinflytande. Det finns också argument för att boendepersonal ibland begränsar eller hindrar brukarinflytande, exempelvis att det sker med hänsyn till brukarens bästa. Resultatet visar att det finns personal med paternalistiska förhållnings- och arbetssätt, vilka utgör hinder för brukarinflytande. Genom kommunikation kan boendepersonal dock skapa förutsättningar för brukarinflytande i personalgruppen, på så sätt kan den stigmatiserande diskursen om personer med psykiska funktionsnedsättningar ifrågasättas. Vidare visar resultatet att boendepersonal även kan främja brukarinflytande genom att öka brukarnas empowerment samt genom att inta ett empowermentinriktat förhållningssätt. Detta balanserar makten i relationen och möjliggör en mer jämlik relation, vilket uppfattas främjande. Boendepersonal kan också främja förutsättningarna för brukarinflytande genom att välja hur de ska hantera sitt handlingsutrymme, exempelvis genom att avsätta tid för brukarinflytande. Resultatet visar vidare att boendepersonals upplevelse av hur brukarinflytande påverkar deras arbete beror på inflytandets utformning. Det är dock tydligt att brukarinflytande ställer ökade krav på boendepersonal och deras arbete, vilka många gånger upplevs svåra att tillmötesgå på grund av tidigare nämnda hinder. Brukarinflytande kan också ha en positiv påverkan för boendepersonals arbete, dels då det kan underlätta arbetet och fylla en vägledande funktion och dels då det fyller en bekräftande och utvecklande funktion. Min slutsats är vidare att brukarinflytande för personer med psykiska funktionsnedsättningar varken är självklart eller enkelt. Men genom att öka förståelsen för det studerade området kan studien förhoppningsvis stimulera till reflektion och diskussion hos anställda inom socialt arbete, vilket kan främja förutsättningarna för brukarinflytande för personer med psykiska funktionsnedsättningar

Bakgrund: Psykossjukdom kan vara en följd av kroppslig sjukdom eller psykisk ohälsa. Vanligt förekommande symtom vanföreställningar, förvrängd verklighetsuppfattning och bristande sjukdomsinsikt. Det sistnämnda kan skapa svårigheter i att patienten inte fullföljer behandling samt en återkommande och svårare symtombild. Syfte: Syftet var att undersöka sjuksköterskors upplevelser av etiska problem i öppen och sluten psykiatrisk vård av psykospatienter. Metod: En kvalitativ intervjustudie baserad på 5 semistrukturerade intervjuer. Informanter valdes ut genom ett strategiskt urval och insamlad data analyserades med hjälp av Lundman och Hällgren Graneheims (2012) kvalitativa innehållsanalys. Resultat: Sjuksköterskor upplevde en etisk problematik då de behöver tvinga psykospatienter att ta emot vård. De upplevde även svårigheter att i vissa situationer upprätthålla olika aspekter av en professionell hållning. Bland annat uppledes problematik i att dra gränser i relationer till patienter då dessa gränser upplevdes stå i konflikt med yrkesbeskrivningens etiska gränser. Slutsats: Sjuksköterskor behöver ibland bortse från etiska ramverk och följa sin intuition. Vårdrelationen kan gynnas av att sjuksköterskan i vissa fall tillåter sig att bli mer eller mindre privat gentemot patienten. Att som sjuksköterska vara öppen och följsam genom att tänja på gränser och vara anpassningsbar bör anses vara ett professionellt förhållningssätt i psykosvård.

Student Number : 0413841X - MA research report - School of Social Sciences - Faculty of Humanities / People living and working on commercial farms in South Africa are the poorest and most vulnerable group in the labour market. They rely on multiple livelihood strategies to alleviate risk and to survive. Wages from their employment in agriculture usually constitute their primary source of income and therefore play an important part in their livelihood strategy, as does their dependence on the farmer for housing, food, credit and access to services. The livelihood strategies of these poor people have been disturbed by the introduction of the Sectoral Determination for the Agricultural Sector, which prescribes a minimum wage for farm workers. It is especially the most vulnerable workers who are hit by the farmers’ reluctance to grant them the same benefits as they received before. The law thus only succeeds in supporting those workers who are better educated, healthy and able to manage the higher amount of cash wage in a responsible way. It is necessary to protect those who are made worse off through the legislation by a comprehensive rural development strategy. Such a development strategy must target those factors keeping the poorest farm workers vulnerable and struggling for survival.

Många motståndare till paternalism har försökt hitta icke-paternalistiska motiveringar för policys som de anser vara försvarbara. Detta har kulminerat till ett ”project of reconcilliation” som menar att förespråka och försvara vissa till synes paternalistiska policys utan att acceptera paternalism. Denna uppsats har till syfte att undersöka, framför allt, tre av dessa möjliga icke-paternalistiska motiveringar, specifikt i förhållande till tvångsvård – ”the psychic harm argument”; autonomi som intrinsikalt värdefullt, och fall av ofrivillighet eller mjuk paternalism. Denna uppsats menar att visa att tvångsvård inte alltid går att motivera icke-paternalistiskt, och att dessa anti-paternalistiska motiveringar lider av vissa stora brister som gör de svåra att acceptera som tillfredsställande, och därmed att ”the project of reconcilliation” misslyckas. / Many opponents of paternalism have tried to find non-paternalistic justifications for policies that they consider justifiable. This has culminated in a "project of reconciliation" that means to advocate and defend some paternalistic policies without accepting paternalism. The purpose of this essay is to examine, in particular, three of these possible non-paternalistic motivations, specifically in relation to compulsory care - "the psychic harm argument", autonomy as intrinsically valuable, and cases of involuntariness or soft paternalism. This thesis aims to show that compulsory care cannot always be motivated by non-paternalism, and that these anti-paternalistic motivations suffer from certain major shortcomings that make them difficult to accept as satisfactory, and thus that “the project of reconcilliation” fails.

This is a thesis about anti-paternalism – the liberal doctrine that we may not interfere with a person’s liberty for her own good. Empirical circumstances and moral values may certainly give us reason to avoid benevolent interference. Anti-paternalism as a normative doctrine should, however, be rejected. Essay I concerns the definitions of paternalism and anti-paternalism. It is argued that only a definition of paternalism in terms of compound reason-actions can accommodate its special moral properties. Definitions in terms of actions, common in the literature, cannot. It is argued, furthermore, that in specifying the reason-actions in further detail, the notion of what is self-regarding, as opposed to other-regarding, is irrelevant, contrary to received opinion. Essay II starts out with the definition of paternalism defended in essay I and claims that however this very general definition is specified, anti-paternalism is unreasonable and should be rejected. Anti-paternalism is the position that certain reasons – referring one way or the other to the good of a person, give no valid normative support to certain actions – some kind of interferences with the same person. Since the reasons in question are normally quite legitimate and important reasons for action, a convincing argument for anti-paternalism must explain why they are invalid in cases of interference. A closer look at the reasons and actions in question provides no basis for such an explanation. Essay III considers a concrete case of benevolent interference – the withholding of information concerning uncertain threats to public health in the public’s best interest. Such a policy has been suggested in relation to the European Commission’s proposed new system for the Registration, Evaluation, and Authorisation of Chemicals (REACH). Information about uncertain threats to health from chemicals would allegedly spread anxiety and depression and thus do more harm than good. The avoidance of negative health effects is accepted as a legitimate and good reason for withholding of information, thus respecting the conclusion of essay II, that anti-paternalism should be rejected. Other reasons, however, tip the balance in favour of making the information available. These reasons include the net effects on knowledge, psychological effects, effects on private decisions and effects on political decisions. / QC 20101115

The aim of this study is to increase knowledge about how a group of newly graduated social workers reflect on the practical daily work and their positions working with clients who are in need of social and/or economic resources. More precisely the purpose is to find out how these seven newly graduated social workers viewed working with clients during theoretical and practical studies. The aim is to analyze which techniques and methods could be seen in these narratives. Furthermore the aim was to find out if and how these seven social workers reflected on the power relation between social worker and client. The material of this study consists of seven semi-structured interviews. Throughout gathering the data and analyzing it, the qualitative method in form of narrative approach was used. Theoretical tools used in both creating the theoretical perspective and analyzing the data material consisted of social constructionism and main theoretical concepts of Bauman’s stranger, Foucault’s concept of power and discipline and Reamer’s paternalism. Results and analysis of data material showed how methods and techniques in social work are used when working with a client, maintaining an unbalanced power relation between social worker and client, for example in the form of creating alliances of social workers, use of language and categorizing the clients. The power relation was directly considered and reflected on by three of seven interviewed social workers. However, it was apparent that many of those interviewed reflected indirectly on the role of power in social workers’ daily work with clients.

Over the fifty years from the end of the First World War, the experience of work in England was increasingly shaped by a concern for industrial welfare which manifested itself in various forms. Large-scale employers, in both the manufacturing and service sectors, often saw the provision of sports and recreational facilities as an important aspect of their commitment to industrial welfare and as a way of maintaining harmonious industrial relations. Sport, along with various recreational activities, increasingly provided a way of encouraging workers to identify with their employer; it was as important in this respect as the company outing or the annual dance. This thesis seeks to build on the existing historiography relating to the ‘sports and social’ side of corporate industrial welfare. Whereas historians to date have focussed on single companies or on a particular sector, it examines four separate case studies – two (Robinsons of Chesterfield and Raleigh of Nottingham) located in the manufacturing sector and two (Lyons and the Bank of England) located primarily in the service sector – to provide an account of this aspect of industrial welfare that is cross-sector in its scope. Company magazines, which played an important part in sustaining clubs and societies by publishing their activities, are the principal primary source used in each case. While underpinning previous work which has emphasised the commitment of employers to industrial welfare, it is argued here that workers themselves had an important part to play in the making of sports and social provision in factories and offices and other places of work, such as the catering establishments and hotels run by Lyons. Often the role of management was simply to respond positively to suggestions made by employees, providing the strategic support that enabled an activity to take off and then sustain itself. In all four case studies here the day-to-day organisation of particular activities was usually undertaken by interested employees. Thus, the characteristics of works-based recreation in a particular workplace could be shaped as much by ‘bottom-up’ initiatives as it was by ‘top-down’ directives. This especially applied to the numerous hobby or interest-based societies – amateur dramatic societies, camera clubs and horticultural societies, for example – which were an important feature of works-based recreation. It is argued here that the importance of such activities has been underestimated in studies to date. They have attracted less attention than company commitment to sport, for example, which manifested itself in the provision of expensive facilities. Yet, clubs and societies which could appeal to employees beyond the age at which most were likely to engage in sport were a relatively inexpensive way of extending the reach of an organisation’s welfare strategy. Accordingly, they are given substantial coverage here.

Ce travail porte sur le consentement à se nuire. L'état doit-il intervenir lorsque des individus consentent à ce qui parait leur être nocif? Cette question soulève la possibilité du paternalisme et de la neutralité de l'État. Le consentement de nuire est un point aveugle de la théorie libérale, et qui concerne en particulier le monde anglo-saxon. Si tous les pays sont concernés par cette question philosophique sérieuse, les Etats-Unis et le Royaume-Uni, du fait de leur héritage libertarien sont plus enclins à être affectés par cette question, la jurisprudence de ces pays en témoigne. Cette thèse interroge les fondements de la théorie libertarienne et libérale, en montrant les ambiguïtés de la notion de consentement. Elle fonde son analyse sur la jurisprudence contemporaine impliquant le consentement à se nuire, en construisant une approche casuistique au problème du consentement de la victime. Ce travail permet de faire une distinction entre deux types de cas: ceux où le consentement est motivé par les forces du marché - le consentement y est souvent contraint; et ceux où le consentement semble être tout à fait volontaire parce qu'il porte sur la sphère de l’intime. / This thesis focuses on consent to harm, and asks what happens when individuals consent to what appears to be harmful. This raises the possibility of paternalism and state neutrality. Consent to harm is a blind spot for liberal theory, and this issue concerns in particular the English-speaking world. If all countries are affected by this serious philosophical question, the US and the UK, because their libertarian tendencies are more prone to be affected by this question, as is visible in the jurisprudence. This work interrogates the premises of libertarian and liberal theory, by showing the ambiguities of the notion of consent. The analysis is based on contemporary jurisprudence involving consent to harm, and constructed on a casuistic approach to the problem of consent to harm. This methodology permits the author to distinguish between two types of cases: those in which consent is motivated by market forces, where consent is often incomplete and coerced; and those in which consent appears to be entirely voluntary because they take place in the intimate sphere.