The role of physicians in Swedish society changed dramatically in the 19th century. The need for people not only to be healthy, but also to be seen as healthy by society gave physicians a power that often has been compared to the power of the clergy in early modern era. How might this change have affected how physicians viewed themselves and others? The historically patriarchal and later also strongly paternalistic relationship between the patient and the physician is not unknown to scholars of medical history but can be supplemented with other perspectives and source material. In this study, I shed light on how physicians who were accused of malpractice or negligence in the course of their duties. I also review how the Disciplinary Board of Swedish State Board of Medicine, responded to the merits of the accusations and to the person behind the accusation in the late 1940s and early 1950s. The words and actions of the physicians and the Disciplinary Board members towards the other party in the disciplinary cases reflect parts of the self-image and professional identity both within the medical profession and the identity which the physicians and the Disciplinary Board wished to convey outside the medical profession. It is therefore interesting to consider for whose sake the Swedish medical disciplinary board was established and run. Several conclusions have emerged during the study, including that the Swedish physicians did not need to have the patient's trust, whereas having the trust of colleagues and of the Board of Medicine appears to be essential to the physicians professional identity. Also, the stereotypical self-images of physicians as scientific, objective, and rational were contrasted with the stereotypical images of patients as subjective, naïve and ignorant, both by the accused physicians and the members of the Disciplinary Board. The indirect and direct power that the medical profession had over both their own profession and their patients perpetuated power imbalances in the patient-physician relationship. Criticism of the handling of disciplinary cases from various quarters in society and politics went unheeded as the criticism evident in the early and mid-1940s persisted also 30 years later.

This study examines the ethical balance of children’s autonomy and parents’ responsibility to protect in relation to the digital environment. The balance also relates to the right to privacy which can be limited with the intention to protect the child, but the child’s evolving capacities and autonomy is to be taken into consideration.  The purpose is to search for a plausible understanding of the ethical balance of children’s autonomy and the parental responsibility to protect within the context of the digital sphere. This means I make the case that how the child’s autonomy is viewed is fundamental for determining the balance within this context. Two theoretical perspectives on autonomy of Amy Mullin and Joseph Raz are utilized in the study. Additionally, I offer an analysis of a general comment on children’s rights in relation to the digital environment and other material from UNICEF’s research centre Innocenti.

[pt] Quando Michael Bloomberg, ex-prefeito de Nova York, propôs o limite para o tamanho de copos de refrigerantes vendidos em lanchonetes, críticos denunciaram o flagrante desrespeito à liberdade de escolha. Apoiadores do prefeito, por sua vez, alardearam os benefícios previstos à saúde da população. Esses valores inconciliáveis, liberdade versus bem-estar, abasteceram um debate sobre os limites do paternalismo de Estado. Recentemente, porém, baseados em evidências de falhas e vieses cognitivos diagnosticados por psicólogos e economistas comportamentais, Cass Sunstein e Richard Thaler sugeriram uma terceira via, o paternalismo fraco ou libertário, que aumentaria o bem-estar das pessoas sem eliminar opções de escolha: em vez de coerção, nudges sutis em direção a melhores decisões. Se, de um lado, o paternalismo fraco teve sucesso entre governantes, o mesmo sucesso não foi acompanhado dentro da academia: Sarah Conly o considerou pouco eficiente para ser uma alternativa ao paternalismo forte e liberais o consideraram contra a liberdade, mais especificamente contra um tipo de liberdade: a autonomia. Assim, chega-se à hipótese de que a rejeição ao paternalismo forte decorre da percepção da perda da liberdade em sentido negativo, ao passo que a rejeição ao paternalismo fraco decorre da percepção de perda de liberdade em sentido positivo ou autonomia. Com o intuito de testar esta hipótese, foram feitos diversos experimentos utilizando métodos da psicologia social. Os resultados dos experimentos corroboram com a hipótese, ao indicar a correlação entre crença em determinismo científico, que desafia a noção de autonomia e autodeterminação, e menor rejeição ao paternalismo fraco de Estado. / [en] When Michael Bloomberg, former mayor of New York, proposed to limit the size of soft drink cups sold in cafeterias, critics denounced the flagrant disregard for freedom of choice. Supporters of the mayor, in turn, boasted the expected benefits to public health. These irreconcilable values, freedom versus well-being, heated a debate about the limits of state paternalism. Recently, however, based on evidences of cognitive failures and biases diagnosed by psychologists and behavioral economists, Cass Sunstein and Richard Thaler suggested a third way, the weak or libertarian paternalism, which would increase people s well-being without eliminating options to choose from: in instead of coercion, subtle nudges toward better decisions. Although the weak paternalism was a success among governors, the same success was not followed within the academy: Sarah Conly considered it inefficient to be an alternative to the strong paternalism and liberals considered it against freedom, specifically against one type of freedom: autonomy. Thus, one comes to the hypothesis that the rejection of strong paternalism stems from the perception of loss of freedom in the negative sense, whereas the rejection of weak paternalism stems from the perception of loss of freedom in a positive sense or autonomy. In order to test this hypothesis, several experiments were ran using methods of social psychology. The results of the experiments corroborate the hypothesis by indicating the correlation between belief in scientific determinism, which challenges the notion of autonomy and self-determination, and less rejection of weak paternalism of state.

The period saw the founding of the first Swedish employers´ associations as a reaction to the preceding decades´ growth of industrial trade unions. Conflicting ideas fought about supremacy. Not only was the fight carried out across the social dividing line separating workers from the bourgeoisie, but also between groups on either side: hawks versus doves among employers; revolutionaries versus reformers among workers. The study uses an actor perspective, comparing three leading industrialists in their particular roles as employers. It analyzes the development of ideas over the period studied, using minutes from meetings, company memos, letters, speeches and newspapers as primary sources. In addition, it is action-orientated and analyzes major labour conflicts that were fought and agreements that were reached. It applies a split vision, taking into regard the contemporary views and actions of the labour unions. Its perspective moves between the individual, the company and the organizational levels, with the primary aim to see what changes in the traditional patriarchal employer policies that were considered and to what extent such changes were realized. A major result is the evidence of the irreconcilable views on the subject of strike breakers/loyal workers -- two conflicting terms for one phenomenon that indicate a gap between two different sets of values. Differing views among employers on how to relate to this gap caused frictions in the years 1906-09. The outcome of the general strike in 1909 ended in a harsh employer organizations policy for more than the two following decades. It was replaced by the mutual spirit, later known as the Swedish Model, materialized in the Saltsjöbaden general agreements of 1938.

This thesis is an attempt to constructively interpret and critically evaluate the liberal doctrine that we may not limit a person’s liberty for her own good, and to discuss its implications and alternatives in some concrete areas of public health policy. The thesis starts theoretical and goes ever more practical. The first paper is devoted to positive interpretation of anti-paternalism with special focus on the reason component – personal good. A novel generic definition of paternalism is proposed, intended to capture, in a generous fashion, the object of traditional liberal resistance to paternalism – the invocation of personal good reasons for limiting of or interfering with a person’s liberty. In the second paper, the normative aspect of this resistance is given a somewhat technical interpretation in terms of invalidation of reasons – the blocking of reasons from influencing the moral status of actions according to their strength. It is then argued that normative anti-paternalism so understood is unreasonable, on three grounds: 1) Since the doctrine only applies to sufficiently voluntary action, voluntariness determines validity of reasons, which is unwarranted and leads to wrong answers to moral questions. 2) Since voluntariness comes in degrees, a threshold must be set where personal good reasons are invalidated, leading to peculiar jumps in the justifiability of actions. 3) Anti-paternalism imposes an untenable and unhelpful distinction between the value of respecting choices that are sufficiently voluntary and choices that are not. The third paper adds to this critique the fourth argument that none of the action types typically proposed to specify the action component of paternalism is such that performing an action of that type out of benevolence is essentially morally problematic. The fourth paper ignores the critique in the second and third papers and proposes, in an anti-paternalistic spirit, a series of rules for the justification of option-restricting policies aimed at groups where some members consent to the policy and some do not. Such policies present the liberal with a dilemma where the value of not restricting people’s options without their consent conflicts with the value of allowing people to shape their lives according to their own wishes. The fifth paper applies the understanding of anti-paternalism developed in the earlier papers to product safety regulation, as an example of a public health policy area. The sixth paper explores in more detail a specific public health policy, namely that of mandatory alcohol interlocks in all cars, proposed by the former Swedish government and supported by the Swedish National Road Administration. The policy is evaluated for cost-effectiveness, for possible diffusion of individual responsibility, and for paternalistic treatment of drivers. The seventh paper argues for a liberal policy in the area of dissemination of information about uncertain threats to public health. The argument against paternalism is based on common sense consequentialist considerations, avoiding any appeal to the normative anti-paternalism rejected earlier in the thesis. / QC 20100714

Syftet med studien är att undersöka och problematisera hur Sida och Afrikagrupperna arbetar med hiv och aids i Sydafrika utifrån den postkoloniala kritik som riktats mot denna typ av arbete. Fokus ligger på de problem och dilemman som finns i utvecklingssamarbetet med Sydafrika. För att få en djupare förståelse och ytterligare ett perspektiv sammanför vi den postkoloniala teorin med teorier om hälsa. I det postkoloniala kapitlet behandlas bland andra Maria Eriksson Baaz och Pal Ahluwalias teorier om hur kolonialismen har skapat strukturer som påverkar Afrikabilden både i västvärlden och i Afrika idag. I teorin om hälsa utgår vi ifrån bland andra Deborah Lupton som menar att folkhälsa har en stark inverkan på politiska och sociala strukturer som fungerar som ett moraliserande system och påverkar hur vi ser på oss själva. För att få en förståelse och kunna problematisera ämnet ytterligare har vi tagit del av de dokument och policys som ligger till grund för Sida och Afrikagruppernas hiv och aidsarbete i Sydafrika. Dessa dokument analyseras och sammanförs med de intervjuer som har genomförts med Sidas och Afrikagruppernas anställda både i Sverige och i Sydafrika. Studien har, förutom att tydliggöra utvecklingssamarbetets komplexitet, också bland annat visat på att de strukturer skapade utifrån bilden av Afrika fortfarande påverkar biståndsarbetet på olika sätt och att västvärldens syn på hälsa i sin tur påverkar synen på Afrika. Sverige har definierat sitt utvecklingsarbete som ett partnerskap och studien visar att Sverige i jämförelse med andra länder ligger långt fram i detta arbete, men att det fortfarande finns brister. / The purpose of the study is to examine and problemize how Sida and the Africa Groups of Sweden´s work with HIV/AIDS in South Africa considering the post-colonial critique that has been directed at this type of work. Focus is on the problems and dilemmas that exist is the development work with South Africa. To get a deeper understanding and further perspectives we bring the post-colonial theory together with health theories. In the post-colonial chapter are Maria Eriksson Baaz and Pal Ahluwalias theories about how the colonial era has created structures that influence how one look at Africa today being discussed. In the health theory Deborah Lupton, amongst others, argues that public health has a strong effect on political and social structures that functions as a norm building system and influence how we view ourselves. To get an understanding and to be able to further problemize the material we have examined documents and policies that are the basis for Sida and the Africa Groups of Sweden´s work with HIV and AIDS in South Africa. These documents are being analysed and brought together with interviews that have been conducted with employees of Sida and the Africa Groups of Sweden in both Sweden and South Africa. The study has, except to elucidate the complexity of the development work, also shown, among other things, that the structures created due to the image of Africa still effects the aid work on different levels and that the western view on public health influence the image of Africa. The Swedish development work has been defined as a partnership and the study shows that Sweden, in comparison with other countries lies far ahead in this work, but that there still are shortages.

The focus of this research has been on how the county of Hertfordshire negotiated the economic, social and political changes of the late nineteenth century. A rural county sitting within just twenty miles of the nation’s capital, Hertfordshire experienced agricultural depression and a falling rural population, whilst at the same time seeing the arrival of growing numbers of wealthy, professional people whose economic focus was on London but who sought their own little patch of the rural experience. The question of just what constituted that rural experience was played out in the local newspapers and these give a valuable insight into how the farmers of the county sought to establish their own claim to be at the heart of the rural, in the face of an alternative interpretation which was grounded in urban assumptions of the social value of the countryside as the stable heart of the nation. The widening of the franchise, increased levels of food imports and fears over the depopulation of the villages reduced the influence of farmers in directing the debate over the future of the countryside. This study is unusual in that it builds a comprehensive picture of how agricultural depression was experienced in one farming community, before considering how farmers’ attempts to claim ownership of the ‘special’ place of the rural were unsuccessful economically, socially and politically. Hertfordshire had a long tradition of attracting the newly wealthy looking to own a country estate. Historians have suggested that in the late nineteenth century there was a shift in how such men understood ownership of these estates, showing little enthusiasm for the traditional paternalistic responsibilities; in the face of a declining political and social premium attached to landownership, their interest lay purely in the leisure and sporting opportunities of the rural. However, as this research will show, the newly wealthy were not immune to that wider concern with social stability, and they engaged with their local environment in meaningful ways, using their energies and wealth to fund a range of social improvements. This research extends our understanding of just how the rhetoric of the rural was experienced by the residents of a county which so many saw as incorporating the best of the ‘south country’. In so doing, it makes a significant contribution to our knowledge of how this period of agricultural depression was interpreted by the wider nation, and the impact on social and cultural understanding of the place of the countryside within the national identity.

Ce mémoire propose une analyse des justifications du paternalisme étatique dans les cas d’acrasie. Nous explorerons d’abord quelques théories et conceptions de l’acrasie, démontrant la nécessité de développer une conception de l’agent acratique qui soit en quelque sorte subdivisible. Mous exposerons par la suite en quoi cette conception de l’individu remet en question certains présupposés fondamentaux du libéralisme. Notre second chapitre sera consacré à une redéfinition de certains principes libéraux en fonction de notre conception de l’individualité. Cette redéfinition nous permettra d’expliquer comment l’intervention étatique de type paternaliste peut être parfois justifiée d’un point de vue libéral. Le cœur de notre argumentation mettra l’accent sur l’importance pour l’État d’assurer l’autonomie de ses citoyens en concevant leur raison comme faculté d’intégration personnelle. Notre troisième chapitre tentera d’explorer divers exemples de cas concrets où les principes développés plus tôt pourront s’appliquer. / The purpose of this master thesis is to analyze paternalistic justifications for State intervention in cases of acrasia. We first start by exploring some theories and conceptions of acrasia showing the necessity to develop a conception of the acratic agent as somehow subdivisible. We then show that this conception of the individual challenges some of the most central presuppositions for political liberalism. Our second chapter means to redefine some liberal principles according to our conception of individuality. This redefinition will enable us to explain how paternalistic State intervention can sometime be justified from a liberal point of view. Our argumentation will focus on the importance for the State to ensure the autonomy of its citizens by securing the role of their reason as a faculty of personal integration. Our third chapter means to explore diverse practical cases in which the principles developed earlier can apply.

The master thesis The concept of libertarian paternalism in the recodification of Czech private law introduces a concept that works as an efficient synthesis of two different approaches to the relationship between the individual and the state: liberalism and paternalism. Libertarian paternalism deals mainly with the default system setting and setting of the recommendations and mechanism that are helpful in the decision making process of an individual as well as the whole society. The master thesis defines this concept, its main attributes and its tradition in the behavioral economics as well as its means and limits. The thesis shows how the use of this concept provides cheap and effective tools for nudging human decisions and behavior. The libertarian paternalistic approach in the law regulation is demonstrated in the new civil recodification, especially Civil Code 2012 as the fundamental act of civil law. The master thesis uses interdisciplinary approach to the topic, applying the perspectives of philosophy of law, economy, psychology and sociology.

The main objective of this study was to explore the problems and solutions surrounding the discursive reality of Swedish drug policy and, at the same time, determine whether its policy could be deemed paternalistic. The theoretical framework used in this study consists of various paternalistic theories – ranging from general paternalism to legal paternalism. The methodological approach is based on Mörkenstams three-dimensional applied method, consisting of the following framework: problem – reason – solution, with its foundation relying on the principles of methodological discourse analysis. The material researched ranges from 1984 through 2000 and consists of two governmental official investigations (SOU) and two government bills. The material was carefully chosen due to each document's contribution to the development of Swedish drug policy under the last two decades of the 20th century. Each document was surveyed using the consistent method of problem – reason – solution. The conclusion is that the use and misuse of narcotics cannot be accepted by the Swedish society. This problematic situation corresponds with the clarification of a need for societal institutions to better collaborate against all forms of illicit drug use. In addition, it is concluded that paternalistic tendencies are shown throughout the policy documents.