Nir Eyal

Most books on ethics are boring. Against Autonomy 1 is fun to read because its helpful and profound points are made without a fuss. Author Sarah Conly is right that “when individuals engage in behavior that undercuts their own chances of happiness, state interference may be justified”.In what follows I argue that Conly misinterprets that thesis in three ways. First, she says that her paternalism seeks to “help people get where they want to go... live the lives they truly want to live”. That's a different idea from the one I quoted earlier. Why? Because people do not always want to live in the way that would give them the highest chance of happiness. Conly is surely right that when we “habitually choose the large fries”, that's not always because large fries is what we want truly. Such choice can also reflect ignorance and miscalculation on our parts—when we simply “choose ineffective means to our ends”. But Conly fails to recognise another potential source. Sometimes self-harming choice reflects what we truly want at the time. Many young people do not care much about health problems in their older years. They habitually choose large fries not because they …

Several contributions in this book tell of doctors' increasing emigration from developing countries where they are in critical shortage, especially from the underserved rural and public sectors of countries in sub-Saharan Africa (SSA) and South Asia. They point out the severe harm from that migration to some of the world's poorest and sickest populations who have no other doctors to turn to, and gain little from their emigration. Since significant harm to the badly off is bad, decline in that migration is usually a good development. But how to strive to achieve it?