Liberty, Paternalism, and Road Safety

Abstract

Traffic safety measures such as seat belts, helmets, and speed limits have often been opposed by people claiming that these measures infringe on their liberty. Safety measures are often described as paternalistic, i.e., as protecting people against their own will. This chapter provides a historical account of such criticism of safety measures, beginning with nineteenth-century opposition to sanitation measures, which were claimed to threaten the freedom to drink dirty water. The historical analysis has a surprising conclusion: Opposition to safety measures does not seem to have much to do with paternalism. Some measures that would typically be described as paternalistic, such as seat belts in commercial aviation and hard hats on construction sites, have met with no significant opposition. In contrast, some of the most vehemently opposed measures, such as speed limits and the prohibition of drunk driving, cannot with any vestige of credibility be described as paternalistic. This is followed by an analysis showing that due to our tendency to follow examples set by others (herd effects), purely self-affecting behavior is much less common than what has usually been assumed. Most of the opposition to safety measures in road traffic seem to result from some individuals’ desires to engage in activities that endanger other people’s lives. The social need to restrain the satisfaction of such desires is obvious.

Full text

Liberty, Paternalism, and Road Safety
Sven Ove Hansson
Contents
Introduction .... . . . .. .............................................................................. 2
Paternalism and Liberty ........................................................................... 3
Defining the Term ............................................................................. 3
How Bad Is Benevolence? .................................................................... 6
What Options Can We Forbear? . ................................................................. 9
Sanitation .... .................................................................................. 9
Workplace Safety . .. . .......................................................................... 10
Seat Belts ...................................................................................... 11
Helmets ........................................................................................ 13
Drunk Driving . .. . ............................................................................. 15
Speeding ....................................................................................... 17
Conclusions ................................................................................... 19
The Significance of Human Connectedness .. . .................................................. 21
Combined Causes and Extended Anti-paternalism ........................................... 22
Herd Effects: How We All Influence Each Other . .. ......................................... 26
Driver Assistance and Self-driving Cars ......................................................... 29
In Conclusion: Vision Zero ....................................................................... 32
Cross-References ................................................................................. 32
References ........................................................................................ 33
Abstract
Traffic safety measures such as seat belts, helmets, and speed limits have often
been opposed by people claiming that these measures infringe on their liberty.
Safety measures are often described as paternalistic, i.e., as protecting people
against their own will. This chapter provides a historical account of such criticism
of safety measures, beginning with nineteenth-century opposition to sanitation
S. O. Hansson (*)
Division of Philosophy, Royal Institute of Technology (KTH), Stockholm, Sweden
Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm,
Sweden
e-mail: soh@kth.se
© The Author(s) 2022
K. E. Björnberg et al. (eds.), The Vision Zero Handbook,
https://doi.org/10.1007/978-3-030-23176-7_6-1
1

measures, which were claimed to threaten the freedom to drink dirty water. The
historical analysis has a surprising conclusion: Opposition to safety measures
does not seem to have much to do with paternalism. Some measures that would
typically be described as paternalistic, such as seat belts in commercial aviation
and hard hats on construction sites, have met with no significant opposition. In
contrast, some of the most vehemently opposed measures, such as speed limits
and the prohibition of drunk driving, cannot with any vestige of credibility be
described as paternalistic. This is followed by an analysis showing that due to our
tendency to follow examples set by others (herd effects), purely self-affecting
behavior is much less common than what has usually been assumed. Most of the
opposition to safety measures in road traffic seem to result from some individuals’
desires to engage in activities that endanger other people’s lives. The social need
to restrain the satisfaction of such desires is obvious.
Keywords
Acceptance of safety measures · Herd effects · Liberty · Paternalism · Traffic
safety · Vision Zero
Introduction
In April 1985, the Senate of the State of Washington discussed a proposal to make
the use of seat belts mandatory. Arguing against the proposal, Senator Kent Pullen
(R) conceded that seat belts would save lives, but in his view, that was not reason
enough to make them mandatory. “There is something more important than life
itself,”he said, “and that’s freedom”(Leichter 1991, p. 12). This is a type of
argument that traffic safety has met with throughout its history, and it is still in
very active use. Currently, a Missouri law-maker, Eric Burlison (R), is working hard
to repeal the motorcycle helmet law in his state. Like Pullen, he recognizes that his
policies will lead to more deaths, but that does not deter him. “At the end of the day,”
he says, “it’s about individual responsibility and individual freedom. I want my
neighbor to stay safe and healthy, but it’s not my business to force those decisions
upon my neighbor”(Huguelet 2020).
We hear similar messages in many other contexts. The American Enterprise
Institute campaigns against the “spirit of anti-smoking paternalism”that has given
us smoke-free bars and restaurants, and they deplore attempts by legislators to
remove unhealthy components such as trans-fats from food, calling all this “a
remarkable confiscation of freedom”(White 2006). The owner of a British pub
who was criticized by the authorities for deficient hygiene complained about “our
modern nanny state’s requirements for sterile and salubrious certification”
(Woolfson 2016). Anti-vaccination campaigners call themselves “freedom keepers,”
and claim that parent’s rights not to have their children vaccinated is a matter of
“civil rights”(Mays 2019). And in 2017, an Australian parliamentarian declared the
prevention of such measures to be his main aim in politics.
2 S. O. Hansson

When our most basic rights and freedoms are being chipped away at on a daily basis through
nanny-state regulations and big-government paternalism, with smoking indoors banned,
irrespective of what the owner of the property thinks; with bicycle helmets mandatory,
despite the rest of the world agreeing that they are really not worth the effort; and with
e-cigarettes, a potentially life-saving alternative pathway to quitting smoking, practically
banned, I will be there, making the case for personal choice and personal responsibility.
(Stonehouse 2017)
What is all this about? Of course we want freedom, but we also want traffic safety,
healthy food, and protection against deadly diseases. How severe is the conflict
between safety and liberty? Can we have safety on the roads in a free society, or do
we have to choose between freedom and safety?
Paternalism and Liberty
At the center of this discussion is the concept of paternalism, protecting someone
against her or his will. The critics of government interventions –or at least the more
thoughtful among them –accept government interventions to prevent people from
harming others, but they reject interventions intended to prevent us from harming
ourselves. The latter type of regulation, they say, treats adults as if they were
children. That is why it is called paternalistic.
Defining the Term
The word “paternalism”is derived from “paternal,”which means fatherly. In the late
nineteenth century, it was often used in a positive sense, in particular about
employers who cared for their employees. Today it is almost universally used in a
negative sense. In the scholarly discussion, Gerald Dworkin’sdefinition of paternal-
ism is widely accepted. In its latest variant it says:
Paternalism is the interference of a state or an individual with another person, against their
will, and defended or motivated by a claim that the person interfered with will be better off or
protected from harm. (Dworkin 2020)
Three major components of this definition should be noticed: (1) a person is
interfered with, (2) the person in question does not desire that intervention, and
(3) the interference has the purpose to benefit this person (Wilson 2015).
A small modification and some clarification of the definition will be useful. To
begin with the modification, Dworkin only mentions that “a state or an individual”
can interfere with a person, but certainly so can also a company or some other type of
organization. For instance, a company that performs construction work may choose
to fence in the worksite for no other reason than a desire to protect the public from
danger. Similarly, a manufacturer may choose to voluntarily withdraw a product
because of problems with its quality or safety, although some consumers still want
Liberty, Paternalism, and Road Safety 3

the product. A company that takes such actions behaves paternalistically in the same
sense as a government that makes the same type of decisions for the same type of
reasons. In these and other cases, an action affecting a group of persons can be
paternalistic towards some but not all of its members, depending on whether or not
they oppose the action (Grill 2018).
Dworkin’s term “interfere with”is in need of clarification, and indeed he provides
such a clarification later on in the text, when he specifies that the paternalist
“interferes with the liberty or autonomy”of the targeted person (Dworkin 2020).
This is an important clarification, since otherwise the list of paternalistic actions
would grow to enormous proportions. In private life and in work-life we often find
ourselves doing something for the benefit of a person who does not appreciate
it. And unavoidably, political decisions intended to benefit large groups of people
are not always appreciated by all of them. Some writers have used the term
“paternalism”for all sorts of political decisions that are intended to benefit the
population, including government funding of healthcare, education, public broad-
casting, museums and theatres, tax deductions for pension savings, and subsidies of
leisure activities and healthy food (Le Grand and New 2015, pp. 12, 52–54, 65–66,
and 153; Conly 2017, p. 208). With such a wide definition, the building and
maintenance of roads is also paternalistic, and so most certainly is law enforcement,
which –just like publicly funded art museums –is intended to benefit all, but
unfortunately is not appreciated by all. If we call all of this paternalism, we risk
losing sight of the much more limited range of cases that have been at the focus of
debates on paternalism, such as seat belts, motorcycle helmets, and vaccination.
These cases all have in common that they satisfy Dworkin’s criterion of interfering
with the liberty or autonomy of the targeted person (Cf. also Dworkin 1972, p. 67).
Another way to express this is that they limit the person’s choices by removing an
option, making an option less accessible, or reducing her ability to choose.
In definitions and more principled discussions of paternalism it is assumed that a
person has a right to harm or risk her own health and well-being, but it is not
assumed that she also has a right to harm her family members or expose them to risk.
However, in political discussions, and even in some academic texts, the latter
assumption is made as well. Even Giubilini and Savulescu (2019, p. 241), who
commendably advocate universal vaccination programs, describe this as a matter of
“how much weight we want to give to paternalism compared to individual freedom,
and particularly the freedom to decide what kind of risks to take on oneself or on
one’s children.”Shiffrin (2000, p. 217) takes this even further, suggesting that a park
ranger behaves paternalistically if he prevents a person from making a dangerous
mountain climb, not at all out of concern for the person himself or herself but for the
person’s spouse who would be left grief-stricken in the case of a fatal accident. As
noted by Dworkin (2015, p. 26), according to how paternalism is usually defined,
this case rather exemplifies “precisely the contrast class to paternalism.”
Non-paternalistic measures to promote safety and public health have a long
tradition. For instance, free vaccinations were an important part of infection control
throughout the nineteenth century, and they still are (Rigau-Pérez 1989, p. 400;
Daker et al. 1893, p. 217; Anon 1894). In order to encourage traffic behavior that
4 S. O. Hansson

reduces the risk of crashes, stop lines have been painted on roads since 1907, and
centerlines and pedestrian crossings since 1911 (Petroski 2016). The strategy behind
these and other similar measures for health and safety was summarized in 1976 by
the American public health scholar Nancy Milio:
The point is that most human beings, professional or nonprofessional, provider or consumer,
make the easiest choices available to them most of the time, and not necessarily because of
what they know is most healthful. Thus, if it is agreed that health-promoting life patterns are
a good thing, then the focus for changing behavior should be on the problem of how to make
health-generating choices more easy, and how to make health-damaging choices more
difficult...
In order then for life-style patterns to alter among individuals in numbers sufficient to
affect the incidence of major diseases, new, health-promoting options must be available, and
more readily so than health-damaging options, i.e., in such a way as to be less costly in dollar
and other costs. (Milio 1976, pp. 435 and 437)
In 2008, the term “nudge”was introduced in a book promoting this approach (Thaler
and Sunstein 2008). Neither this nor most other texts on “nudge”acknowledges the
long tradition of similar ideas in public health. This was pointed out by Signild
Vallgårda (2012), who also noted that “while renaming an activity has the benefitof
creating enthusiasm and new energy and providing the encouraging feeling of being
part of something new, it also has a drawback: it could lead to a neglect of insights
generated by the pursuance of similar policies in the past.”In their book, Thaler and
Sunstein used the term “libertarian paternalism”about the “nudge”approach. As
already mentioned, this is a usage that, if applied consistently, would lead us to
classify a large part of the benevolent activities that take place in society as
“paternalistic.”It should be recognized, though, that some of the actions that are
“libertarian paternalistic”according to Thaler and Sunstein, but not paternalistic
according to traditional definitions, are problematic in other ways, for instance, by
being manipulative (Mols et al. 2015; Dworkin 2020). This was also noted by
Dworkin, who said:
Their definition of Paternalism is very weak in the sense that it allows many more acts to
count as paternalistic than would be under almost all traditional definitions of paternalism.
(Dworkin 2020)
In order to avoid thinning out the concept, I will use the term “paternalism”only for
interventions that satisfy Dworkin’sdefinition, as explicated above. This is the
terminology that appears to be most in line with the tradition, at least in philosophy.
Of course, a different terminology could have been chosen. We could choose to use
the term “paternalistic”about all measures that have the purpose to benefit a person
against that person’s will, or without her consent. Then, however, we would have to
introduce a new term for what is called “paternalism”here.
Liberty, Paternalism, and Road Safety 5

How Bad Is Benevolence?
Dworkin’sdefinition of paternalism has a peculiar feature, which it apparently shares
with all other definitions of the term. This is his third criterion, which says that a
paternalistic action is “defended or motivated by a claim that the person interfered
with will be better off or protected from harm”. We can call this the criterion of
benevolence.
Something seems to be wrong here. That an action affecting another person is
benevolent towards that person is surely a morally good feature of that action. But
paternalism is presumably bad. So how can a good feature of an action be a
necessary requirement for the action to belong to a category of bad actions?
The mystery deepens if we consider how benevolence is usually assessed from a
moral point of view. Consider the following example (which happens to be based on
an actual occurrence):
After spreading thawing salt (road salt) on the asphalt outside his own house, Ahmad walked
over to his elderly neighbor’s house and strewed some salt on her entrance stairs. When she
noticed this a couple of hours later, she was much annoyed since she believes that thawing
salt will cause the stairs to crack.
Case A: Ahmad did this because he was worried that she might otherwise slip and break
her leg.
Case B: Ahmad did this because his wife had told him that another neighbor wanted him
to sprinkle salt over her stairs, but he mistakenly went to the wrong neighbor’s house.
Case C: Ahmad did this because he wanted to wreck her stairs.
In case A, Ahmad’s action is benevolent. In case C it is malevolent. In case B it is
neither benevolent nor malevolent; we can call it neutral in that case.
It can, I believe, be safely assumed that most of us would agree that Ahmad’s
action is morally better in case B than in case C, and even better in case A. Wanting
to help your neighbor seems to be a better excuse than confusing her with someone
else. Case A is the case in which Ahmad’s action was benevolent. Apparently, this
example confirms the supposition that benevolence contributes to making actions
good, rather than to making them bad.
But perhaps this example is untypical since it concerns actions by individuals,
rather than actions by governments or organizations? Let us consider such examples,
and begin with an example of a business organization.
Liliana owns the only hardware store in town. She has stopped selling a particular brand of
electric jigsaws, although several customers would still like to buy one.
Case A: Liliana did this because the protection of the user’s hands on this particular saw
is inferior to that of other brands, and she did not want her customers to be hurt.
Case B: Liliana did this because her supplier did not offer this particular saw any more,
and she did not take the trouble to look for someone else who can supply it.
In case A, Liliana’s purpose is clearly benevolent towards the customers whom she
has deprived of the option to buy this particular saw. Furthermore, according to
standard usage of the term, her decision in this case is paternalistic. In case B, in
6 S. O. Hansson

contrast, her action is neither benevolent nor paternalistic. It is just an ordinary
business decision. The decision in case A is clearly praiseworthy from a moral point
of view, and we might even use it as an example of corporate social responsibility on
a small scale. In case B, her decision does not seem to be particularly praiseworthy
from a moral point of view. So is paternalism better than business as usual? Then it
cannot be terribly bad, or can it?
Let us consider a similar example where the government is involved:
Liliana had to stop selling the power jigsaw. It would have been illegal to sell it since the
government did not prolong its type approval.
Case A: The government decided not to prolong the type approval because the jigsaw did
not have a satisfactory protection of the user’s hands.
Case B: The reason why the type approval was not prolonged was that a government
official failed to include this brand on a list of electric tools for routine prolongation of the
type approval. Due to procedural rules introduced by a previous government, it will take a
full year to correct the mistake.
In case A, the motive of the decision was benevolent, and it can also be described as
paternalistic. And again, the paternalistically motivated version of the decision
would appear to be the morally best version.
Thus, it seems as if benevolence cannot make an action or a decision worse than
what it would otherwise have been. Then how can benevolence be a defining
characteristic of an undesirable feature of an action, namely, that it is paternalistic?
Can the notion of paternalism at all be saved from this conundrum?
Yes, there is in fact a fairly satisfactory solution to this, but it requires a small
change in the definition: The definition should not refer to the presence of paternal-
istic justifications of the action, but rather to the absence of sufficient non-paternal-
istic justifications. This is also what Dworkin indicates. When he elaborates his
benevolence criterion more in detail, the crucial phrase is:
Xdoes so only because X believes Zwill improve the welfare of Y(Dworkin 2020; emphasis
added)
(Xis the agent who behaves paternalistically, Zthe paternalistic action, and Ythe
person who is the target of the paternalistic action.)
In other words, a sensible anti-paternalist cannot maintain that it is wrong to have
paternalistic motives or justifications for one’s actions. (The terminology is some-
what intricate. A motive or justification for an intervention affecting a person is
commonly called “paternalistic”if it is benevolent towards that person,
irrespectively of whether or not the intervention infringes on that person’s liberty.
This usage will be followed here.) The wrong will have to be identified as that of not
having sufficient non-paternalistic motives or justifications. Let us consider an
example that illustrates this:
For many years Stephen has earned his living by travelling around with a pendulum ride,
which he sets up on various festivals and fairs. One day he is visited by a safety inspector
Liberty, Paternalism, and Road Safety 7

from a government agency. After discovering a serious fault in the machine, the inspector
issues an injunction prohibiting Stephen from offering any more rides on it.
Case A: The inspector does this because of a serious risk that the attendant, that is
Stephen himself, can be killed in an accident. Riders are not at risk.
Case B: The inspector does this because of a serious risk of an accident in which both the
riders and the attendant can get killed.
Case C: The inspector does this because of a serious risk that the riders can be killed in an
accident. The attendant is not at risk.
Stephen, we may assume, is a fervent anti-paternalist. In case A, he can legitimately
claim that the inspector has acted against him on purely paternalistic grounds. Such a
claim would not be tenable in the other two cases, since the risk to the riders is reason
enough for the inspector’s decision. But would it be reasonable for Stephen to claim
that the inspector’s argument for closing down his machine is weaker in case B than
in case C, since a concern for Stephen’s own well-being is involved in the former
case but not in the latter?
INSPECTOR: I have decided to close down your machine because there is a large risk that riders
can get killed if you continue to operate it.
STEPHEN: I fully respect your decision.
INSPECTOR: I appreciate that. I should also tell you that you would probably be killed
yourself in such an accident, and of course that contributed to my decision.
STEPHEN: What are you saying? Are you a paternalist wanting to protect me? Then I
cannot respect your decision any longer. Are you really sure that it is necessary to close
down the machine immediately?
It would not be absurd to claim that a paternalist argument has no weight at all. (This
would mean that the inspector’s injunction is justified to the same degree in cases B
and C.) However, as this example shows, it would be utterly absurd to maintain that a
paternalist argument carries a negative weight. There may of course be anti-
paternalists who maintain that it is blameworthy to harbor concerns for other
people’s well-being. I am not claiming that such a position is impossible or
non-existent, only that is a morally absurd position that is not worth taking seriously.
This is written during the Covid-19 epidemic in 2020. Among the many statements
that have been made on what governments should and should not do in relation to
this health crisis, I have as yet not heard a claim that governments have no business
to be concerned with the population’s health. (This would mean that the injunction is
less well justified in case B than in case C.) This confirms the limit to sensible anti-
paternalism that was proposed above: It has to be concerned with the absence of
sufficient non-paternalistic motives or justifications, not with the presence of pater-
nalistic ones. This also means that the legitimate concerns of anti-paternalism are
concerns about infringements of liberty, not about other people’s benevolence.
Wilson (2015, p. 212) reached a similar conclusion. Several authors have pointed
at the difficulties involved in judging an action by a government or an institution by
its intention (e.g., Dworkin 1972, p. 65). Participants in a decision may differ in their
intentions, and it is far from clear how their intentions can be aggregated (Preyer
8 S. O. Hansson

et al. 2014;O’Madagain 2014; Salice 2015). I will give the last word to the safety
inspector:
INSPECTOR: Look here, Stephen. I have full respect for your strong views on personal liberty. I
certainly cherish the idea of a free society myself. But there is an imminent risk to your
customers, and that is reason enough to close down the ride. The freedom that I believe in is
not a freedom to hurt others. And if you don’t like that I care for your safety, then let me just
tell you one thing: I am in my right to do so. How can you bother about your own liberty
without accepting my liberty to care and worry about other people? Would you now please
close down the ride?
What Options Can We Forbear?
We have identified the bad that anti-paternalists legitimately worry about as infringe-
ments in liberty. Liberty consists in being able to choose between different options.
We can therefore express this as a concern that people are deprived of options that
they could otherwise have chosen among. This is clearly an important concern.
Everyone’s right to make their own decisions and to choose their own way of life is a
crucial part of what it means to live in a free society.
Living in a society with other people comes with a wealth of options that an
eremite living in the wilderness does not have. (Just think of what you have been
doing today, before reading this. How much of that could you have done without the
combined effects of the actions of innumerable other humans, of present and past
generations?) As our societies develop, some options are lost while others are added.
Some options have been lost due to commercial decisions; for instance, you cannot
buy a new car with a 20 hp engine any more. (That was the power of the Ford Model
T motor.) Other options have been lost due to government decisions; you cannot
spray DDT on your garden roses to get rid of insects. (This use of the pesticide was
still recommended by the US Department of Agriculture in 1967, 5 years after
Rachel Carson’s book Silent Spring (1962) was published (Smith 1967, pp. 6 and
9–12).) Both these are examples of lost options that few would wish to regain. They
illustrate that not all losses of options are regrettable. In the case of DDT, there was
considerable resistance to the change (Krupke et al. 2007), but that reaction has since
long abated. Let us have a look at some examples of safety-related infringements of
liberty, what reactions they have encountered and how those reactions have
developed.
Sanitation
Our first example is a classic issue in public health, namely, clean water and hygienic
sewage systems. The British Public Health Act, adopted in 1848, authorized local
authorities to take control over water supply, sewerage, and other facilities needed to
ensure hygienic living conditions. The new law was strongly supported by those
whose living conditions it would improve, as well as by philanthropists and radicals
Liberty, Paternalism, and Road Safety 9

in higher social strata, but it also met with considerable resistance (Roberts 1958,
1979, pp. 200 and 258–259; Wiggins 1987; Porter 1999, pp. 119–120).
Speaking in the House of Commons, the Tory MP Charles Newdegate (1816–
1887) described the law as “a departure from the free principles of the British
Constitution”. His liberal colleague George Muntz (1794–1857) considered the
whole issue of sanitation to be “grossly exaggerated,”and denounced the legislation
as unnecessary since “[t]he people were clever enough to manage their own affairs”
(House of Commons 1847, cc. 729 and 750). Another liberal MP, Edward Divett
(1797–1864), warned against “the constant meddling and dictation”that he expected
from the government authority overseeing the legislation. “The electors did not
object, it was true,”he said, “to sanitary improvement; but they did not choose to
be ordered how to set about it.”(House of Commons 1848, c. 725) The most
prominent opponent of the law was the influential conservative MP David Urquhart
(1805–1877), who opposed the bill because it placed “despotic powers”in the hands
of the Government. Government had already too much power, he said, and he was
determined to do whatever he could “not merely to prevent any increase to that
power, but to reduce the amount of it which the Government at present enjoyed.”
(House of Commons 1848, cc. 712 and 715)
The most vociferous critics could be found in the Tory papers. For instance, the
London journal Morning Herold argued that “[a] little dirt and freedom may after all
be more desirable than no dirt at all and slavery”(Roberts 1979, p. 200). However,
the prevalence of such sentiments receded in the coming decades, and today we do
not hear much talk about the importance of being free to drink contaminated water or
walk on filthy streets.
Workplace Safety
The legal approach to workplace health and safety underwent large changes in the
late nineteenth and early twentieth centuries. According to the old tradition, male
workers were responsible for their own safety, and any attempt to lay responsibility
on the employer was conceived as an infringement on the workmen’s freedom of
contract. For instance, in 1880 a liberal government in Britain introduced new
legislation that gave workers right to compensation from the employer for injuries
incurred on the workplace. The Tories vehemently opposed this measure. In Parlia-
ment, the conservative member Thomas Knowles (1824–1883), who had business
interests in coal mining, warned that the new legislation would be disastrous for
mine owners, whose companies in his view had so many accidents that the law
would in practice “confiscate their property”. He also told Parliament that due to the
new liability legislation, he estimated that his own assets in coal mines had only half
the value that they had had a week ago (Knowles 1880, cc. 1100–1101. Cf. Green
1995, p. 73.). There was also considerable resistance against the law within the
liberal party (Green 1995, p. 75). The prominent left liberal philosopher Thomas Hill
Green (1836–1882), who supported the legislation, summarized the most prominent
argument of his opponents as follows:
10 S. O. Hansson

“The workman,”it was argued, “should be left to take care of himself by the terms of his
agreement with the employer. It is not for the state to step in and say, as by the new act it says,
that when a workman is hurt in carrying out the instructions of the employer or his foreman,
the employer, in the absence of a special agreement to the contrary, shall be liable for
compensation. If the law thus takes to protecting men, whether tenant-farmers, or pitmen, or
railway servants, who ought to be able to protect themselves, it tends to weaken their self-
reliance, and thus, in unwisely seeking to do them good, it lowers them in the scale of moral
beings.”(Green 1888 [1881], p. 365)
(Crossley (1999, p. 292) quotes this passage, but removes Green’s four quotation
marks as well as the phrase “it was argued”. He correctly attributes the text to Green,
but omits the crucial information that Green described his opponents’views, and
incorrectly describes the text as written by “[o]ne opponent of the Act”.) This, said
Green, was an argument “which many of us, without being convinced by it, may
have found it difficult to answer.”(Green, p. 365) But he had an answer:
When we speak of freedom as something to be so highly prized, we mean a positive power or
capacity of doing or enjoying something worth doing or enjoying, and that, too, something
that we do or enjoy in common with others. We mean by it a power which each man
exercises through the help or security given him by his fellow-men, and which he in turn
helps to secure for them... If the ideal of true freedom is the maximum of power for all
members of human society alike to make the best of themselves, we are right in refusing to
ascribe the glory of freedom to a state in which the apparent elevation of the few is founded
on the degradation of the many, and in ranking modern society, founded as it is on free
industry, with all its confusion and ignorant licence and waste of effort... (ibid., pp. 371–
372)
A contract in which someone “bargains to work under conditions fatal to health”
could not, in his view, be defended in the name of freedom since it was “an
impediment to the general freedom,”preventing the workers from making the best
of themselves (ibid., p. 373). At the core of his argument was his assertion that the
freedom to take a dangerous job, without even a right to compensation in the case of
an accident, was simply not a freedom worth having. This was also the general
viewpoint among workers, and it was therefore Thomas Knowles and other oppo-
nents of this “paternalist”legislation, rather than its proponents, who claimed to
know better than the workers what their interests were. With the exception of
marginal mavericks, the anti-paternalist argument against workplace safety regula-
tions and workers’compensation is since long a historical phenomenon. (See
Spurgin (2006) for a refutation of anti-paternalist argumentation for unsafe
workplaces.)
Seat Belts
The seat belt was invented by the English engineer George Cayley (1773–1857),
who intended it for use in airplanes. In aviation, the use of seat belts was
uncontroversial from the very beginning. For instance, the very first aircraft of the
Liberty, Paternalism, and Road Safety 11

US army, delivered by the Wright brothers in 1910, came with seat belts. From the
beginning of commercial aviation traffic, passenger seats were provided with seat
belts. In the US, the first government regulation requiring passenger seat belts went
into force in 1926. The use of seat belts has continued to be uncontested in air traffic.
Flight attendants asking passengers to buckle up are seldom met with negative
reactions. In spite of the standard phrase “for your own safety”used in the safety
announcements, airlines do not seem to be accused of being instruments of the
“nanny state.”In short, no one seems to demand the right to travel in an airplane
without using a seat belt (Johannessen 1984; Vivoda and Eby 2011).
Already in 1885, seat belts could be found on some horse carriages. They were
also used in racing cars as early as in 1922. However, the automobile industry did not
equip their vehicles with belts. In the 1930s, physicians with experience of treating
victims of automobile accidents started to advocate the mounting and use of seat
belts in motor vehicles. However, not much happened until the 1950s, when
designers developed safer and more convenient seat belts for cars. In the beginning,
their constructions were largely based on the belts used in airplanes. In 1959, the
Swedish engineer Nils Bohlin (1930–2002), who had a background in constructing
ejection seats for airplanes, invented the three-point seat belt for cars. In the 1960s,
more and more countries required all new cars to be equipped with seat belts, and car
manufacturers started to include them as a standard (Johannessen 1984; Vivoda and
Eby 2011).
In 1970, the Australian state Victoria adopted the first law making the use of seat
belts mandatory (but only for drivers and front seat passengers). This was followed
in the 1970s, 1980s, and 1990s by more and more countries. Today, the use of seat
belts is mandatory in front seats in most countries, but many countries still do not
require the use of belts in rear seats. In the beginning, considerable anti-paternalist
resistance was mobilized against seat belt legislation. It was described as an
infringement on liberty. For instance, one American opponent claimed that such
legislation “violates the right to bodily privacy and self-control”of the drivers and
passengers, and that it treated them in a “coercive, demeaning manner”(Solan 1986).
The critics did not hesitate to oppose seat belt legislation for children. For instance,
in a debate in the British parliament in 1988, the Conservative MP Gary Waller said
that it “would be going too far”to require that parents refrain from driving more
children in the car than there are belts for. He favored a noncompulsory approach and
argued that “we should consider carefully whether a regulation is necessary or
whether it would be better for advice to be given in the highway code, and for
persuasion rather than compulsion to be exercised to ensure that children are carried
in cars as safely as possible”(Waller 1988, cc. 591–598).
As seat belt laws have been introduced and enforced, this type of reaction has
become increasingly uncommon. As Elvebakk (2015, p. 298) noted, opposition to
obligatory seat belts is now “long forgotten in Europe.”In 2019, two ethicists
summarized the situation as follows:
12 S. O. Hansson

Within a few years, wearing seat belts became widely accepted and indeed endorsed in most
countries. It became not only a legal, but also a social norm precisely because it was made
compulsory and people started buckling up...
As often happens, people simply get used to and comply with new legal requirements
even when they are initially opposed to them, and in the long run they see it simply as a
social norm. (Giubilini and Savulescu 2019, pp. 237–238 and 243)
This appears to be an accurate description of the general picture, although there are
still a few people, both in politics and in academia, who oppose mandatory seat belt
legislation (Solomon 2010; Flanigan 2017).
Helmets
Helmets have been worn by soldiers for at least four and a half millennia (Gabriel
2007, pp. xiv and 80). There does not seem to have been any uproar or mutinies
against orders to wear protective headgear on the battlefield.
In 1917, the US Navy provided workers in shipyards with hard hats to protect
them from falling objects. In the early 1930s, some construction workers used
homemade hard hats for the same purpose, whereas others used surplus WW1
helmets provided by their trade union. The Golden Gate Bridge in San Francisco,
built in 1933 to 1937, seems to have been first major construction workplace where
the employer provided helmets to all workers and made their use mandatory.
Advertisements from the 1930s onwards for helmets of different shapes and mate-
rials show that there was a demand for protective headgear (Snell 2018; Rosenberg
and Levenstein 2010). Although some individual workers found hard hats uncom-
fortable, there does not seem to have been any ideological or organized resistance,
and their use is now undisputed on construction sites and other workplaces with risks
of head injuries. The requirement to wear them is seldom questioned, or as two
researchers on occupational safety wrote:
Hard hats are different from other forms of P[ersonal] P[rotective] E[quipment]; people wear
them even when they don’t need to. There is no compliance issue with hard hats. They’re
cool. (Rosenberg and Levenstein 2010, p. 240)
The first motorcycle helmet seems to have been constructed by the English physician
Eric Gardner. It was used for the first time in a race on the Isle of Man in 1914. After
the race, Dr. Gardner received the following message from a colleague: “Every year
the humdrum of medical practice in the Isle of Man is relieved by interesting
concussion cases in our hospital from the Tourist Trophy Race; this year, thanks to
your damned helmet, we have had none.”(Gardner 1941) In the inter-war period,
motorcycle helmets seem to have been used on racetracks but not much on roads.
In 1939, the Australian-British neurologist Hugh Cairns (1896–1952) started to
work with brain-injured WW2 soldiers. Many of them were military motorcycle
messengers. After studying their injuries, he emphatically proposed “for all motor-
cyclists, civilians and fighting Forces alike, the use of a crash helmet of the type worn
Liberty, Paternalism, and Road Safety 13

by racing motor-cyclists”(Cairns 1941, p. 466). Following his advice, both the
Army and the Air Force provided all their motorcyclists with helmets, which they
were required to use (Lanska 2009). This initiative seems to have been well received
by the motorcyclists themselves. Cairns wrote:
When we began to treat Army motor-cyclists at [a military hospital in] Oxford, we naturally
got to know their comrades—keen motor-cyclists in the Army Training Schools, Royal
Corps of Signals, and other units, who were very much alive to the wastage of their
man-power from accidents, and they needed little encouragement to become enthusiastic
advocates of compulsory use of crash helmets. (Cairns 1946, p. 322)
Summing up his work after the war, Cairns wrote:
From these experiences there can be little doubt that adoption of a crash helmet as standard
wear by all civilian motor-cyclists would result in considerable saving of life, working time,
and the time of the hospitals. (Cairns 1946, p. 323)
After the war, motorcycle helmets were probably more common than before, and
much improved helmets reached the market. However, a large number of motorcy-
clists continued to ride unprotected. This was changed through political decisions.
During the period when seat belts became mandatory in country after country,
motorcycle helmets also became mandatory (but often somewhat later than seat
belts). Currently, motorcycle helmets are obligatory almost everywhere in the world,
except in the US (https://apps.who.int/gho/data/view.main.51427. Accessed April
9, 2020.).
In 1977, all but a handful states in the US had mandatory helmet laws that applied
to all riders. However, there was considerable resistance from an active anti-helmet
lobby, whose anti-paternalistic message appealed to Conservative and Libertarian
lawmakers. In consequence, several states rescinded their helmet laws or weakened
them to apply only to teenage drivers. In 1995, Congress repealed the federal
legislation that had incentivized states to uphold the helmet requirement. This led
to an avalanche of revocations of state laws (Jones and Bayer 2007). At the time of
writing (2020), only 19 states and the District of Columbia have universal helmet
laws (https://www.iihs.org/topics/motorcycles. Accessed April 9, 2020).
Just like motorcycle helmets, bicycle helmets protect efficiently against severe
brain damage and fatalities that may result from cycling accidents. In bicycle sport, a
minority of riders have used helmets at least since the 1950s, and helmets became
much more common in the 1990s. They became obligatory in 2003 (https://web.
archive.org/web/20160304110024/ http://oldsite.uci.ch/english/news/news_2002/
20030502i_comm.htm. Accessed April 9, 2020.). In the 1970s, a small minority
of non-racing (transportational and recreational) cyclists began to use helmets, and a
few companies sold helmets intended specifically for cycling. Standards were
adopted, and helmets satisfying the standards were designed. In Victoria
(Australia), helmet promotion activities led up to the introduction of a law in 1990
that made helmets mandatory for all cyclists (Cameron et al. 1994). The other
Australian states have followed suit, and universal helmet laws have also been
14 S. O. Hansson

adopted in New Zealand and Argentina. Some other countries have made helmets
mandatory only for children, but still in 2020, most countries have no legislation
requiring the use of bicycle helmets.
Ice hockey has been played since the late nineteenth century. It is a sport with
many head injuries, but up till and through the 1950s, almost no player ever used a
helmet or any other type of head or face protection. This was much due to a “culture
of toughness”that led players to view injuries as a part of the sport, which one had to
endure. In the 1960s, the major hockey organizations introduced obligatory helmets
for youth players. In 1979, the National Hockey League made helmets obligatory for
professional players (with an exemption for older players, who were allowed to
continue playing without a helmet). Helmets are now an uncontroversial part of the
equipment of hockey players, and there is no sign that players crave for playing
without them (Bachynski 2012).
Drunk Driving
Patricia Waller has described the attitudes to drunk driving that still prevailed in
many countries in the 1970s:
Drunk driving was considered more or less a “folk crime,”almost a rite of passage for young
males. Most adults in the United States used alcohol, and most of them, at some point, drove
after doing so. This is not to say that they drove drunk, but many of them undoubtedly drove
when they were somewhat impaired. Although the law provided for fairly harsh penalties,
they were rarely applied. Upon arraignment, defendants would ask for a jury trial, and
because drinking and driving was so widespread, juries almost invariably acquitted the
defendant, thinking, “There but for the grace of God go I.”(Waller 2001,p.3)
Writing in 2001, she noted that “[r]emarkable progress has been made”(ibid., p. 4).
This would not have been possible without the convincing data produced by the
research community, she said, but another contribution was at least as important:
It was citizen action groups that provided the impetus for major changes in public policy
governing drinking and driving. Their activities generated public support for enforcement of
existing laws and enactment of new ones. (Waller 2001,p.3)
Particularly in the 1980s, activist groups changed the focus of the discussion from
the drivers to the victims, not least children (Williams 2006). As emphasized by
Leonard Evans (1991, p. 352), “the most important factor was the widespread
serious discussion of the tragic dimension of the problem in the media, with the
consequent deglamorizing of the drunk as a likeable humorous character.”
A few contrary voices have been heard. In 1994, a philosopher published a journal
article in which he claimed that drunk driving is not a serious offense.As an alternative
to preventing drunk driving he proposed the removal of roadside trees, which are the
“most commonly struck objects”by drunk drivers, as well as the introduction of
airbags, which “would make drunk driving much less risky”(Husak 1994,p.68).As
Liberty, Paternalism, and Road Safety 15

late as in 2011, a major libertarian magazine in the US published an article describing
the prohibition of drunk driving as “nanny state”legislation. The author claimed,
incorrectly, that “[e]xperienced drinkers”differ from less experienced ones in that they
“can function relatively normally with a B[lood] A[lcohol] C[ontent] at or above the
legal threshold.”He used this as an argument for entirely “repealing drunk driving
laws”so that a drunk person should be allowed to drive unless he is “violating road
rules or causing an accident”(Balko 2011). However, in experiments with driving
simulators, heavy (“experienced”) drinkers did not perform better under the influence
of alcohol than unexperienced drivers (Marczinski and Fillmore 2009; Fell and Voas
2014).
Today it is difficult to defend drunk driving in public. In some countries,
opponents of efficiently enforced drunk driving laws have instead turned against
the means of enforcement, for instance, claiming that random sobriety checks on the
roads (sobriety checkpoints) are an unbearable infringement of the liberty of drivers.
In Australia, activists working for the introduction of random breath testing found
themselves opposed by “the alcohol industry and its supporters, notably civil
libertarians and anti-nanny state proponents,”who claimed that this would be an
infringement on individual freedom (Howat et al. 1992, p. 20). One American legal
scholar described this method of law enforcement as “[f]ascist-like sobriety check-
points”(Miller 1993, p. 174). This argumentation has not been without success; in
several states in the US the police are not allowed to perform random sobriety checks
(Fell et al. 2004; Vissing 2014).
In the 1990s, a reliable method to prevent drunk driving was introduced in the
form of alcohol interlocks (breath alcohol ignition interlock devices). Currently
available technology requires the driver to provide a breath sample prior to starting
the vehicle (and usually also at random times when driving, to prevent the use of
another person’s exhalation air). Ongoing research aims at obtaining the same result
without a breath sample –either through analysis of the driver’s normal exhalations
or by measuring blood alcohol levels noninvasively with infrared light directed at the
driver’sfingertips (https://www.dadss.org. Accessed 10 April 2020.). In a large
number of countries as well as all states in the US, courts can order convicted
drunken drivers to install alcohol interlocks in their cars, as a means to prevent repeat
offence. In 2005, the Swedish (social democratic) government announced a coming
bill that would make alcohol interlocks mandatory in new cars by 2012. However,
the new (conservative) government that entered office after the general election in
2006 decided not to go forward with the legislation, and since then there has not been
a political majority for the measure (Grill and Nihlén Fahlquist 2012).
As yet, there does not seem to be much resistance against alcohol interlocks. That
may be because their current use has the effect of increasing the automotive freedom
of convicted drunk drivers. By installing the alcolock, they can keep or regain their
driver’s license, which they would otherwise have lost. However, it is plausible that
proposals to introduce breathalyzers in all motor vehicles can give rise to counter-
reactions of the same types that we have seen against laws mandating seat belts and
motorcycle helmets. In 2019, the European Union announced plans to require all
new cars from 2022 to be technically prepared for easy installation of alcohol
16 S. O. Hansson

interlocks. This will facilitate later installation of interlocks if the driver is convicted
of drunk driving, or chooses to mount an interlock for other reasons (such as,
possibly, a future tax reduction for those who do so). It will of course also simplify
any future decision to make alcohol interlocks obligatory. This latter possibility was
keenly observed by a conservative motorist organization in the US, the National
Motorists Association (NMA). In one of their newsletters, they first criticized other
safety features mandated in Europe, such as advanced emergency braking systems
(AEBS) and systems that warn a driver who gets drowsy. They continued:
The other mandatory element that is problematic: Every new car would include an alcohol
interlock installation facilitation. The driver’s blood alcohol content could potentially be
checked by breathalyzer or by tactile sensors. The mandate would mean no driver could start
a car without passing the electronic testing... Vision Zero proponents want to rein in
irresponsible, that is, all (in their minds) motorists by literally limiting speed, choice, privacy
and personal responsibility. The war on cars and on drivers is heating up. (National Motorists
Association 2019)
Speeding
It was known long before the introduction of the modern automobile that high speed
increases the risk of accidents involving vehicles. The oldest speed limit on record
seems to be a regulation that was passed in Newport, Rhode Island, in 1678,
forbidding horse-riders to “gallop or to run speed”in the streets. In Boston in
1757, carriages were limited to “foot pace”on Sundays to protect church visitors.
The first speed limit referring to an exact velocity was probably the legislation
passed in Britain in 1865 for steam carriages on highroads, which were limited to
at most 4 mph (6 km/h). In the early twentieth century, many countries introduced
speed limits for automobiles, often with different velocities for different kinds of
roads (Elston 1971, pp. 21–22). This was “a time when motorists were in the
minority and unpopular”(Tripp 1928, p. 535), and judging by articles in the
newspapers at the time, there was considerable public support for these restrictions.
In 1907, the American magazine Harper’s Weekly published an article about “speed
mania,”describing the perpetrators as follows:
[I]n every case their mania arises from an overweening sense of their own importance,
accompanied by very slight capacity for self-restraint. The type of man who motors at
dangerous speed is the same type that speculates in more stocks than he is able to carry, eats
and drinks more than he can assimilate, covers himself with gaudy jewels, makes an
objectionable exhibition of himself on every possible occasion. The strong arm of the law
is the only effective curb for this species... (Underwood 1907)
In contrast, he said, “[a] decent regard for the safety of mankind will always preserve
the normal man from giving way to speed mania”(ibid.). It did not take long before
motorists started to strike back. In 1911, the Automobile Club of America demanded
that “all speed limitations should be omitted from the law,”for the somewhat curious
Liberty, Paternalism, and Road Safety 17

reason that “no matter what the limit is, the majority of drivers will try to exceed it.”
They did however emphasize that “[c]areful driving”should be enforced (Dorrian
1911).
Speeding continues to be a major factor contributing to the prevalence and
severity of road traffic accidents (Farmer 2017; de Bellis et al. 2018). Cavalier
attitudes to the dangers of speeding are perpetuated by widespread and entrenched
myths such as “a general belief that speeding slightly in excess of the limit (up to at
least 5 km/h, perhaps as much as 10 km/h) is not associated with increased crash risk
if the driver is otherwise driving safely”(Delaney et al. 2005b, p. 23). A Swedish
writer who obviously believed in this myth claimed that speed limits are a form of
“collective punishment”in order to solve the problem with “those who do not
manage reasonably safe”at higher speeds (Eberhard 2006, p. 291).
Speed cameras, which have been introduced throughout the world since the
1970s, have met with considerable resistance. The experiences reported from an
Australian speed camera program appear to be typical:
As the speed camera program expanded in 2001 and lower speeds over the limit were
targeted, various controversies came to the fore and had high public profile. These included
the notions that the program was established principally to raise revenue for the government
(fine money goes to consolidated government revenue), that camera locations included those
where it was “safe”to speed, that overt operation of cameras was most appropriate if the aim
was to deter speeders at unsafe locations, that exceeding the speed limit by only a small
amount was safe, that there was no opportunity afforded to explain the circumstances of the
event, and that the reliability of cameras and speedometers came into doubt when the
tolerance was perceived to be only about 3 km/h (1.9 mi/h) above the speed limit. (Delaney
et al. 2005a, p. 408)
This is a long list of complaints, but interestingly, it does not contain any clear anti-
paternalist or “nanny state”argumentation. In Britain around the year 2000, resis-
tance to speed cameras was even more outspoken and active than in Australia, but
the argumentation was about the same (Pilkington 2003). Even the clandestine
organization Motorists Against Detection (MAD), which claimed to have destroyed
600 speed cameras, justified their activities by claiming that the real purpose of the
cameras was to collect speeding fines for the government (Chancellor 2003). Speed
cameras are still vandalized in many countries (Max 2019; Robinson 2019). In
summary, there are people who hate speed cameras so intensely that they go to the
extreme of vandalizing them, but they do not usually invoke anti-paternalist argu-
ments to justify their opinions or their actions.
Speed control can be taken to a new level with Intelligent Speed Adaptation
(ISA), i.e., a system that keeps track of the speed limit where the car is driven and
relates it to the actual speed. ISA systems can be either passive or active. A passive
system warns the driver, whereas an active system reduces the speed to the legal limit
(possibly with an option for the driver to override the system). Active ISA systems
(speed limiters) have been predicted to drastically reduce the number of fatalities in
road traffic (Carsten and Tateb 2005). Based on this, a strong moral argument can be
made in favor of making active ISA obligatory (Hansson 2014, p. 373; Smids 2018).
18 S. O. Hansson

However, several studies indicate that drivers’willingness to install and use such a
system is low (Fu et al. 2020). Numerous newspaper articles describe speed limiters
as an entrance gate to the “nanny state”(e.g., Mowat 2019). A Canadian truck-driver
who had been ordered to use a speed limiter went to court, arguing that this order
infringed on his freedom (Nyholm and Smids 2020). Although he lost his case, this
indicates that the introduction of automatic speed adaptation can lead to a clash
between traffic safety objectives and strongly felt anti-paternalistic sentiments.
Conclusions
Summing up the above, we have studied quite a few examples of legal requirements
and mandatory practices that can be said to reduce the freedom of choice of
individuals in some way or other. We can classify them in three main categories.
The first category consists of the uncontested restrictions, i.e., the restrictions in
liberty or freedom of choice that have never encountered significant ideological or
organized opposition:
•helmets in the military
•seat belts in airplanes
•helmets in motorcycle racing
•helmets on construction workplaces
•alcohol interlocks for convicted drunk drivers
These examples have somewhat different backgrounds. Soldiers have been ordered
to wear helmets since ancient times, and no one seems have come up with the idea of
accusing their commanders of thereby restricting the soldiers’liberty, or freedom of
choice.
Seat belts were mounted on passenger airplanes from the beginning of commer-
cial aviation (at a time when flights were much more shaky than today), and today
their use is an entrenched habit, which no one seems to put in question. They are just
one of a large number of safety arrangements that we take for granted without
thinking much about them. To see how common and how generally accepted such
arrangements are, let us suppose that you try to avoid them. Suppose that you go to a
household appliances store and look for a microwave oven that can emit microwaves
when the lid is open. You will be told that no such ovens are made. If you go to the
hardware store and look for power tools with uncovered live electrical parts, you will
be equally disappointed. All the power tools on sale have sturdy protective shields to
keep the user safe from electric shocks. Next, you go to an auto glass shop in order to
have the cracked windshield of your car replaced. You want a windshield of common
inexpensive window glass, instead of the expensive laminated safety glass that you
are offered. “I am sorry,”says the repairman, “but all windshields are made of
laminated glass.”
What has happened? Has the nanny state invaded the shops and stopped them
from providing the articles you asked for? Yes, in a sense it has, since there are
Liberty, Paternalism, and Road Safety 19

(in most countries) regulations enforcing safety standards for microwave ovens,
power tools, windshields, and a myriad of other products. However, even in the
absence of such regulations, it is much to be doubted whether any of the articles you
asked for would be manufactured, or whether, if they were made, anyone would buy
them. No one seems to care for the liberty to avail themselves of such products. And
similarly, no one seems to ask for the liberty of remaining unbelted in an aircraft
during take-off or landing. In fact, few would even care to know if it is the
government, the airline, or perhaps some international aviation organization that
decided that we all have to use a safety belt onboard.
The last three examples in this group differ from airplane seat belts in having been
introduced as a new practice in an existing activity. Motorcycle racing and construc-
tion work were originally performed without helmets. The protective headgear was
introduced without any ideological or organized opposition. Similarly, in-car
breathalizers for convicted drunk drivers were introduced without resistance.
Our second major category consists of previously contested restrictions in liber-
ties and freedom of choice that are now generally accepted:
•clean water and hygienic treatment of sewage
•employer’s responsibility for safe workplaces
•seat belts in cars (in most countries)
•helmets in ice hockey
•prohibition of drunk driving
There have been days when fervent campaigners fought for the liberty to forgo
modern sanitation, to work in extremely dangerous mines (or rather, to hire others to
do so), to drive drunk, and to play ice hockey without helmets. Today, no one (with
the possible exception of a few eccentrics) propagates these standpoints, for the
simple reason that desires to exercise these liberties are no longer considered to be
reasonable or worth supporting. The same is now, in most countries, true of desires
to travel without seat belts in motorcars. This means, for instance, that hockey
helmets are now equally uncontroversial on the ice rink as hard hats on the
construction site. Notably, in all these cases, the transition has been gradual, and it
has been accomplished by activists concerned about other people’s health and safety.
Our third and final category contains the currently contested restrictions in
liberties and freedom of choice. These are the practices that encounter significant
ideological or organized resistance:
•motorcycle helmets on roads
•bicycle helmets
•universal alcohol interlocks
•speed cameras
•speed limiters in cars
Judging by the historical experience, some of these practices may in the future find
their way into the second category. For instance, in countries such as Sweden,
20 S. O. Hansson

motorcycle helmets seem to be at a rather late stage in that process. However, this is
not a transition that can be taken for granted. Vaccination belongs to this third
category. It has remained contested for more than two centuries, despite its tremen-
dous contributions to public health (Meyer and Reiter 2004).
At least four important conclusions can be drawn from this résumé of
uncontested, previously contested, and currently contested infringements on liberty.
First, some but far from all restrictions of individual liberties are at all contested,
and over time, there are large changes in what restrictions are contested. We saw
this clearly in the discussion of the second category (previously contested).
Secondly, which restrictions are contested has very little to do with the distinction
between paternalistic and non-paternalistic constraints on liberty. Some of the most
passionately opposed restrictions cannot with any vestige of credibility be described
as paternalistic. This applies, for instance, to prohibition of drunk driving, as well as
speed cameras and speed limiters. On the other hand, some of the restrictions that
have encountered little or no opposition are commonly considered to be paternalis-
tic. This includes seat belts in airplanes and hard hats in the building industry.
Thirdly, we accept restrictions more easily if we encounter them in situations
where we are accustomed to do as we are instructed. This goes a long way towards
explaining why helmets have been accepted in armies and on workplaces, as well as
–after some initial opposition –in organized sport activities, where directives from
referees and coaches have to be followed (Bachynski 2012).
Fourthly and finally, we are less prone to accept restrictions if they require
changes in our entrenched habits. This seems to have been an important factor in
resistance to several safety measures in road traffic, such as seat belts, helmets,
sobriety, and reduced speed. As a corollary, we can expect restrictions to encounter
little opposition if they are introduced from the beginning in a new activity (e.g., seat
belts in airplanes). Habits also seem to have a role when previously disputed
restrictions gain acceptance. For instance, seat belt laws induced law-biding people
to buckle up. This became a habit –the “new normal”–and habituation to this
convenient and well-justified routine appears to have led to its acceptance (Boughton
1984, p. 187).
Seen in this perspective, many of the issues that have been depicted as conflicts
between paternalism and anti-paternalism are in fact largely fought along other –no
less important –conflict lines, such as that between one person’s freedom and other
persons’safety. However, this does not imply that the issue of paternalism is
irrelevant. In the next section we are going to have a close look at the scope of
anti-paternalist arguments.
The Significance of Human Connectedness
The purpose of anti-paternalism is to protect everyone’s right to make and follow her
own choices in matters that only concern herself and nobody else. Therefore, the
scope and importance of anti-paternalism depends on what types of situations there
are that answer to that description.
Liberty, Paternalism, and Road Safety 21

Obviously, there are many choices that only concern the person who makes them.
This includes many of the liberties we have in private life. The color of my coat,
what books I read, what furniture I buy (if I can afford it and I live alone) are under
normal circumstances nobody else’s business, and these are only a few of the many
liberties that we should all have. There are also many liberties that we should all
have, although our exercise of them can have large impact on others; this includes
the political liberties of democracy. However, many of the allegedly private actions
that have been at focus in discussions on paternalism are not as unconnected to other
people’s lives as they have often been claimed to be. This, as we will see, can have
considerable impact on the scope and strength of anti-paternalist arguments.
Some discussions of liberty give the impression that we humans are rational
atoms, each with her own, individually chosen, goals, and with no other obligations
to each other than to avoid colliding when we follow our chosen trajectories in the
huge space of possibilities. But this is not a true picture of human life. To the
contrary, we are all bound to each other in innumerable ways, and no one can
reach very far without the –past or present, willing or unwilling, intended or
unintended –actions by others. Sometimes this interdependence is hidden from us,
and sometimes we prefer to see it as an unchangeable background, like the moun-
tains and the seas. But that is an illusion. Almost everything we do connects us with
other human beings.
This interdependence is reciprocal, which means that it goes in two directions. On
the one hand, the choices and decisions that we make are far less individual than
what we tend to believe, and much more co-determined by others. On the other hand,
our actions have effects on others, effects that we are often not aware of. Both these
aspects of our social interdependence have important moral implications, not least
for the scope and applicability of anti-paternalist arguments. Let us begin with the
first of them.
Combined Causes and Extended Anti-paternalism
The causality of human actions is much more complex than what we usually think
(Hansson 2022). Most of the actions that we ascribe to a single person do in fact
depend on the combined actions of many persons (sometimes acting at different
points in time). In a discussion on paternalism, we have reason to apply this insight
in particular to self-harming actions, or more generally, actions that go against the
interests of the person who performs them. (There are of course many cases in which
it is impossible to determine univocally what goes against a person’s interests and
what does not. For our present purpose, we can leave such cases aside.) In many
cases when we talk of a person as harming herself, or acting against her own
interests, others have made choices and taken actions without which the self-harm
would not have been possible:
•A drug addict harms herself by buying addictive drugs that destroys her health.
22 S. O. Hansson

This would not have been possible without drug dealers who choose to sell
products that havoc the health and the lives of most of the people who use them.
•A smoker harms her own health by smoking cigarettes.
This would not have been possible without the cigarette companies that have
chosen to sell and aggressively market products that kill about half of the people
who use them.
•A cyclist rides to work on a dangerous road among cars and trucks driving at
high speed.
This would not have happened if the road authorities had arranged a separate
bicycle lane.
•A motorist drives without a seat belt.
In the vast majority of cases, she would have fastened the seat belt if the
manufacturer had equipped the car with a seat belt reminder.
•A motorist drives at an excessively high speed on the expressway, endangering
both her own life and that of others.
This would not have happened if the manufacturer had installed a speed limiter
making it impossible to drive the car at speeds at which it cannot be controlled.
These are all cases of “mixed”causality, in which harm to a person is caused by a
combination of her own actions and actions by others. In such cases, the causal role
of the others is often downplayed, and the action is described as purely self-harming.
For instance, the drug dealer is sure to claim that “it was her own decision to buy the
drug”and “if I hadn’t sold it to her, then someone else would have done so.”(For a
discussion of responsibility ascriptions in such cases, see Hansson (2022).)
Anti-paternalism, properly speaking, defends a person’s right to harm herself.
From such a right it does not follow that others have a right to harm her, or to
contribute to harming her. However, attempts have often been made to extend the
“green light of liberty”that anti-paternalism bestows on self-harming actions to
other-harming actions by others that contribute to the same harm. One of the most
remarkable examples of this is the argumentation of the tobacco industry. This is an
industry with a long and still on-going record of aggressively marketing massively
death-bringing products. For instance, in three decades, the 1970s to 1990s, tobacco
companies focused disproportionately large resources on areas in American big
cities with predominantly African American residents. They distributed free ciga-
rettes in the streets, and focused particularly on what they called the “starter market,”
i.e., new smokers, mostly minors. These marketing activities led to a considerable
increase in smoking among blacks. One of the consequences of this was that the
prevalence of lung cancer among black men, which had previously been lower than
among white men, rose to levels higher than those among white men (Yerger et al.
2007). This is only one of many examples of the decisive impact that marketing and
propaganda has on smoking. However, the tobacco industry spends considerable
efforts on describing smoking as depending exclusively on the smokers’own free
decisions, claiming, for instance, that “the growing intrusion of government in the
lives of adult smokers is a threat to the freedoms of all citizens”(Katz 2005, p. ii33.
Cf: Cardador et al. 1995; Apollonio and Bero 2007; Schneider and Glantz 2008;
Liberty, Paternalism, and Road Safety 23

Fallin et al. 2014). With these campaigns they try two achieve two results: First, they
try to attribute smoking entirely to the individual smoker’s decision. They have been
remarkably successful in promoting this rather obvious fallacy. For instance, in a
book published in 2006, a Swedish physician (!) ridiculed lung cancer patients who
sued tobacco companies, claiming that these plaintiffs professed “not to know that it
was dangerous to smoke”(Eberhard 2006, p. 313). Secondly, by appealing to anti-
paternalism on behalf of the smokers, they try to ensure that anti-paternalism also
protects their own, massively other-harming, activities.
This is an extreme example, but the same pattern of thought can be found in many
other contexts where anti-paternalism is invoked to protect other-harming actions.
But how valid is this type of argument? If anti-paternalism protects my right to drink
so much that I am unable to walk home, does it also absolve the publican who serves
me that much liquor? If anti-paternalism allows me to eat food with toxic mold or
pesticide residues, does it also acquit the food industry or my grocer for selling such
food (properly labeled) to me? If anti-paternalism lets me ride a motor-cycle without
a helmet, does it also exonerate the rental agency that rents out a motorbike to me
without including a helmet in the rental? And if it permits me to drive a car without a
seat belt, does it also condone a carmaker who refrains from mounting a seat belt
reminder as standard equipment?
The general issue illustrated in these examples is that of extended anti-paternal-
ism, by which is meant the use of anti-paternalist arguments to justify actions or
activities that harm (consenting) others, usually in combination with self-harming
actions or decisions by the persons in question. The term “extended anti-paternal-
ism”was introduced in Hansson (2005). In the literature on paternalism, the distinc-
tion between anti-paternalism in the proper sense and this extension has usually not
been made. Authors who observed the distinction, or some variant of it, have usually
not made much of it (Mill (1977 [1859], pp. 296–299; Dworkin 1972, pp. 67–68;
Dworkin 2020, section 2.4; Feinberg 1986, pp. 9–11; Schramme 2015).
From a logical point of view, it is obvious that a right to harm oneself does not
imply a right to harm consenting others or to facilitate or contribute to their self-
harming activities. But logic alone cannot tell us if it is reasonable to extend anti-
paternalism in this way. That is a moral question, and it has to be discussed in terms
of moral principles. We can approach this moral issue by first reminding ourselves of
how we deal with it in private life. What moral attitudes do we usually have to the
combined effects on a person of actions by herself and actions performed by others?
It does not take much reflection to see that this depends on the nature of the
combined effect.
We are at liberty to do many things that are presumed to have a positive value. For
instance, suppose that you have a friend who likes to read books. We would normally
see it as not only allowed, but also commendable, to help her to exert that liberty, for
instance, by picking up books at the library for her or recommending her books that
she might like. We also see it as positive if (commercial or nonprofit) services, such
as bookshops, libraries, and reading groups, are available for her and others wishing
to exert this liberty. The same applies to a multitude of other activities that people are
at liberty to perform, and which we presume to have predominantly positive effects
24 S. O. Hansson

on the well-being of those who choose them. This is how we usually perceive actions
that help people to exert their liberties.
But there are also liberties that are endorsed per se (for the sake of liberty as such),
rather than for any positive effects of realizing them. Liberties to harm oneself
belong to this category. In private life, helping others to harm themselves is usually
held to be morally misguided, if not outright wrong. Suppose that your neighbor has
the unusual obsession of burning small scars on his body with a burning glass. This
action is presumably not illegal, and neither do we tend to morally condemn
it. (On what grounds could we condemn it, and of what use would it be to do so?)
Let us assume that we take an anti-paternalist position to this activity; in other words
we consider it to be a form of self-harm that he is at liberty to perform, and which we
have no right to prevent him from. Is it then reasonable to augment our anti-
paternalism in this case to extended anti-paternalism? In other words: Is it morally
allowable to help him by holding the burning glass over his back so that he can get
scars there as well? Is it OK to recommend him a stronger burning-glass, or buy one
for him? And if he becomes an Internet celebrity and attracts followers burning scars
into their own skins, is it good business ethics to produce and market “scar burners,”
specially adapted to the purpose?
The obvious answer to all these questions is “no.”In private life, morality
requires that we care for other people, and doing so is not compatible with encour-
aging or helping them to harm themselves, or even with looking the other way when
they do so. The morally laudable reaction to his burning obsession would be to try to
help him: talk to him about why he does it and what could to make him stop, find
ways to help him break the habit, perhaps find a psychiatrist who can help him.
The example is unusual, but it illustrates how we usually react to clear examples
of self-harming activities when we encounter them in our private lives: Instead of
contributing to other people’s self-harm, we try to help them out of it. We do not
praise those who buy liquor to the alcoholic, emetics to the bulimic, or poison to the
depressed and suicidal friend. Instead, we praise those who try to make them change
their minds and develop more positive thoughts and habits. Extended anti-paternal-
ism does not work in our everyday lives. Empathy and care do.
This insight can also be applied on a larger social scale, in discussions about what
communities, organizations, companies, and governments should do. By breaking
up the false inference from anti-paternalism to extended anti-paternalism, we open
up for a more efficient strategy to promote safety and public health. Such a strategy
should actively prevent the exploitation of self-harming action. This includes, for
instance, effective curtailment of the pathogenic activities of tobacco companies.
Instead of blaming each other for dangerous and self-destructive behavior, we should
make our society and the options it offers less dangerous. This is the approach that
has been applied for more than a century in occupational safety, with considerable
success. Instead of admonishing workers not to put their fingers into the press
machine, the employer installs a machine that does not move unless both hands
are in safe places. If this approach was ever criticized for being paternalistic, then
that criticism is long since forgotten. Applying it in road traffic would mean to ensure
that vehicles and the road system are so constructed that self- and other-harming
Liberty, Paternalism, and Road Safety 25

activities on the road, such as speeding, driving drunk or on the wrong lane, are
technically impossible. This, by the way, is a large part of what Vision Zero is all
about.
Herd Effects: How We All Influence Each Other
In the discussion on paternalism in public health, it has often been pointed out that
many activities that seem to be “pure self-harm”with no effect on others do in fact
have significant impact on others than the person who exposes herself to a harm or
risk. An unbelted back seat passenger can become a projectile in the event of a crash,
and injure or even kill front seat occupants. This effect is surprisingly large;
according to one study, the risk for a belted driver or front seat passenger to die in
a crash increases almost fivefold if she has an unbelted passenger behind her on a
rear seat (Ichikawa et al. 2002). Psychological costs to bystanders who witness a
deadly crash have also been mentioned, and should most certainly be taken seriously
(Feinberg 1986, pp. 139–141). An even more serious concern is the suffering of
family members: children who lose a parent and spouses who have to care for a
seriously injured accident victim, or mourn the loss of their partner (McKenna
2007). The risk of making one’s children father- or motherless is probably an
important consideration in many private discussions and deliberations. It was also
discussed in the newspapers after the death of a female climber, the mother of two
small children, in a descent from the summit of K2 in 1995 (Barnard 2002).
However, it does not seem to have been much discussed in connection with accidents
in road traffic such as the around 2000 unhelmeted motorcyclists who die on
American roads every year, many of whom are sure to be parents (NHTSA 2019,
p. 11). Arguments referring to the economic costs have had a more prominent role.
They concern the costs of hospital care, rehabilitation, a future life in a nursing
home, and subsistence for family members (Hundley et al. 2004). In some of the
American states that allow unhelmeted motorcycling, unhelmeted riders are required
to have an extra insurance to cover personal injuries (Langland-Orban and Flint
2011). Obviously, if these psychological, social, and economic costs of injuries and
fatalities on the road are taken into account, then the common anti-paternalist
argumentation against measures to improve traffic safety will lose almost all its bite.
However, arguably the most important reason why anti-paternalism cannot be
applied to actions such as helmetless motorcycling has been absent from these
discussions, namely, what I propose to call the herd effects of individual behavior.
Many authors have provided what appears to be intended as a complete list of effects
of helmetless motorcycling that anti-paternalism cannot legitimize, without men-
tioning herd effects (Schonsheck 1994, pp. 107–141; Camerer et al. 2003;de
Marneffe 2006, pp. 82–83; Thaler and Sunstein 2008, pp. 232–233; Nolte et al.
2017).
Herd effects a rise because in almost all our decisions, we humans tend to follow
the examples of others. This has been known for long. Already Julian of Eclanum
(c.386-c.455) wrote about the “contagion of sin”(Barclift 1991, p. 14), and his
26 S. O. Hansson

contemporary John Chrysostom (c.349–407) strongly emphasized the positive side
of this, namely, the importance of being a good example to others (Chrystostomus
1836, p. 788, c.1D). The concept of behavioral or social contagion was introduced
into social science by the French scientist Gustave Le Bon (1841–1931). Today there
is an extensive literature on how all kinds of human behavior is propagated in
populations through our tendency to copy or imitate the behavior of others (Leh-
mann and Ahn 2018).
This applies not least to behaviors relevant to public health, such as smoking,
drinking, substance abuse, and physical exercise (Christakis and Fowler 2013).
There is also ample evidence of strong contagion effects on both the following and
the breach of safety rules on workplaces (Liang et al. 2018; Liang and Zhang 2019).
In road traffic, social contagion has a large role in creating a “culture of driving.”An
important study in the early 1990s showed that “drivers are sensitive to the influence
of others and... that a small shift in the behavior of few can be amplified, through the
interaction between individuals and their collectives, to a larger effect, resulting in a
changed social environment or a modified ‘culture of driving’” (Zaidel 1992,
p. 585). Other studies have confirmed that drivers have a strong tendency to adapt
to the prevailing speed pattern (Connolly and Åberg 1993; Edwards et al. 2014).
There is also evidence of similar effects on risky pedestrian behavior McGhie et al.
2012).
Unusually clear evidence of social contagion has been found in those states in the
US that replaced a law requiring all motorcyclists to carry a helmet by a law that only
required this of young riders. In these states, large numbers of young riders chose not
to use a helmet when they saw older riders riding helmetless. In Florida, the number
of motorcycle fatalities among riders younger than 21 nearly tripled after the helmet
law was downgraded in this way in 2000 (Bachynski 2012, p. 2216. Cf. Nolte et al.
2017). A group of public health researchers have pointed out that a similar effect can
be expected for bicycle helmets:
We also conjecture that by applying the [bicycle helmet] law to children but not adults we
would encourage a “rite of passage”effect (much as happens with cigarette smoking),
whereby older children abandoned helmets to signify their maturity. This perverse effect
would subvert an explicit, if secondary, policy aim of making helmets compulsory for
children, which is to encourage adults to adopt helmets in order to set an example without
compromise to adults’legal liberty and moral autonomy. (Sheikh et al. 2004, p. 264)
These results put what seemed to be purely self-affecting decisions, such as whether
or not to use a seat belt or a helmet, in an important, previously neglected, perspec-
tive, namely, that of how our actions influence other people’s actions. We humans are
not mental solitarians who make decisions and choices independently of each other.
To the contrary, we are herd creatures. We all observe what others do, and we usually
follow trends, in particular trends among people whom we feel akin to. If you speed,
others will feel encouraged to do the same. If you use a bicycle helmet, then that can
have a considerable influence on people whom you know, and it can also have a
Liberty, Paternalism, and Road Safety 27

smaller influence on a larger number of people, namely, those who see you riding
with the helmet.
Do these herd effects have any moral relevance? Do we have a moral obligation to
behave in ways that give rise to positive rather than negative effects on our fellow
beings? Or are these effects just byproducts of our actions and choices, for which we
have no responsibility? I can see no reason to treat herd effects differently than other
consequences of human action. In other words, they are morally relevant. This
means that we are morally accountable for the foreseeable effects of the examples
we set. It is morally blameworthy to set bad examples, for instance, by taking foolish
risks to no avail, and it is morally praiseworthy to set good examples, for instance, by
following safety rules and using protective equipment. This is not a new or original
standpoint; presumably it has never been a highly esteemed conduct to drink oneself
into a stupor or play dangerously with knives in the sight of children or adolescents.
But apparently we need to be reminded that the same moral principles apply to many
behaviors that have been considered protected by anti-paternalism.
A useful comparison can be made with another type of contagion, namely,
infectious contagion. There are two reasons why you should take vaccinations
against infections that threaten public health. First, vaccination protects your own
health. Secondly, vaccination protects other people, since if you do not get the
disease you will not spread it to others. This is particularly important for vulnerable
people who cannot, for medical reasons, take the vaccine. For instance, vaccination
against measles, a potentially deadly childhood disease, cannot be given to babies.
Their only protection is herd immunity in the population, which is obtained when
those who can take the vaccine do so. This means that vaccination is not just a
personal matter, and consequently refusal to vaccinate is by no means protected by
anti-paternalism. There are strong reasons to regard vaccination against diseases that
threaten the community as a moral obligation (Jamrozik et al. 2016; Pierik 2018).
This is written during the Covid-19 pandemic in 2020, which has led to drastic
measures all over the planet to contain the infection, including lockdowns and social
distancing. The same reasons for these measures apply as for vaccination: You do
this in order to protect yourself against the disease, but also to avoid spreading it to
others. In this case, vulnerable, mostly elderly, people are most at risk, and they
depend for their protection on the willingness of others to take the measures
necessary to avoid contracting and spreading the disease.
Unfortunately, there is in both cases, vaccination and social distancing, a minority
of people who either have not understood that the recommended measures are
needed to protect others than themselves, or just do not care. We can call this the
Bolsonaro fallacy after the Brazilian president Jair Bolsonaro who has flagrantly and
defiantly violated the directives of his own administration to reduce the spread of
Covid-19, with the justification “If I have got myself infected, so OK? Look, that is
my responsibility, no one has anything to do with this.”(“Se eu me contaminei, tá
certo? Olha, isso é responsabilidade minha, ninguém tem nada a ver com isso.”From
an interview on March 16, 2020. Last accessed 14 April 2020 on https://www.
youtube.com/watch?v¼M0za8MSoO64&feature¼youtu.be. At 6:58–7:02.)
28 S. O. Hansson

This example provides a useful background for the moral appraisal of how we
contribute to social contagion, which is no less a formidable force in society. The
mechanisms through which our behaviors impact on those of others can be even
more imperceptible than viruses and bacteria, but they are just as real. A motorcyclist
who wears a helmet contributes to creating a culture, or social environment, in which
helmets are an unquestioned part of motorcycling, just as hard hats are worn
routinely on construction sites. A motorcyclist who refrains from using a helmet
contributes, to the contrary, to maintaining or creating a social environment in which
it is normal, perhaps even “tough”or “cool,”to ride unhelmeted. The analogy with
taking vaccines and complying with social distancing in times of an epidemic is
obvious. The vaccine shot that you receive reduces the risk of contracting the disease
by a small amount for each of the persons who could potentially be infected by you,
and the sum of all these small amounts matters morally. Similarly, the helmet on your
own head encourages others to do the same, thereby contributing to making wearing
a helmet the normal and expected thing to do. Social contagion is just as real, just as
unavoidable, and just as morally important, as infectious contagion.
For both social and infectious contagion, what matters is the sum of a large
number of small effects. But in both cases, we can see from the sums that these
effects are real. Countries with high vaccination rates are almost unaffected by
diseases that have devastating effects in unprotected populations. And in countries
like Sweden, where young people may never have seen an unhelmeted motorcyclist,
the question of riding helmetless does not even arise. In neither case does the fact
that each of the many small individual effects cannot be perceived make them
morally irrelevant (Hansson 1999). Therefore, a motorcyclist who refrains from
wearing a helmet, claiming that this concerns no one but herself, makes the same
mistake as the vaccine refuser and the organizer of crowds in a pandemic, namely,
the Bolsonaro fallacy.
Putting this more positively, the fact that we are so much influenced by each other
is a reason to put more weight on the old but sometimes forgotten moral value –and
moral imperative –of setting good rather than bad examples. Asking a person to use
a helmet, or to fasten her seat belt, is not a meddlesome intrusion into her private life.
It is an invitation to take part in a joint effort to create or maintain a custom that
protects us all. It is for obvious reasons better if such customs can be achieved and
preserved without the force of law. This is how ice hockey helmets were introduced.
However, if this does not work, then we should not forget what we have govern-
ments and laws for. We certainly need them when children contract potentially life-
threatening diseases due to adults’vaccine refusal, or when older bikers inspire
teenagers to risk their lives by riding without a helmet.
Driver Assistance and Self-driving Cars
Vehicle technology is in a process of increasing automation. Modern cars have a
whole set of driver assistance functions that reduce the risk or the severity of
accidents: anti-lock braking systems, cruise control, lane departure warning systems,
Liberty, Paternalism, and Road Safety 29

driver attention monitors, collision warning and automatic brake systems, etc. This
began with systems that merely warn the driver, but increasingly, functions are
introduced that take control of the car if the driver does not heed a serious warning,
for instance, automatic braking to avoid a head-on collision or mitigate its effects.
There does not seem to have been much opposition to these systems. This may be
because they have been constructed not to reduce the driver’s feeling of control in
normal driving.
However, it does not follow from these experiences that fully automatic, self-
driving cars will easily be accepted. As it now seems, autonomous vehicles will not
be introduced, at least not on a large scale, until and unless they are far much safer
than manually driven cars. We tend to be less willing to accept machine errors than
errors made by human beings. Our tolerance for safety-critical malfunctions in cars
is already low. Vehicles are recalled for repair even of faults that have a compara-
tively low probability of giving rise to injuries or fatalities. Occasionally, car
manufacturers have refrained from recalls that they deemed too costly in relation
to the gains in safety, but that led to strong negative reactions from the public (Smith
2017). Some authors have worried that a large number of avoidable fatalities and
severe injuries will ensue if the introduction of autonomous vehicles is delayed by
safety requirements that are inordinately high as compared to those applied to
conventional vehicles (Brooks 2017; Hicks 2018, p. 67).
To the extent that automated vehicles run a smaller risk of crashes than humanly
driven vehicles, there may be a movement towards relaxing safety measures such as
the use of seat belts. Already in 2006, a year when more than 300 persons were killed
in Swedish road traffic and around 9000 were injured, a Swedish physician (!) asked:
“Do we even need the seat belts any more, now that the cars have become better?”
(Eberhard 2006, p. 321) The answer to that question depends, of course, on your
attitude to human death and suffering. Needless to say, less safe behavior by car
occupants can at least partly offset the gains in safety obtainable with the new
technology. Since no driver is needed, children can presumably travel alone in a
self-driving cars, and so can a company of severely inebriated persons. This can have
consequences for occupant behavior. This means that questions about safety culture
and how we influence each other’s behavior will continue to be pertinent in auto-
mated vehicles.
In a traffic system with automated vehicles that are much safer than human-driven
cars, questions may arise about the legitimacy of the latter. Proposals have already
been made to prohibit human driving on at least parts of the road net (Nyholm and
Smids 2020). This can surely meet with ardent resistance, since driving is a major
source of pleasure and pride for many people (Edensor 2004; Moor 2016; Borenstein
et al. 2019, p. 392). However, such conflicts can possibly be avoided if future
human-driven cars are equipped with advanced assistive technology, including an
emergency autopilot function that takes over in extreme cases when this is necessary
to avoid a crash.
Some authors have maintained that human moral agency is in some way stymied
by technology that reduces the risk of injuries or other adverse effects of human
failures. These authors call such technology “techno-regulation”(Brownsword
30 S. O. Hansson

2005)or“technology paternalism”(Spiekermann and Pallas 2006). Examples that
have been used include automated entrance barriers at railway and metro stations
(to prevent fare dodging) (Yeung 2011, p. 22), alcohol interlocks (Spiekermann and
Pallas 2006, p. 10), and –of course –self-driving cars (Brownsword 2005,
pp. 16 and 18). Roger Brownsword maintains that these technologies have a problem
in common:
When regulators design people, products, or places in such a way that regulatees have no
choice but to act in whatever way is judged to be appropriate, we cannot meaningfully speak
about them being morally responsible agents, to be credited with acts that respect others and
to be blamed where they fall short of moral requirements. (Brownsword 2005, p. 18)
Similarly, Karen Yeung writes:
Although an isolated techno-regulatory measure may appear benign, the cumulative effect of
techno-regulatory action by a range of regulators acting independently across a variety of
social contexts might ultimately lead to such a significant erosion of moral freedom that
meaningful moral agency can no longer be sustained. (Yeung 2011, p. 27)
These arguments are based on an extremely one-sided selection of technological
innovations. All through human history, technology and social arrangements have
shifted in ways that have both created and closed down options for moral decision-
making. New weapons have given rise to moral issues on when they could legiti-
mately be used. Would it have been a disadvantage if weapons of mass destruction
were not available, so that no one could exercise their moral agency by deciding
(hopefully) not to use them? New means of food production have reduced the burden
of deciding how to distribute food in times of famine. Would it have been better if
there was even more scarcity of food so that more people could flourish as moral
agents by distributing it rightfully? Technological devices, such as fences, locks,
safes, and alarm systems have made burglary next to impossible in some places.
Would it be preferable to ensure that all jewelry shops and bank vaults (and your
home) have doors that are easy to force open, so that prospective burglars have
ample opportunity to make virtuous decisions not to break in?
Arguably, these examples are sufficient to show the absurdity of valuing options
for moral deliberation higher than the avoidance of human suffering. But it may
nevertheless be of some interest to ask: Are these authors right in contending that
modern technology, as a general tendency, removes moral choices and thereby moral
agency from us humans? That is extremely difficult to determine, since examples
pointing in both directions are easily found. Notably, the Internet as well as social
media have given rise to a host of new moral issues that concern our private lives,
information on climate change has put air travel in a new moral perspective, and
environmental concerns have added moral aspects to our choices of foodstuff and
other consumer products. This may very well add up to outweigh a potential
reduction in the need for moral choices in road traffic.
Liberty, Paternalism, and Road Safety 31

In Conclusion: Vision Zero
Vision Zero has not been much mentioned in this chapter, but in a sense it has been
all about Vision Zero. Questions about personal freedom and how we influence each
other’s behavior are central for the choice of a traffic safety strategy, and many of the
differences between Vision Zero and previous road safety policies are closely
connected with the issues we have penetrated. In at least three respects, the conclu-
sions we have arrived at can serve as moral underpinnings of Vision Zero.
First, we found that some of the freedoms that were deeply cherished in former
times, such as the freedoms to have “a little dirt”in your water pipes, to hire workers
to work in mines with incessant rockfalls, or to drive drunk, are now considered by
almost everyone as weird wishes, rather than worthy objects of liberty. This histor-
ical perspective shows that conceptions of what is normal and desirable can change.
Vision Zero aims at one fundamental such change: Conditions and behaviors that
lead to deaths and serious injuries in road traffic should no longer be seen as normal,
or even acceptable.
Secondly, we noted that many habits and actions that are commonly conceived as
“self-harming”are in fact the result of a combination of self-harming and other-
harming actions. The smoker’s own decision is only part of the causal history behind
her unhealthy habit. Another, in fact quite crucial, part is the tobacco industry’s
ruthless promotion of a death-bringing product. Similarly, the motorist who speeds
on the expressway is certainly to blame, but the reason why it is at all possible for
him to do so is that the car manufacturer sells vehicles that can be driven at illegal
speeds, and that the legislature allows this. This analysis shows that we need to
consider the systemic causes behind events that have traditionally been ascribed
exclusively to individual road users. This is one of the methodological cornerstones
of Vision Zero.
Thirdly, we saw that traffic behavior is subject to strong effects of social conta-
gion. For instance, people tend to wear seat belts and helmets if others do so, and to
drive slower if others refrain from speeding. Therefore, safe traffic behavior is
important not only for the direct effects of one’s own actions, but also as a
contribution to the creation of a safety culture that protects us all. This is the major
reason why driving a motorcycle without a helmet is not a “purely self-harming”
action; it unavoidably sets a negative example that contributes to enticing other
bikers to do the same. This is a communal and socially inclusive perspective on
traffic safety that has not had a large role in Vision Zero, but it can arguably
contribute constructively to its implementation.
Cross-References
▶Arguments Against Vision Zero: A Literature Review
32 S. O. Hansson

Acknowledgment I would like to thank Henok Girma Abebe, Karin Edvardsson Björnberg, Kalle
Grill, Jesper Jerkert, Claes Tingvall and the participants in seminar at the Philosophy Division at
KTH in October 2020 for valuable comments on an earlier version of this chapter.
References
Anon. (1894). Chicago. British Medical Journal, 1(1726), 216–217.
Apollonio, D. E., & Bero, L. A. (2007). The creation of industry front groups: The tobacco industry
and ‘get government off our back’.American Journal of Public Health, 97(3), 419–427.
Bachynski, K. E. (2012). Playing hockey, riding motorcycles, and the ethics of protection. Amer-
ican Journal of Public Health, 102(12), 2214–2220.
Balko, R. (2011). Nanny state: Abolish drunk driving Laws. Reason, January 2011. Downloaded
April 10, 2020, from https://reason.com/2010/12/31/abolish-drunk-driving-laws
Barclift, P. L. (1991). In controversy with Saint Augustin: Julian of Eclanum on the nature of sin.
Recherches de Théologie Ancienne et Médiévale, 58,5–20.
Barnard, J. (2002). I loved her because she wanted to climb the highest peak. That’s who she was.
Guardian 28 August.
Borenstein, J., Herkert, J. R., & Miller, K. W. (2019). Self-driving cars and engineering ethics: The
need for a system level analysis. Science and Engineering Ethics, 25(2), 383–398.
Boughton, B. J. (1984). Compulsory health and safety in a free society. Journal of Medical Ethics,
10(4), 186–189.
Brooks, R. (2017). Unexpected consequences of self driving cars. https://rodneybrooks.com/
unexpected-consequences-of-self-driving-cars. Accessed 15 Apr 2020.
Brownsword, R. (2005). Code, control, and choice: Why east is east and west is west. Legal Studies,
25(1), 1–21.
Cairns, H. (1941). Head injuries in motorcyclists. The importance of the crash helmet. British
Medical Journal, 2(4213), 465–471.
Cairns, H. (1946). Crash helmets. British Medical Journal, 2(4470), 322–323.
Camerer, C., Issacharoff, S., Loewenstein, G., O’donoghue, T., & Rabin, M. (2003). Regulation for
conservatives: Behavioral economics and the case for ‘asymmetric paternalism’.University of
Pennsylvania Law Review, 151(3), 1211–1254.
Cameron, M. H., Peter Vulcan, A., Finch, C. F., & Newstead, S. V. (1994). Mandatory bicycle
helmet use following a decade of helmet promotion in Victoria, Australia –An evaluation.
Accident Analysis and Prevention, 26(3), 325–337.
Cardador, M. T., Hazan, A. R., & Glantz, S. A. (1995). Tobacco industry smokers’rights publica-
tions: A content analysis. American Journal of Public Health, 85(9), 1212–1217.
Carson, R. (1962). Silent spring. Boston: Houghton Mifflin.
Carsten, O. M. J., & Tateb, F. N. (2005). Intelligent speed adaptation: Accident savings and cost–
benefit analysis. Accident Analysis and Prevention, 37, 407–416.
Chancellor, A. (2003). In need of speed. The Guardian, 7 June.
Christakis, N. A., & Fowler, J. H. (2013). Social contagion theory: Examining dynamic social
networks and human behavior. Statistics in Medicine, 32(4), 556–577.
Chrystostomus, J. (1836). Diatriba ad opus imperfectum in Matthaeum. In Opera Omnia,
Tomus Sextus (pp. 731–972). Paris: Gaume Fratres.
Conly, S. (2017). Paternalism, coercion and the unimportance of (some) liberties. Behavioural
Public Policy, 1(2), 207–218.
Connolly, T., & Åberg, L. (1993). Some contagion models of speeding. Accident Analysis &
Prevention, 25(1), 57–66.
Crossley, D. (1999). Paternalism and corporate responsibility. Journal of Business Ethics, 21(4),
291–302.
Daker, G. et al. (1893). Foreign Abstract of Sanitary Reports, 8(30), 630–648.
Liberty, Paternalism, and Road Safety 33

de Bellis, E., Schulte-Mecklenbeck, M., Brucks, W., Herrmann, A., & Hertwig, R. (2018). Blind
haste: As light decreases, speeding increases. PLoS One, 13(1), e0188951.
de Marneffe, P. (2006). Avoiding paternalism. Philosophy and Public Affairs, 34(1), 68–94.
Delaney, A., Ward, H., Cameron, M., & Williams, A. F. (2005a). Controversies and speed cameras:
Lessons learnt internationally. Journal of Public Health Policy, 26(4), 404–415.
Delaney, A., Ward, H., & Cameron, M. (2005b). The history and development of speed camera use
(Report no. 242). Monash University Accident Research Centre.
Dorrian, C. I. (1911). Better automobile laws. Country Life in America, 19(12), 467.
Dworkin, G. (1972). Paternalism. The Monist, 56(1), 64–84.
Dworkin, G. (2015). Defining paternalism. In T. Schramme (Ed.), New perspectives on paternalism
and health care (pp. 17–29). Cham: Springer.
Dworkin, G. (2020). Paternalism. In E. N. Zalta (Ed.), The Stanford encyclopedia of philosophy.
https://plato.stanford.edu/archives/spr2020/entries/paternalism/.
Eberhard, D. (2006). I trygghetsnarkomanernas land: om Sverige och det nationella
paniksyndromet. [In the land of security addicts. On Sweden and the national panic syndrome.]
Stockholm: Prisma.
Edensor, T. (2004). Automobility and national identity: Representation, geography and driving
practice. Theory, Culture and Society, 21(4–5), 101–120.
Edwards, J., Freeman, J., Soole, D., & Watson, B. (2014). A framework for conceptualising traffic
safety culture. Transportation Research Part F, 26, 293–302.
Elston, P. A. (1971). Maximum speed limits. The development of speed limits: a review of the
literature. Report under contract FH-11-7275 for the National Highway Traffic Safety Admin-
istration. Indiana University, Institute for Research in Public Safety. Downloaded April 10, 2020
from https://rosap.ntl.bts.gov/view/dot/16506
Elvebakk, B. (2015). Paternalism and acceptability in road safety work. Safety Science, 79,
298–304.
Evans, L. (1991). Traffic safety and the driver. New York: Van Nostrand Reinhold.
Fallin, A., Grana, R., & Glantz, S. A. (2014). ‘To quarterback behind the scenes, third-party efforts’:
The tobacco industry and the tea party. Tobacco Control, 23(4), 322–331.
Farmer, C. M. (2017). Relationship of traffic fatality rates to maximum state speed limits. Traffic
Injury Prevention, 18(4), 375–380.
Feinberg, J. (1986). Harm to self. Oxford: Oxford University Press.
Fell, J. C., & Voas, R. B. (2014). The effectiveness of a 0.05 blood alcohol concentration (BAC)
limit for driving in the United States. Addiction, 109(6), 869–874.
Fell, J. C., Lacey, J. H., & Voas, R. B. (2004). Sobriety checkpoints: Evidence of effectiveness is
strong, but use is limited. Traffic Injury Prevention, 5(3), 220–227.
Flanigan, J. (2017). Seat belt mandates and paternalism. Journal of Moral Philosophy, 14(3),
291–314.
Fu, C., Liu, H., & Zhou, Y. (2020). A review of the speeding intervention effectiveness and
acceptance of intelligent speed adaptation. In Sixth International Conference on Transportation
Engineering, Proceedings (ICTE 2019) (pp. 299–310). Reston: American Society of Civil
Engineers.
Gabriel, R. A. (2007). Soldiers’lives through history: The ancient world. Westport: Greenwood
Press.
Gardner, E. (1941). Head injuries in motor-cyclists. British Medical Journal, 2(4216), 592–592.
Giubilini, A., & Savulescu, J. (2019). Vaccination, risks, and freedom: The seat belt analogy. Public
Health Ethics, 12(3), 237–249.
Green, T. H. (1881). Lecture on liberal legislation and freedom of contract. In R. L. Nettleship (Ed.),
Works of Thomas Hill Green (Vol. 3, pp. 365–386). London: Longmans, Green and Co.
Green, E. H. H. (1995). The crisis of conservatism. The politics, economics and ideology of the
British conservative party, 1880–1914. London: Routledge.
Grill, K. (2018). Paternalism by and towards groups. In K. Grill & J. Hanna (Eds.), The Routledge
handbook of the philosophy of paternalism (pp. 46–58). Routledge: Abingdon.
34 S. O. Hansson

Grill, K., & Nihlén Fahlquist, J. (2012). Responsibility, paternalism and alcohol interlocks. Public
Health Ethics, 5(2), 116–127.
Hansson, S. O. (1999). The moral significance of indetectable effects. Risk, 10, 101–108.
Hansson, S. O. (2005). Extended antipaternalism. Journal of Medical Ethics, 31,97–100.
Hansson, S. O. (2014). Making road traffic safer: Reply to Ori. Philosophical Papers, 43, 365–375.
Hansson, S. O. (2022). Responsibility in road traffic, this volume.
Hicks, D. J. (2018). The safety of autonomous vehicles: Lessons from philosophy of science. IEEE
Technology and Society Magazine, 37(1), 62–69.
House of Commons. (1847). The health of towns bill. Debate 18 June. Hansard’s Parliamentary
Debates, 3rd series, Vol. 93, cc. 727–753.
House of Commons. (1848). Public Health Bill. Debate 5 May. Hansard’sHansard’s Parliamentary
Debates, 3rd series, Vol. 98, cc. 710–743 and 764–803.
Howat, P., O’Connor, J., & Slinger, S. (1992). Community action groups and health policy. Health
Promotion Journal of Australia, 2(3), 16–22.
Huguelet, A. (2020). ‘It’s about freedom’: Local lawmaker trying again on motorcycle helmet law
repeal. Springfield News-Leader, February 29, 2020. Downloaded April 5, 2020 from https://eu.
news-leader.com/story/news/politics/2020/02/29/motorcycle-helmet-law-repeal-rides-again-its-
freedom/4902534002/
Hundley, J., et al. (2004). Non-helmeted motorcyclists: A burden to society? A study using the
National Trauma Data Bank. Journal of Trauma: Injury, Infection, and Critical Care, 57(5),
944–949.
Husak, D. N. (1994). Is drunk driving a serious offense? Philosophy and Public Affairs, 23(1),
52–73.
Ichikawa, M., Nakahara, S., & Wakai, S. (2002). Mortality of front-seat occupants attributable to
unbelted rear-seat passengers in car crashes. Lancet, 359(9300), 43–44.
Jamrozik, E., Handfield, T., & Selgelid, M. J. (2016). Victims, vectors and villains: Are those who
opt out of vaccination morally responsible for the deaths of others? Journal of Medical Ethics,
42(12), 762–768.
Johannessen, G. (1984). Historical perspective on seat belt restraint systems (SAE Technical Paper
no. 840392). Society of Automotive Engineers.
Jones, M. M., & Bayer, R. (2007). Paternalism & its discontents: Motorcycle helmet laws,
libertarian values, and public health. American Journal of Public Health, 97(2), 208–217.
Katz, J. E. (2005). Individual rights advocacy in tobacco control policies: An assessment and
recommendation. Tobacco Control, 14(Suppl. 2), ii31–ii37.
Knowles, T. (1880). Speech in the House of Commons. Hansard’s Parliamentary Debates, 3rd
series, Vol. 252, cc. 1096–1102.
Krupke, C. H., Prasad, R. P., & Anelli, C. M. (2007). Professional entomology and the 44 noisy
years since Silent Spring. Part 2: Response to Silent Spring. American Entomologist, 53(1),
16–26.
Langland-Orban, B., & Flint, L. (2011). Another perspective on motorcycle helmet use. Journal of
the American College of Surgeons, 213(2), 336–337.
Lanska, D. J. (2009). Historical perspective: Neurological advances from studies of war injuries and
illnesses. Annals of Neurology, 66(4), 444–459.
Le Grand, J., & New, B. (2015). Government paternalism: Nanny state or helpful friend? Princeton:
Princeton University Press.
Lehmann, S., & Ahn, Y.-Y. (Eds.). (2018). Complex spreading phenomena in social systems
influence and contagion in real-world social networks. Cham: Springer.
Leichter, H. M. (1991). Free to be foolish. Princeton: Princeton University Press.
Liang, H., & Zhang, S. (2019). Impact of supervisors’safety violations on an individual worker
within a construction crew. Safety Science, 120, 679–691.
Liang, H., Lin, K.-Y., Zhang, S., & Yikun, S. (2018). The impact of coworkers’safety violations on
an individual worker: A social contagion effect within the construction crew. International
Journal of Environmental Research and Public Health, 15(4), 773.
Liberty, Paternalism, and Road Safety 35

Marczinski, C. A., & Fillmore, M. T. (2009). Acute alcohol tolerance on subjective intoxication and
simulated driving performance in binge drinkers. Psychology of Addictive Behaviors, 23(2),
238–247.
Max, J. (2019). Speed cameras vulnerable to vandalism worldwide –But studies say they save lives.
Forbes, 21 January. Downloaded 4 April 2020 from https://www.forbes.com/sites/joshmax/
2019/01/21/speed-cameras-vulnerable-to-vandalism-worldwide-but-studies-say-they-save-
lives/#40f342b66f00
Mays, M. (2019). Anti-vaccine protesters are likening themselves to civil rights activists. Politico,
19 September. Downloaded April 5, 2020 from https://www.politico.com/story/2019/09/18/
california-anti-vaccine-civil-rights-1500976
McGhie, A., Lewis, I., & Hyde, M. K. (2012). The influence of conformity and group identity on
drink walking intentions: Comparing intentions to drink walk across risky pedestrian crossing
scenarios. Accident Analysis and Prevention, 45, 639–645.
McKenna, F. P. (2007). The perceived legitimacy of intervention: A key feature for road safety. In
Improving traffic safety culture in the United States: The journey forward (pp. 165–175).
Washington, DC: AAA Foundation for Traffic Safety.
Meyer, C., & Reiter, S. (2004). Impfgegner und Impfskeptiker. Geschichte, Hintergründe, Thesen,
Umgang. Bundesgesundheitsblatt –Gesundheitsforschung –Gesundheitsschutz, 47,
1182–1188.
Milio, N. (1976). A framework for prevention: Changing health-damaging to health-generating life
patterns. American Journal of Public Health, 66, 435–439.
Mill, J. S. (1977 [1859]). On liberty. In J. M. Robson (Ed.), Collected works of John Stuart Mill
(Vol. 18, pp. 213–310). Toronto: University of Toronto Press.
Miller, J. M. (1993). A swinging pendulum or Damocles’sword: A dramatic perspective on
constitutional liberties in the 1990s. Western State University Law Review, 21(1), 165–218.
Mols, F., Alexander Haslam, S., Jetten, J., & Steffens, N. K. (2015). Why a nudge is not enough: A
social identity critique of governance by stealth. European Journal of Political Research, 54(1),
81–98.
Moor, R. (2016). What happens to American myth when you take the driver out of it? The self-
driving car and the future of the self. Intelligencer,New York Magazine, October 16. http://
nymag.com/selectall/2016/10/is-the-self-driving-car-un-american.html
Mowat, L. (2019). Nanny state: Speed limiter tech for your car has black box recording your
EVERY move. Daily Mail, 28 March.
National Motorists Association. (2019). Vision zero invasion of the car itself. NMA E-Newsletter
#532. Downloaded 10 April 2020 from https://www.motorists.org/blog/vision-zero-invasion-
of-the-car-itself-nma-e-newsletter-532/
NHTSA. (2019). 2017 State traffic data. Traffic Safety Facts, DOT HS 812 780. Downloaded
19 April 2020 from https://crashstats.nhtsa.dot.gov/#/
Nolte, K. B., Healy, C., Rees, C. M., & Sklar, D. (2017). Motorcycle policy and the public interest:
A recommendation for a new type of partial motorcycle helmet law. Journal of Law, Medicine
and Ethics, 45(1 Suppl), 50–54.
Nyholm, S., & Smids, J. (2020). Automated cars meet human drivers: Responsible human-robot
coordination and the ethics of mixed traffic. Ethics and Information Technology, 22(4), 335–344.
O’Madagain, C. (2014). Can groups have concepts? Semantics for collective intentions. Philo-
sophical Issues, 24(1), 347–363.
Petroski, H. (2016). The lines on the road: Infrastructure in perspective. Mechanical Engineering,
138(2), 42–47.
Pierik, R. (2018). Mandatory vaccination: An unqualified defence. Journal of Applied Philosophy,
35(2), 381–398.
Pilkington, P. (2003). Speed cameras under attack in the United Kingdom. Injury Prevention, 9,
293–294.
Porter, D. (1999). Health, civilisation and the state. A history of public health from ancient to
modern times. London: Routledge.
36 S. O. Hansson

Preyer, G., Hindriks, F., & Chant, S. R. (Eds.). (2014). From individual to collective intentionality:
New essays. Oxford: Oxford University Press.
Rigau-Pérez, J. G. (1989). The introduction of smallpox vaccine in 1803 and the adoption of
immunization as a government function in Puerto Rico. Hispanic American Historical Review,
69(3), 393–423.
Roberts, D. (1958). Tory paternalism and social reform in early Victorian England. American
Historical Review, 63(2), 323–337.
Roberts, D. (1979). Paternalism in early Victorian England. New Brunswick: Rutgers University
Press.
Robinson, M. (2019). Gilets jaunes protesters vandalize 60% of France’s speed cameras. CNN,
January 11. https://edition.cnn.com/2019/01/10/europe/gilets-jaunes-speed-cameras-destroyed-
france-scli-intl/index.html. Accessed 17 Oct 2020.
Rosenberg, B., & Levenstein, C. (2010). Social factors in occupational health: A history of hard
hats. New Solutions: A Journal of Environmental and Occupational Health Policy, 20(2),
239–249.
Salice, A. (2015). There are no primitive we-intentions. Review of Philosophy and Psychology, 6(4),
695–715.
Schneider, N. K., & Glantz, S. A. (2008). ‘Nicotine Nazis strike again’: A brief analysis of the use of
Nazi rhetoric in attacking tobacco control advocacy. Tobacco Control, 17(5), 291–296.
Schonsheck, J. (1994). On criminalization. An essay in the philosophy of the criminal law.
Dordrecht: Kluwer Academic Publishers.
Schramme, T. (2015). Contested services, indirect paternalism and autonomy as real liberty. In
T. Schramme (Ed.), New perspectives on paternalism and health care (pp. 101–114). Cham:
Springer.
Sheikh, A., Cook, A., & Ashcroft, R. (2004). Making cycle helmets compulsory: Ethical arguments
for legislation. Journal of the Royal Society of Medicine, 97(6), 262–265.
Shiffrin, S. V. (2000). Paternalism, unconscionability doctrine, and accommodation. Philosophy
and Public Affairs, 29(3), 205–250.
Smids, J. (2018). The moral case for intelligent speed adaptation. Journal of Applied Philosophy,
35(2), 205–221.
Smith, F. F. (1967). Controlling insects on flowers (Agricultural Information Bulletin, no. 237).
U.S. Department of Agriculture.
Smith, B. W. (2017). The trolley and the Pinto: Cost-benefit analysis in automated driving and other
cyber-physical systems. Texas A&M Law Review, 4, 197–208.
Snell, L. M. (2018). Hard hat –Origins and evolution. Concrete International, 40(7), 48–49.
Solan, D. (1986). Seat-belt laws violate your civil rights. New York Times, 26 February. National
edition, Section A, p. 22.
Solomon, D. (2010). Questions for Rand Paul. Tea time. New York Times Magazine, 31 March.
Spiekermann, S., & Pallas, F. (2006). Technology paternalism–wider implications of ubiquitous
computing. Poiesis and Praxis, 4(1), 6–18.
Spurgin, E. W. (2006). Occupational safety and paternalism: Machan revisited. Journal of Business
Ethics, 63(2), 155–173.
Stonehouse, A. (2017). Speech in the Legislative Council of the Parliament of Western Australia,
24 May 2017. Downloaded 5 April 2020, from https://www.parliament.wa.gov.au/parliament/
Memblist.nsf/(MemberPics)/8D0A3D52071587BF482580F30020A00C/$file/AaronStone
houseInaug2017.pdf
Thaler, R. H., & Sunstein, C. R. (2008). Nudge: Improving decisions about health, wealth, and
happiness. New Haven: Yale University Press.
Tripp, H. A. (1928). Police and public: A new test of police quality. Police Journal, 1(4), 529–539.
Underwood, H. (1907). Speed mania and how to cure it. Harper Weekly, 51:1(2623), 470.
Vallgårda, S. (2012). Nudge –A new and better way to improve health? Health Policy, 104(2),
200–203.
Liberty, Paternalism, and Road Safety 37

Vissing, J. (2014). Preserving liberty while increasing safety: Why Indiana should outlaw sobriety
checkpoints. Indiana Law Review, 48, 1089–1113.
Vivoda, J. M., & Eby, D. W. (2011). Factors influencing safety belt use. In B. E. Porter (Ed.),
Handbook of traffic psychology (pp. 215–230). Waltham: Academic Press.
Waller, G. (1988). Multiple contributions to a debate on the Road Traffic Act, Hansard’s Parlia-
mentary Debates, series 6, vol. 133, cc. 588–621, 13 May.
Waller, P. F. (2001). Public health’s contribution to motor vehicle injury prevention. American
Journal of Preventive Medicine, 21(4), 3–4.
White, D. (2006). Take two servings of paternalism. Downloaded April 5, 2020, from https://www.
aei.org/articles/take-two-servings-of-paternalism/
Wiggins, D. E. (1987). The cholera and public health in Mid-Victorian Britain. Master’s thesis,
Texas Tech University. Downloaded 25 April 2020 from https://ttu-ir.tdl.org/bitstream/handle/
2346/14620/31295005215370.pdf?sequence¼1
Williams, A. F. (2006). Alcohol-impaired driving and its consequences in the United States: The
past 25 years. Journal of Safety Research, 37(2), 123–138.
Wilson, J. (2015). Why it’s time to stop worrying about paternalism in health policy. In
T. Schramme (Ed.), New perspectives on paternalism and health care (pp. 203–218). Cham:
Springer.
Woolfson, D. (2016). Barbecue pub slams ‘nanny state’after zero food hygiene rating, 29 August
2016. Downloaded April 5, 2020, from https://www.morningadvertiser.co.uk/Article/2016/08/
30/BBQ-pub-slams-nanny-state-after-zero-food-hygiene-rating
Yerger, V. B., Przewoznik, J., & Malone, R. E. (2007). Racialized geography, corporate activity, and
health disparities: Tobacco industry targeting of inner cities. Journal of Health Care for the Poor
and Underserved, 18(6), 10–38.
Yeung, K. (2011). Can we employ design-based regulation while avoiding Brave New World? Law,
Innovation and Technology, 3(1), 1–29.
Zaidel, D. M. (1992). A modeling perspective on the culture of driving. Accident Analysis and
Prevention, 24(6), 585–597.
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