Whenever I complained of a sore throat as a child, my father would press his fingers gently behind my jawbone, checking for swollen lymph nodes. “I think you’re going to be okay,” he would say upon completing his examination. This was his verdict, too, when I called him from college, miserably ill with what he identified as “probably influenza.” I asked him if there was anything I could do and he suggested, to my disappointment, drinking plenty of fluids. Then he recommended his grandmother’s prescription for a bad cold—buttered toast dipped in warm milk. He described the way the butter floated on the surface of the milk and how comforting he found his grandmother’s care. I wanted to know if there was some sort of medicine I could take, but what I needed, my father understood, was comfort. As an adult, I still never cease to feel a little surprise when a doctor reaches behind my jawbone to check for swollen nodes. I associate the tenderness of that gesture with my father’s care.
Paternalism has fallen out of favor in medicine, just as the approach to fathering that depends on absolute authority no longer dominates parenting. But how we should care for other people remains a question. In his discussion of efforts to control childhood obesity, the philosopher Michael Merry defines paternalism as “interference with the liberty of another for the purposes of promoting some good or preventing some harm.” This type of paternalism, he notes, is reflected in traffic laws, gun control, and environmental regulations. These are limits to liberty, even if they are benevolent. Interfering with the parenting of obese children, he argues, is not necessarily benevolent. There is risk in assigning risk. Children who are already stigmatized for their body type are further targeted. And families who are identified as “at risk” for obesity become at risk to discriminatory oversight. The prevention of risk, Merry observes, is often used to justify a coercive use of power.