Abstract
In Fostering Autonomy: A Theory of Citizenship, the State, and Social Service Delivery, Elizabeth Ben-Ishai offers a theory of the elements that characterize an autonomy-fostering state. While many theorists have seen the state as only a means of social control, the author argues the government can and should foster autonomy among its most vulnerable citizens. However, to understand how to foster autonomy, the author argues we must re-conceptualize autonomy and social citizenship.
Ben-Ishai conceptualizes autonomy similarly to other theorists, viewing it as a state of self-government or “the ability to live one’s life according to one’s own plans” (p. 3). Her reconceptualization, however, defines autonomy as relational, ascribed to individuals, “weak” substantive, and capacity-oriented. To examine how social citizenship and autonomy relate, Ben-Ishai examines four examples of service delivery, including: pregnancy prevention programs and workfare; immigration and welfare; coordinated community response (CCR) domestic violence programs; and harm reduction drug programs. She finds the latter two programs can foster autonomy while the first two do not. What, according to the author, accounts for these differences? We will summarize key points from the example cases below.
In the first case is an examination of workfare and pregnancy prevention programs under the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA). These programs are oriented from the social services delivery philosophy of new paternalism, based on the idea that some individuals require a more supervisory and intrusive approach to service delivery because they are incompetent or lack the capacity for personal responsibility. Thus, current “welfare” programs are based on “conditionality,” in which clients must behave in a certain way (as dictated by the state) in order to receive benefits. Further, Ben-Ishai argues that new paternalism is based on faulty assumptions concerning the relationship between paid work and women’s autonomy. She concludes that the flawed assumptions of new paternalism and conditionality underlying PRWORA make it difficult for these particular programs to foster autonomy in clients.
In the second case study the author also examines PRWORA, but focuses on aspects of the legislation that restrict immigrants’ access to cash assistance programs. Ben-Ishai begins by noting that the debate within the literature is not whether PWORA limits immigrant access (it is widely acknowledged that it does), but whether these restrictions are warranted or just. She argues that these limitations are not warranted or just because the justification for these limitations (welfare use represents a failure to take responsibility) is deeply flawed. Specifically, this assumption is flawed because it is anchored from a definition of autonomy that is individualistic as opposed to relational, and this justification is “divorced from the reality of the economic and political interdependence of nation-states throughout the world” (p. 70). Ben-Ishai argues that instead of failing to take personal responsibility, welfare use is actually a form of claiming political responsibility, and thus, “by denying welfare to many immigrants, the state ironically prevents them from both exercising autonomy and taking responsibility—the very values that welfare reform advocates argue PWORA is meant to enhance” (p. 71). The author concludes that, ultimately, “PWORA’s immigration restrictions are rooted in a problematic notion of personal responsibility that is itself founded on an individualistic, atomistic notion of autonomy” (p. 93).
The third case study of service delivery is the first to illustrate how state intervention can serve to foster autonomy. In this case study, Ben-Ishai examines coordinated community response (CCR) domestic violence programs. The author notes the controversy surrounding these types of programs, particularly with respect to mandatory arrest policies, but argues that CCR programs can be viewed as inhibiting autonomy only if one conceives of autonomy as independence or privacy. However, if one views autonomy as relationally constituted and not solely as the infringement of one’s boundaries, a different perspective on CCRs emerges: that CCRs are coordinated and fragmented in such a way that governmental intervention can actually foster autonomy in domestic violence victims while holding perpetrators responsible. As such, she argues that while the potential publicity associated with mandatory arrests could represent a cost to the survivors’ privacy, “the hardships [for DV survivors] are ultimately a lesser threat to autonomy than is the failure to hold the batterer responsible” (p. 119).
Ben-Ishai examines harm reduction substance abuse programs as the final example of how state intervention can foster autonomy. She believes that this is an important area of analysis, as harm and autonomy are often considered a zero-sum relationship (i.e., if there is harm, autonomy is necessarily compromised). The author analyzes two harm reduction programs, methadone maintenance treatment (MMT) programs and needle exchange programs, to examine whether the zero-sum relationship claim holds. Despite the physical, mental, and social harms associated with substance abuse, if one does not conflate independence with autonomy, and instead considers autonomy as relational in nature, these programs present an “interesting case of a mechanism for fostering autonomy through relations of embodied recognition” (p. 138). Specifically, because these programs typically recognize the embodied and relational nature of autonomy, and have substantial user-involvement and/or are user-run, these programs can become sources of social support and can serve as a site to enact autonomy.
In the conclusion to the book, the author provides an account of the methodology that she utilized in this work, a technique she refers to as an “empirically situated approach.” She also utilizes this chapter to highlight the benefits of conducting contextual analyses and the use of a “feminist theoretical foundation” (p. 162). While we agree this sort of approach could be very advantageous, the author draws mainly on findings from published work. Although she engages in some analysis of documents pertaining to the programs and laws, it was unclear when the author was pulling from a primary source or a secondary source. Primary data analysis may have proven to be richer than employing secondary sources. This limitation aside, the book presents a number of strengths. It is well organized, with each chapter including strong introductions and conclusions that outlined the key arguments. Sociologists who are unfamiliar with political science will be exposed to political science theories of autonomy and social citizenship, including political feminist theory. Finally, Ben-Ishai’s attention to re-conceptualizing different concepts and the coverage of a wide spectrum of social service programs are important assets of this work.