More on Subsidiarity and SIDS

Albert J. Brooks asks some good questions about my subsidiarity-driven criticism of the American Academy of Pediatrics' condemnation of co-sleeping:

[G]iven that we are talking about a health and safety issue, I don't think the AAP is out of line in speaking to the subject. Is this much differently, qualitatively, than doctors counseling against smoking around children or recommending mandatory vaccinations?

The best we can hope for is that competent experts will provide concerned parents with the best available and up-to-date information to permit us to make informed decisions. Remember, subidiarity is a two-way street.

In that regard, the size of the organization can't work against the principle, as the larger the group, the more likely it is to be more competent and comprehensive to base its decision on a broader consensue of current medical opinion.

I agree that simply providing information can actually further the cause of subsidiarity to the extent it empowers lower bodies to make informed choices.  But the AAP may be crossing the line from acting as a resource to acting as an arbiter of acceptable practices.  It's a tricky case assuming that the AAP does not act to legally enshrine their pronouncements, but I'm wondering whether, at some point, bright-line edicts on acceptable child care from a group of that stature unduly limits the practical autonomy of parents even absent the backing of the law's coercive power. 

As for other public health measures, we need to draw some distinctions.  I see the co-sleeping issue differently than the smoking issue for two reasons.  First, the evidence against smoking around children is much more compelling than the evidence against co-sleeping, as I understand it.  Second -- and this relates more directly to subsidiarity -- instructing parents not to co-sleep with their kids intrudes much more directly on parental autonomy than instructing parents not to smoke around their kids.  Deciding whether or not to sleep with one's children is at the core of the child-raising function; smoking around one's children is not.  (Similarly, requiring everyone to wear seat belts is a minimal intrusion into the substantive life of the family even though it might be in tension with the preferences of some parents.)

As for the AAP's large size, that poses its own subsidiarity problems.  I'm not sure that more minds assembled in an organization produce more competence, but even so, subsidiarity is not concerned simply with reaching a "correct" result, but in reflecting lower bodies' values and priorities in the result and the process by which it is reached.  The AAP's size means that it might be able to pour lots of resources into studies showing connections between co-sleeping and SIDS, but its size also means that the group's recommedations are unlikely to account for the divergent values of subcommunities.  Maybe some parents co-sleep based only on their concern for the baby's physical well-being, but others might co-sleep because of concerns over emotional bonding, and these concerns might be grounded in particular cultural or religious worldviews.  The size of the AAP makes it less able to respond to, much less reflect, those divergent values.

Rob