The basic relationship between people should be one of care, and the caring life is the highest which humans can live. Unfortunately, care that is ill-considered can easily become an illegitimate intrusion on autonomy. Autonomy is a basic good, not to be abridged without good reason. It is not, on the other hand, the only good. Kultgen argues that it is sometimes necessary to intervene in the lives of others in order to protect them from harm or provide important benefits.

Guidelines, therefore, must be established so that care is both respectful and balanced.

Some contemporary moralists categorically condemn paternalism, the forementioned intervention without consent. Kultgen examines weaknesses in these arguments and proposes new guidelines for paternalism, which he then names parentalism.

As the term implies, Kultgen's reconception abandons the patriarchal connotations of the old term, relying instead on the optimal caring roles characteristic of "mothers" and "fathers." Kultgen distinguishes between the personal sphere of interaction (i.e., friends, family, and intimates), and the public sphere of institutions, legislation, and the professional practices, and goes on to explore the implication of parentalism in both these spheres.

Though Kultgen agrees that paternalistic intervention is morally dangerous, he makes the case that it is equally dangerous to decline to intervene when another's welfare is in jeopardy.