Most sources interpret this expression as meaning that good intentions are worthless unless followed up with action.
Some offer an alternative interpretation: that actions that are taken with good intent can have unintended negative consequences.
According to The Phrase Finder (phrases.org.uk), the expression is often attributed to the Cistercian abbot Saint Bernard of Clairvaux (1090 – 1153), but that provenance is suspect given that the earliest reference to Saint Bernard saying this is in a work written almost 500 years later.
The English theologian John Ray published A Collection of English Proverbs in 1670, which includes a variation on hell being filled with good intentions, but no reference to the road there being paved with them.
Road got added sometime between then and the mid-19th century, as it appears in Henry G. Bohn’s A Hand-book of Proverbs in 1855.
Although we have always used this expression to mean that good intentions can lead to negative consequences, others interpret it as meaning that good intentions are worthless unless followed up with action.
Perhaps a clue to these two different interpretations lies in Bohn’s book of proverbs where he lists three similar expressions:
The first would appear to align neatly with the interpretation that it is the failure to act on good intentions that lands one in hell; whereas the second and third would seem to line up with the idea that sometimes well intended actions can have negative consequences. Perhaps, somewhere in the last 150 or so years, the different expressions merged into the one idiom we use today (the road to hell is paved with good intentions) while retaining the two different interpretations?
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