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Salvaging the concept of nudge.
1Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, USA. ysaghai@jhu.edu
Journal of Medical Ethics
|February 22, 2013
Summary
Nudge theory influences health interventions by preserving choice without deliberation. This study argues nudges robustly preserve freedom of choice, making them suitable for moral evaluation in public health policy.
Area of Science:
- Behavioral Economics
- Public Health Policy
- Cognitive Science
Background:
- Nudge theory is increasingly used for population-wide health interventions.
- Nudges influence choices without engaging deliberative processes.
- Debate exists on whether nudges truly preserve freedom of choice.
Purpose of the Study:
- To determine if health nudges, relying on automatic cognitive processes, sufficiently preserve freedom of choice.
- To provide a framework for evaluating the moral serviceability of nudges in health policy.
- To explore healthcare contexts favoring nudges over controlling influences.
Main Methods:
- Conceptual analysis of 'freedom of choice' in the context of nudges.
- Explication of preservation of freedom of choice using 'choice-set preservation' and 'noncontrol'.
- Exploration of ethical considerations for nudges in healthcare.
Main Results:
- Nudges can preserve freedom of choice in a robust sense, defined by choice-set preservation and noncontrol.
- This robust preservation supports the moral evaluation of nudges in public health.
- Nudges may be ethically preferable to more controlling interventions in certain healthcare settings.
Conclusions:
- Nudge interventions can ethically preserve freedom of choice.
- The framework of choice-set preservation and noncontrol validates nudges for public health.
- Nudges offer a valuable, less controlling alternative in healthcare decision-making.
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