The Meta-Nudge - A Response to the Claim That the Use of Nudges During the Informed Consent Process is Unavoidable

Area of Science:

• Bioethics
• Decision Science
• Medical Ethics

Background:

• Nudge theory, popularized by Thaler and Sunstein, suggests nudges are often unavoidable in decision-making.
• Schlomo Cohen applies this to surgical consent, arguing surgeons may inevitably nudge patients.
• Cohen posits that nudging toward surgery, when deemed best, is morally permissible due to unavoidability.

Purpose of the Study:

• To critically evaluate the 'Unavoidability Argument' as applied to nudges in informed consent.
• To challenge the assertion that nudges in the context of surgical consent are always inevitable.
• To explore the ethical implications of unavoidable versus avoidable nudges in medical decision-making.

Main Methods:

• Philosophical argumentation and ethical analysis.
• Deconstruction of the 'Unavoidability Argument' presented by Cohen.
• Examination of the concept of 'avoidability' in the context of medical nudging.

Main Results:

• The study contends that many instances labeled as 'unavoidable nudges' in informed consent are, in fact, avoidable.
• It questions the ethical justification for nudging patients toward surgery based solely on the premise of unavoidability.
• The findings suggest a need to re-evaluate the ethical permissibility of nudges when alternatives exist.

Conclusions:

• The 'Unavoidability Argument' for nudging in informed consent is not universally applicable.
• Surgeons and ethicists should critically assess whether nudges are truly unavoidable or if alternative, less coercive methods can be employed.
• Rethinking the inevitability of nudges is crucial for upholding the principles of truly informed consent.