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Blameworthy bumping? Investigating nudge's neglected cousin
Journal of Medical Ethics
|January 12, 2019
Summary
Doctors can unintentionally harm patients through "bumping," a form of non-rational influence. This systematic, unintentional influence, particularly in medical decisions, can lead to patient harm and potential blameworthiness for healthcare providers.
Area of Science:
- Behavioral Economics
- Medical Ethics
- Decision Science
Background:
- Non-rational influence, including nudging, shapes choices in various domains.
- Unintentional non-rational influence, termed 'bumping,' occurs when individuals' decisions are affected by others in their environment.
- This phenomenon is prevalent in healthcare settings, impacting patient treatment choices.
Purpose of the Study:
- Introduce and define the concept of 'bumping' as unintentional non-rational influence.
- Explore the implications of bumping in the context of medical decision-making.
- Argue for the potential blameworthiness of healthcare providers who systematically bump patients towards harmful decisions.
Main Methods:
- Conceptual analysis of non-rational influence and decision-making.
- Examination of medical overuse as a case study for bumping.
- Ethical argumentation regarding unintentional influence and responsibility.
Main Results:
- Bumping is a constant feature of environments where people make choices influenced by others.
- Doctors can unintentionally 'bump' patients towards suboptimal treatment decisions.
- Systematic bumping towards harm, as seen in medical overuse, raises ethical concerns about provider blameworthiness.
Conclusions:
- The concept of bumping offers a new lens for understanding unintentional influence in healthcare.
- Healthcare providers may be blameworthy for systematically bumping patients towards medical overuse.
- Further research is needed to identify and mitigate harmful bumping in clinical practice.
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