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Shove and Nudge: A Commentary on Iserson
1Associate Professor, Department of Historical, Philosophical and Religious Studies, Umeå University, Umeå, Sweden. kalle.grill@umu.se.
The Journal of Clinical Ethics
|March 28, 2020
Summary
This comment explores the ethics of nudging in patient care, defining it as persuasive advice and trust-building. While not inherently unethical, nudging can potentially limit patient autonomy and liberty.
Area of Science:
- Medical Ethics
- Behavioral Science
- Health Communication
Background:
- Kenneth Iserson's article "Do You Believe in Magic? Shove, Don't Nudge: Advising Patients at the Bedside" prompts a discussion on nudging.
- Nudging in healthcare involves influencing patient choices through subtle recommendations.
Purpose of the Study:
- To define nudging in the context of patient-clinician interactions.
- To morally evaluate the practice of nudging in healthcare.
- To propose that persuasive communication and trust-building constitute nudging.
Main Methods:
- Commentary on existing literature.
- Analysis of the definition and ethical implications of nudging.
- Discussion of persuasive communication and trust-building strategies.
Main Results:
- Nudging, defined as persuasive descriptions and trust-building, is not inherently morally problematic.
- Nudging can be controlling and may limit patient liberty, contrary to some proponents' claims.
- Clinicians should provide explicit advice and be aware of subtle psychological effects.
Conclusions:
- Nudging requires careful ethical consideration.
- Clinicians must balance providing advice with respecting patient autonomy.
- Awareness of psychological impacts is crucial for ethical patient communication.
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