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Why Health-enhancing Nudges Fail.

Thomas Schramme1

  • 1Department of Philosophy, University of Liverpool, Gillian Howie House Mulberry Street, Liverpool, L69 7SH, UK. t.schramme@liverpool.ac.uk.

Health Care Analysis : HCA : Journal of Health Philosophy and Policy
|July 21, 2023
PubMed
Summary

Health-enhancing nudges, interventions influencing choices for better health, are ineffective. They fail due to insufficient knowledge of holistic health and potential negative impacts, like causing resentment and anger, which harm well-being.

Keywords:
HealthNudgingPaternalismPublic healthSunstein

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Area of Science:

  • Public Health
  • Behavioral Economics
  • Bioethics

Background:

  • Nudges are strategies influencing choice architecture to promote desired behaviors.
  • Health-enhancing nudges aim to improve population and individual health beyond disease prevention.
  • Ethical and knowledge-based challenges exist for these nudges.

Purpose of the Study:

  • To critically evaluate the efficacy and ethical implications of health-enhancing nudges.
  • To examine the epistemic limitations in defining and promoting holistic health.
  • To assess the potential negative health consequences of implementing nudges.

Main Methods:

  • Philosophical analysis of nudge theory and its application to health.
  • Ethical critique focusing on agency, autonomy, and potential harms.
  • Examination of the relationship between emotions (resentment, anger) and health outcomes.

Main Results:

  • Health-enhancing nudges face significant epistemic challenges: defining 'health' holistically is complex.
  • Nudges can negatively impact health by fostering resentment and anger, linked to adverse health effects.
  • The underlying assumption of diminished agency in targets can be ethically problematic.

Conclusions:

  • Health-enhancing nudges are fundamentally flawed due to persistent ignorance and a presumptuous approach.
  • The effectiveness and ethical justification of nudges for health improvement remain questionable.
  • A more nuanced understanding of health and respect for individual agency are needed.