Nudging: Influence Without Manipulation

EthicsLab

What type of influence should physicians, nurses and patients have on tough choice healthcare decisions? Clinicians want to offer their experience and their competence, so should they be neutral and simply support patient decisions? What type of influence would be helpful and what type would be inappropriate, coercive, or biased? In this episode, our guests explore these questions and a behavioral economics tool called “nudging”. Nudges are subtle changes to the design, framing of information, and decision options that can influence behaviors. These subtle changes, stemming from decision psychology, enable clinicians to inform patients of their options, while at the same time, being very intentional about avoiding manipulation of patient decisions.

Our guests in this episode include:

• Joanna Hart, assistant professor of medicine and medical ethics and Health Policy at the University of Pennsylvania and core faculty of the palliative and advanced illness Research Center at Penn
• Jennifer Blumenthal-Barby, professor of medical ethics at Baylor College of Medicine
• Dr. Aliza Olive, pediatric intensivist currently working in Kansas City, Missouri

This episode was recorded in December 2021.

Additional resources relating to or referenced in this episode:

• Penn Medicine Nudge Unit
• Nudging for Ethics, Applying Small Changes To Promote Ethical Outcomes, University of Notre Dame
• The ethics of nudging: An overview, by Andreas T. Schmidt
• Good Ethics and Bad Choices: The Relevance of Behavioral Economics for Medical Ethics, by Jennifer Blumenthal-Barby
• The Ethics of Nudging, by Cass R. Sunstein
• Nudge Units to Improve the Delivery of Health Care, by Mitesh S. Patel, Kevin G. Volpp, and David A. Asch
• Designing Nudges for Success in Health Care, by Joseph D. Harrison