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Physicians’ framing and recommendations. Are they nudging? And do they violate the requirements of informed consent?
  1. Thomas Ploug
  1. Correspondence to Dr Thomas Ploug, Department of Communication, Centre for Applied Ethics and Philosophy of Science, Aalborg University Copenhagen, København S 2450, Denmark; ploug{at}

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In his recent article ‘Nudging, Informed Consent and Bullshit’, William Simkulet1 convincingly argues that certain types of nudging satisfy Frankfurt’s criteria of bullshit. As a prelude to this argument, Simkulet considers whether recommendations and framing are types of nudging and whether they satisfy the requirement of adequate disclosure essential for a valid informed consent. He defines nudging as the systematic attempt at altering behaviour by non-rational means, and describes adequate disclosure as providing the patient with true information that enables an understanding of treatment options and their risks and benefits. Simkulet argues that recommendations and framing are types of rational persuasion in that they potentially enhance patients’ understanding of treatment options and their risks and benefits. Therefore, (1) not only do they not qualify as nudging, but (2) they may be required in order to secure adequate disclosure. In this brief comment, I focus on Simkulet’s considerations of framing and show that framing may be nudging and that it may violate the requirements of informed consent.

Simkulet on framing

The framing of medical information may influence patients’ preferences for treatment. It has been shown that framing information about a risky medical intervention in chance of survival rather than risk of death increases patients’ preferences for the intervention.2 3 In his exploration of framing, Simkulet contends that the fact that people respond differently to …

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  • Contributors TP is the sole author.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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