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Truth be told: not all nudging is bullshit
  1. Jennifer Blumenthal-Barby1,
  2. Peter A Ubel2
  1. 1 Baylor College of Medicine, Center for Medical Ethics and Health Policy, Houston, Texas, USA
  2. 2 Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina, USA
  1. Correspondence to Professor Jennifer Blumenthal-Barby, Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX 77030, USA; jsswinde{at}

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‘The fact about himself that the bullshitter hides, on the other hand, is that the truth-values of his statements are of no central interest to him; what we are not to understand is that his intention is neither to report the truth nor conceal it. It is just this lack of connection to a concern with truth—this indifference to how things really are—that is the essence of bullshit.’1

          —Harry Frankfurt

In his paper, Nudging, informed consent, and bullshit, William Simkulet accuses doctors of being bullshitters when they knowingly influence patient decision making through means other than argument and reasoning, that is, through ‘nudges.’ In these instances, he contends that they care little about patient understanding or communicating the truth about the options and, instead, care only about presenting alternatives in ways that cause patients to do what the physicians think they should do.2

However, doctors can intend to enhance patient understanding at the same time that they try to influence patients’ choices. Consider a physician who wants her patient to get a vaccine. …

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  • Contributors All authors meet authorship criteria for this paper.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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