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Nudging in the clinic: the ethical implications of differences in doctors’ and patients’ point of view
  1. David Avitzour1,
  2. Rani Barnea2,3,
  3. Eliana Avitzour4,
  4. Haim Cohen5,
  5. Ittay Nissan-Rozen6
  1. 1Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  2. 2Department of Neurology, Tel Aviv Medical Center, Tel Aviv, Israel
  3. 3Department of Medical Education, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
  4. 4School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
  5. 5Department of Cognitive Science and the Federmann Center for the Study of Rationality, The Hebrew University of Jerusalem, Jerusalem, Israel
  6. 6Department of Philosophy and the PEP Program, The Hebrew University of Jerusalem, Jerusalem, Israel
  1. Correspondence to David Avitzour, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 9603035, Israel; davitzour{at}gmail.com

Abstract

There is an extensive ethical debate regarding the justifiability of doctors nudging towards healthy behaviour and better health-related choices. One line of argument in favour of nudging is based on empirical findings, according to which a healthy majority among the public support nudges. In this paper, we show, based on an experiment we conducted, that, in health-related choices, people’s ethical attitudes to nudging are strongly affected by the point of view from which the nudge is considered. Significant differences have been found between doctors’ ethical attitude to clinical nudging and that of patients. We show how these differences weaken the argument for nudging from public support. Moreover, our findings raise concerns regarding doctors’ ability to nudge ethically according to their own standards, as they may underestimate the degree of harm medical nudges can cause to informed consent, doctor–patient trust and other important ethically relevant features of health-related choices.

  • informed consent
  • health promotion
  • decision-making
  • patient perspective
  • autonomy

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