Traditional medical practices and relationships are changing given the widespread adoption of AI-driven technologies across the various domains of health and healthcare. In many cases, these new technologies are not specific to the field of healthcare. Still, they are existent, ubiquitous, and commercially available systems upskilled to integrate these novel care practices. Given the widespread adoption, coupled with the dramatic changes in practices, new ethical and social issues emerge due to how these systems nudge users into making decisions and changing (...) behaviours. This article discusses how these AI-driven systems pose particular ethical challenges with regards to nudging. To confront these issues, the value sensitive design approach is adopted as a principled methodology that designers can adopt to design these systems to avoid harming and contribute to the social good. The AI for Social Good factors are adopted as the norms constraining maleficence. In contrast, higher-order values specific to AI, such as those from the EU High-Level Expert Group on AI and the United Nations Sustainable Development Goals, are adopted as the values to be promoted as much as possible in design. The use case of Amazon Alexa's Healthcare Skills is used to illustrate this design approach. It provides an exemplar of how designers and engineers can begin to orientate their design programs of these technologies towards the social good. (shrink)

Andreas Schmidt and Neil Levy have recently defended nudging against the objection that nudges fail to treat nudgees as rational agents. Schmidt rejects two theses that have been taken to support the objection: that nudges harness irrational processes in the nudgee, and that they subvert the nudgee’s rationality. Levy rejects a third thesis that may support the objection: that nudges fail to give reasons. I argue that these defences can be extrapolated from nudges to some nonconsensual neurointerventions; if Schmidt’s and (...) Levy’s defences succeed, then some nonconsensual neurointerventions neither harness irrationality, nor subvert rationality, nor fail to give reasons. This, I claim, poses a challenge both to opponents of nonconsensual neurointerventions, and to defenders of nudging. (shrink)

This paper offers a theoretical framework that can be used to derive viable engineering strategies for the design and development of robots that can nudge people towards moral improvement. The framework relies on research in developmental psychology and insights from Stoic ethics. Stoicism recommends contemplative practices that over time help one develop dispositions to behave in ways that improve the functioning of mechanisms that are constitutive of moral cognition. Robots can nudge individuals towards these practices and can therefore help develop (...) the dispositions to, for example, extend concern to others, avoid parochialism, etc. (shrink)

Can Artificial Intelligence be more effective than human instruction for the moral enhancement of people? The author argues that it only would be if the use of this technology were aimed at increasing the individual's capacity to reflectively decide for themselves, rather than at directly influencing behaviour. To support this, it is shown how a disregard for personal autonomy, in particular, invalidates the main proposals for applying new technologies, both biomedical and AI-based, to moral enhancement. As an alternative to these (...) proposals, this article proposes a virtual assistant that, through dialogue, neutrality and virtual reality technologies, can teach users to make better moral decisions on their own. The author concludes that, as long as certain precautions are taken in its design, such an assistant could do this better than a human instructor adopting the same educational methodology. (shrink)

Many of our daily activities are now made more convenient and efficient by virtual assistants, and the day when they can be designed to instruct us in certain skills, such as those needed to make moral judgements, is not far off. In this paper we ask to what extent it would be ethically acceptable for these so-called virtual assistants for moral enhancement to use subtle strategies, known as “nudges”, to influence our decisions. To achieve our goal, we will first characterise (...) nudges in their standard use and discuss the debate they have generated around their possible manipulative character, establishing three conditions of manipulation. Secondly, we ask whether nudges can occur in moral virtual assistants that are not manipulative. After critically analysing some proposed virtual assistants, we argue in favour of one of them, given that by pursuing an open and neutral moral enhancement, it promotes and respects the autonomy of the person as much as possible. Thirdly, we analyse how nudges could enhance the functioning of such an assistant, and evaluate them in terms of their degree of threat to the subject’s autonomy and their level of transparency. Finally, we consider the possibility of using motivational nudges, which not only help us in the formation of moral judgements but also in our moral behaviour. (shrink)

Acceding to the demand that public policy should be based on “the best available evidence” can come at significant moral cost. Important policy questions cannot be addressed using “the best available evidence” as defined by the evidence-based policy paradigm; the paradigm can change the meaning of questions so that they can be addressed using the preferred kind of evidence; and important evidence that does not meet the standard defined by the paradigm can get ignored. We illustrate these problems in three (...) contexts of evidence-based policy. (shrink)

Is implementing the beneficent nudge program morally permissible in worlds like ours? I argue that there is reason for serious doubt. I acknowledge that beneficent nudging is highly various, that nudges are in some circumstances morally permissible and even called for, and that nudges may exhibit respect for genuine autonomy. Nonetheless, given the risk of epistemic injustice that nudges typically pose, neither the moral permissibility of beneficent nudging in the abstract, nor its case-by-case vindication, appears sufficient to justify implementing a (...) nudge program in worlds like ours. Drawing on Miranda Fricker’s account of epistemic injustice, I argue that the cogent defense of any nudge program, relative to worlds like ours, stands in need of serious attention to its potential for fostering or sustaining epistemic injustice. A more specific point hinges on recognizing a form of epistemic injustice not enough attended to in the literature to date, which I call reflective incapacitational injustice. This includes relative disadvantages in the attaining of the capacity to engage in critical reason, such as the capacity to go in for potentially critical reasoned deliberation and discursive exchange concerning ends. Since Cass Sunstein’s First Law of behaviorally informed regulation would be taken, in worlds like ours, to justify indeterminately many nudges leading to such epistemic injustice we have general grounds for doubting the moral permissibility of this nudge program. We should hence oppose the implementation of any such program until it is shown not to violate the demands of epistemic justice. (shrink)

Organisations increasingly use digital nudges to influence their workforces’ behaviour without coercion or incentives. This can expose employees to arbitrary domination by infringing on their autonomy through manipulation and indoctrination. Nudges might furthermore give rise to the phenomenon of “organised immaturity.” Adopting a balanced approach between overly optimistic and dystopian standpoints, I propose a framework for determining the moral permissibility of digital nudging in the workplace. In this regard, I argue that not only should organisations provide pre-discursive justification of nudges (...) but they should also ensure that employees can challenge their implementation whenever necessary through legitimation procedures. Building on Rainer Forst’s concept of the right to justification, this article offers a way to combine contract- and deliberation-based theories for addressing questions in business ethics. I further introduce the concept of meta-autonomy as a capacity that employees can acquire to counter threats of arbitrary domination and to mitigate organised immaturity. (shrink)

As behavioural economics reveals, human decision-making deviates from neoclassical assumptions about human behaviour and people (often) fail to make the ‘right’ welfare-enhancing choice. The purpose of Sunstein and Thaler’s concept of ‘nudge’ is to improve individual welfare. To provide normative justification, they argue that the only relevant normative criterion is whether the individual is ‘better off as judged by themselves’, so that the direction in which people are to be nudged is defined by their own preferences. In light of behavioural (...) findings, however, people’s choices do not provide a sound basis for eliciting preferences and thus for assessing welfare. In this paper, I aim to challenge Sunstein and Thaler’s normative view, arguing that it is unreasonable to rely on conventional welfare economics, particularly considering the given context. Sunstein and Thaler depend on an approach of ‘preference purification’ which assumes informed, latent, and true preferences: As a result they face crucial methodological, epistemological, and practical objections, and cannot show how their approach enhances individual welfare. By building on the concepts of R. Sugden and C. Schubert, I develop an alternative normative framework for behavioural public policy, based on a contractualist perspective in which people may consent to collective choice rules in order to align future behaviour with values, to achieve particular goals or to preserve personal integrity. Individual consent and citizens’ participation and deliberation are crucial to this approach. This contractualist approach may provide a normative justification for behavioural public policy, and help to reconcile behavioural and normative economics. (shrink)

In discussions of nudging, transparency is often taken to be important; it is often suggested that a significant moral consideration to take into account when nudging is whether the nudge is transparent. Another consideration taken to be relevant is whether the nudge is easy to resist. Sometimes, these two considerations are taken to be importantly related: if we have reason to make nudges easy to resist, then we have reason to make them transparent, insofar as a nudge’s transparency is relevant (...) to whether the nudge is easy to resist. In this paper, we critically scrutinize this view. First, we draw out the purported connections between transparency and resistibility, combining them into what we call the Resistibility-to-Transparency Argument (RTA). Then, we do some conceptual groundwork elaborating on different forms of transparency mentioned in the debate. With this in place, we argue that in order to be plausible, the RTA must appeal to certain forms of transparency; those on which the transparency of a nudge depends on the nudgee’s ability to become aware of the relevant facts about the nudge. We then argue against the common assumption that in order for a nudge to be easy to resist for an individual, that individual needs to have the capacity to easily become aware of the relevant nudge facts. We conclude that the connection between the easy resistibility of a nudge and its transparency is, at best, a weak one. (shrink)

Behavioral economics is the latest trendy form of economics. Increasingly theorists are advocating using behavioral economics to do normative ethics or claiming that the behavioralists’ findings render normative claims otiose. I argue in this paper that we should be extremely wary when it comes to accepting any such normative pronouncements. I argue that behavioral economics: (a) minimizes and/or misunderstands the role that character and architectonic life goals play in accounting for the why of ethical behavior, (b) fundamentally misconceives human practical (...) rationality, (c) often unduly narrows the range of human action and choice, (d) misleadingly assumes that options are merely given to us rather than generated by us in accordance with our character, (e) is parasitic upon normative ethics, (f) results in an unhelpful ad hoc approach to ethical thinking, which is unlikely to prove all that useful and may even dangerously mislead ordinary agents or those who operate corporate compliance programs and who seek to improve corporate cultures, and (g) ignores the key role played in ethical behavior by meso‐ and macro‐factors. (shrink)

As the use of nudges by governmental agencies becomes more common, the need for normative guidelines regarding the processes by which decisions about the implementation of specific nudges are taken becomes more acute. In order to find a justified set of such guidelines one must meet several theoretical challenges to Libertarian Paternalism that arise at the foundational level. In this paper, I identify three central challenges to Libertarian Paternalism, and suggest that Susan Hurley's political philosophy as presented in her Natural (...) Reasons (1989) can be viewed as offering powerful responses to them. (shrink)

In this article, we discuss the role that ‘true preferences’ can and should play in discussions on the possibility and desirability of paternalist nudges. Critics have claimed that such preferences do not exist, cannot be known reliably by third parties, and cannot justify whether and how to nudge people. In this article, we argue that these objections undermine the extent to which philosophers and laypeople can make sense of autonomy and authenticity. We aim to identify what kinds of preferences can (...) plausibly be labelled ‘true’ and how that impacts discussions on the ethics of paternalist nudging. We analyse what ‘true preferences’ can mean, not for Econs, but for Humans, and argue, more specifically, that some of our existing preferences have special status. In addition, we argue that satisfying them is good for individuals and that nudgers should seek to overcome the epistemic challenges of discovering their content. (shrink)

BackgroundThe advent of learning healthcare systems (LHSs) raises an important implementation challenge concerning how to request and manage consent to support secondary use of data in learning cycles, particularly research activities. Current consent models in Quebec were not established with the context of LHSs in mind and do not support the agility and transparency required to obtain consent from all involved, especially the citizens. Therefore, a new approach to consent is needed. Previous work identified the meta-consent model as a promising (...) alternative to fulfill the requirements of LHSs, particularly large-scale deployments. We elicited the public’s attitude toward the meta-consent model to evaluate if the model could be understood by the citizens and would be deemed acceptable to prepare for its possible implementation in Quebec.MethodsEight focus groups, with a total of 63 members of the general public from various backgrounds were conducted in Quebec, Canada, in 2019. Explicit attention was given to literacy levels, language spoken at home and rural vs urban settings. We assessed attitudes, concerns and facilitators regarding key components of the meta-consent model: predefined categories to personalized consent requests, a dynamic web-based infrastructure to record meta-consent, and default settings. To analyse the discussions, a thematic content analysis was performed using a qualitative software.ResultsOur findings showed that participants were supportive of this new approach of consent as it promotes transparency and offers autonomy for the management of their health data. Key facilitators were identified to be considered in the implementation of a meta-consent model in the Quebec LHSs: information and transparency, awareness campaigns, development of educational tools, collaboration of front-line healthcare professionals, default settings deemed acceptable by the society as well as close partnerships with recognized and trusted institutions.ConclusionsThis qualitative study reveals the openness of a sample of the Quebec population regarding the meta-consent model for secondary use of health data for research. This first exploratory study conducted with the public is an important step in guiding decision-makers in the next phases of implementing the various strategies to support access and use of health data in Quebec. (shrink)

:Behavioural public policy has come under fire by critics who claim that it is illiberal. Some authors recently suggest that there is a type of BPP – boosting – that is not as vulnerable to this normative critique. Our paper challenges this claim: there's no non-circular way to draw the distinction between nudge and boost that would make the normative difference required to infer the permissibility of a policy intervention from its type-membership. We consider two strategies: paradigmatic examples and causal (...) mechanisms. We conclude by sketching some suggestions about the right way to approach the normative issues. (shrink)

Adding an option is a neglected mechanism for bringing about behavioural change. This mechanism is distinct from nudges, which are changes in the choice architecture, and instead makes it possible to pursue republican paternalism, a unique form of paternalism in which choices are changed by expanding people's set of options. I argue that this is truly a form of paternalism (albeit a relatively soft one) and illustrate some of its manifestations in public policy, specifically public options and market creation. Furthermore, (...) I compare it with libertarian paternalism on several dimensions, namely respect for individuals' agency, effectiveness, and efficiency. Finally, I consider whether policymakers have the necessary knowledge to successfully change behaviour by adding options. Given that adding an option has key advantages over nudges in most if not all of these dimensions, it should be considered indispensable in the behavioural policymaker's toolbox. (shrink)

Libertarian paternalism is a weak form of paternalism that recommends nudges rather than bans, restrictions, or other strong interventions. Nudges influence people’s choice by modifying contextual factors (the “choice architecture”). This paper explores the possibility of an epistemic analogue of libertarian paternalism. What I call “epistemic libertarian paternalism” is a weak form of epistemic paternalism that recommends “epistemic nudges” rather than stronger paternalistic interventions. Epistemic nudges influence people’s beliefs and judgments by modifying contextual factors (the “epistemic choice architecture”). The main (...) aim of this paper is to defend epistemic libertarian paternalism from the “irrationality problem”, which I take to be the most urgent problem for epistemic libertarian paternalism; given how epistemic nudges work (i.e. they typically co-opt psychological biases), nudged beliefs are irrational. In response to the irrationality problem, I admit that nudged beliefs are often (not always, though) irrational, but insist that there are conditions in which epistemic nudging can be justifiable nonetheless. I will propose two conditions that are jointly sufficient for justifiable epistemic nudging: “Veridicality Condition” (which says that nudged beliefs are more likely to be true than non-nudged beliefs) and “Not-More-Irrationality Condition” (which says that nudged beliefs are not more likely to be irrational than non-nudged beliefs). (shrink)

Critics frequently argue that nudges are more covert, less transparent, and more difficult to monitor than traditional regulatory tools. Edward Glaeser, for example, argues that “[p]ublic monitoring of soft paternalism is much more difficult than public monitoring of hard paternalism”. As one of the leading proponents of soft paternalism, Cass Sunstein, acknowledges, while “[m]andates and commands are highly visible”, soft paternalism, “and some nudges in particular[,] may be invisible”. In response to this challenge, proponents of nudging argue that invisibility for (...) any given individual in a particular choice environment is compatible with “careful public scrutiny” of the nudge. This paper offers the first of its kind experimental evidence that tests whether nudges are, in fact, compatible with “careful public scrutiny”. Using three sets of experiments, the paper argues that, even when entirely visible, nudges attract less scrutiny than their “hard law” counterparts. (shrink)

Der libertäre Paternalismus befürwortet Eingriffe in die Entscheidungsfindung von Bürgern, ohne ihnen Optionen völlig nehmen zu wollen. Vielmehr soll die Lenkung des Willens durch Schubser geschehen. Im folgenden Beitrag möchte ich zeigen, dass der libertäre Paternalismus auf tönernen Füßen steht. Ich bediene mich dabei des polemischen Bilds von Quacksalbern. Dieses Bild passt zu meinem argumentativen Vorgehen, da ich erstens zeigen will, dass der libertäre Paternalismus falsche Diagnosen über vermeintliche Krankheiten der Willensbildung stellt, und zweitens, dass er die falsche Therapie empfiehlt. (...) Im ersten Teil des Artikels kritisiere ich die Diagnose des libertären Paternalismus, wonach Menschen in ihrer Entscheidungsfindung systematisch fehlschlagen. Die Auswirkungen der zugrundeliegenden psychologischen Forschung werden missinterpretiert und damit vielen menschlichen Entscheidungen eine Art Defekt zugeschrieben. Der zweite Teil des Beitrags hinterfragt die Therapie des libertären Paternalismus. Für entsprechende Interventionen in die Wahlarchitektonik muss Wissen erlangt werden über die Richtung, in welche die Menschen jeweils geschubst werden sollten. Die hier genannte epistemische Aufgabe kann mit den theoretischen Mitteln des libertären Paternalismus nicht gelöst werden. (shrink)

Nudges are means to influence the will formation of people to make specific choices more likely. My focus is on nudges that are supposed to improve the health condition of individuals and populations over and above the direct prevention of disease. I point out epistemic and moral problems with these types of nudges, which lead to my conclusion that health-enhancing nudges fail. They fail because we cannot know which choices enhance individual health—properly understood in a holistic way—and because health-enhancing nudges (...) are often themselves bad for our health. They can be bad for our health because they assume inferior agency in their targets and accordingly regularly lead to appropriate resentment and anger—strong emotions which go along with an increased risk of health impairments. Briefly, health-enhancing nudges fail because they are based on persistent ignorance and on a presumptuous attitude. (shrink)

Given that the concept of coercion remains a central concern for bioethics, Quigley's (Monash Bioethics Rev 32:141–158, 2014) recent article provides a helpful analysis of its frequent misapplication in debates over the use of ‘nudges’. In this commentary I present a generally sympathetic response to Quigley’s argument while also raising several issues that are important for the larger debates about nudges and coercion. I focus on several closely related topics, including the definition of coercion, the role of empirical research, and (...) the normative concerns at the core of these disputes. I suggest that while a degree of precision is certainly required when deploying the relevant concepts, perhaps informed by empirical data, we need to continue to push these debates towards more pressing normative considerations. (shrink)

Science is widely regarded as the most reliable epistemic source of providing knowledge about the world. Policymakers intend to make purposeful changes in the world. The practice of policymakers relying on scientific experts to make informed decisions about which policies to implement is called Evidence Based Policymaking. This thesis provides a perspective from the philosophy of science in order to discuss the justifiability of Evidence Based Policymaking (EBP) with respect to broadly democratic and liberal values. Justifying EBP with broadly democratic (...) and liberal values entails that the practices of EBP promote, or at least are in harmony with, values such as democratic governance and enhancement of people’s freedom and autonomy. Identifying the conditions under which practices of EBP meet such desiderata minimally requires an understanding of how sciences and scientific experts are instrumental in realizing the public’s values, needs, interests, and pursuit of freedom. In order to approach this project, the thesis adopts a philosophical perspective to conceptualize how sciences are supposed to be guided by or promote society’s values, needs, and interests. Specifically, it adopts a perspective from the philosophy of science that focuses on the relationship between science and (societal) values. The kind of philosophy of science perspective on “values in science” that this thesis adopts has two overarching pursuits relevant for the project of the thesis. Firstly, it seeks to inform the debates about which values and non-epistemic considerations are supposed to inform scientific research. For instance, it discusses the proper sources/owners of the non-epistemic desiderata that inform scientific research and the proper social mechanisms to identify these non-epistemic desiderata (e.g. Kourany, 2010; Kitcher, 2011). Second, it offers theories of the non-epistemic values’ proper roles in scientific reasoning and research that specify how their involvement in science does not unduly compromise the epistemic pursuits of science. The values-in-science perspective thereby seeks to balance the instrumental value of science (i.e., its use to pursue certain societal projects and values) with its epistemic authority (i.e., its objectivity, non-dogmatism, and reliability). The thesis advances an understanding of EBP from the perspective of the values in science by addressing issues that come to the fore when EBP is acknowledged as a value-laden practice of informed decision-making. (shrink)

Der Beitrag betrachtet die für die Gegenwartsgesellschaft charakteristische Orientierung an Sicherheit und Risikovermeidung vor dem Hintergrund der Reflexionen Søren Kierkegaards und Friedrich Nietzsches bezüglich der Abgründigkeit der menschlichen Existenz. Die Untersuchung wirft die Frage auf, ob die Suche nach einem im alltäglichen Sinne verstandenen „guten Leben“ letzten Endes zu Lasten der Möglichkeiten einer als sinnhaft erlebten Existenz geht.

In diesem Beitrag argumentieren wir, dass eine umfassende Implementierung sogenannter Nudges weitreichende Auswirkungen für rechtliche und politische Institutionen hat. Die wissenschaftliche Diskussion zu Nudges ist derzeit hauptsächlich von philosophischen Theorien geprägt, die im Kern einen individualistischen Ansatz vertreten. Unsere Analyse bezieht sich auf die Art und Weise, in der sich Anhänger des Nudging neuster Erkenntnisse aus den Verhaltenswissenschaften bedienen – immer in der Absicht, diese für effektives Regieren einzusetzen. Wir unterstreichen, dass die meisten Nudges, die derzeit entweder diskutiert werden oder (...) bereits implementiert sind, nicht Teil eines Rechtssystems sind und keinen normativen Charakter haben. Dazu unterscheiden wir zwischen zwei Idealtypen, um menschliches Verhalten zu beeinflussen, die wir als normativ bzw. instrumentell bezeichnen. Diese Idealtypen stehen für verschiedene Weisen, in denen öffentliche Regeln strukturiert werden können; sie erlauben uns, die institutionellen Implikationen von Nudges zu verstehen und zu bewerten. Hier betonen wir den Wert des Rechts als Absicherung gegenüber den möglichen schädlichen Konsequenzen von in der Politik und Regierungsführung eingesetzten Nudges. Unser Beitrag schließt mit Reaktionen auf einige Einwände, die unsere Vorschläge bereits erhalten haben. (shrink)

ABSTRACTThis paper focuses on unveiling the underlying conceptions required to elaborate a concept such as indirect legislation, and on possible methods of distinguishing it from direct legislation. Three elements will be put to the test to analyse whether they could be used as distinguishing criteria. Firstly, indirect legislation – like contemporary forms of indirect means to influence behaviours, such as the famous nudges of Thaler and Sunstein – relies heavily on an accurate and complete account of human nature. However, so (...) does direct legislation. Having human psychology as a foundation for legislation leads to several epistemic and evidential issues. Secondly, temporality seems initially to be a likely candidate for the sought for criterion: direct legislation, through punishment, applies after the offence, whereas indirect legislation applies before the offence, precisely in order to prevent it. However, I will show that this understanding needs to be revised. Thirdly, the solution to the difficulty might lie in resolving the issue of what is really the target of influence: what is it that indirect means attempt to modify. At the end of this paper, I will show that the difficulties faced both by Bentham and by contemporary nudge theory seem to imply that a complete re-evaluation of indirect means to influence behaviour is needed. (shrink)