Policymakers, employers, insurance companies, researchers, and health care providers have developed an increasing interest in using principles from behavioral economics and psychology to persuade people to change their health-related behaviors, lifestyles, and habits. In this article, we examine how principles from behavioral economics and psychology are being used to nudge people (the public, patients, or health care providers) toward particular decisions or behaviors related to health or health care, and we identify the ethically relevant dimensions that should be considered for (...) the utilization of each principle. (shrink)

In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats—or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the (...) broad middle terrain—and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the “manipulation” label and relabeling this space “nonargumentative]influence,” with two subtypes: “reason-bypassing” and “reason-countering.” Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to the surgery. (shrink)

A teacher controls the release of materials in attempt to get students to appreciate the appeal of a popular yet wrongheaded argument before exposing them to its shortcomings. An instructor uses body language, tone of voice, and images in a Power-Point presentation that appeal to non-deliberative mechanisms in order to influence the students to pay more attention, maintain their focus, or to remember the content better. How do we draw the line between such innocuous educational practices and problematic manipulation, such (...) as deterring students from questioning certain views by instilling fear or shame? I help answering this question by illuminating one significant danger, which hasn’t been accurately identified in the relevant literature: the danger that manipulations in education—even when they’re non-deceptive and aim for the good of the students—will hinder the development or fulfillment of the students’ deliberative projects. (shrink)

At the most general level, "manipulation" refers one of many ways of influencing behavior, along with (but to be distinguished from) other such ways, such as coercion and rational persuasion. Like these other ways of influencing behavior, manipulation is of crucial importance in various ethical contexts. First, there are important questions concerning the moral status of manipulation itself; manipulation seems to be mor- ally problematic in ways in which (say) rational persuasion does not. Why is this so? Furthermore, the notion (...) of manipulation has played an increasingly central role in debates about free will and moral responsibility. Despite its significance in these (and other) contexts, however, the notion of manipulation itself remains deeply vexed. I would say notoriously vexed, but in fact direct philosophical treatments of the notion of manipulation are few and far between, and those that do exist are nota- ble for the sometimes widely divergent conclusions they reach concerning what it is. I begin by addressing (though certainly not resolving) the conceptual issue of how to distinguish manipulation from other ways of influencing behavior. Along the way, I also briefly address the (intimately related) question of the moral status of manipulation: what, if anything, makes it morally problematic? Then I discuss the controversial ways in which the notion of manipulation has been employed in contemporary debates about free will and moral responsibility. (shrink)

ABSTRACTThe aim of this paper is to draw attention to an issue which has been largely overlooked in contemporary just war theory – namely the impact that the conditions under which an army is assembled are liable to have on the judgments that are made with respect to traditional principles of jus ad bellum and jus in bello. I argue that the way in which an army is assembled can significantly alter judgments regarding the justice of a war. In doing (...) so, I present and defend a principle of ‘just assembly’ and argue that satisfying this principle is an essential part of any deliberation regarding the justice of a particular conflict. (shrink)

In this article, we argue that rational persuasion can be a _pro tanto_ wrong and that online platforms possess features that are especially conducive to this wrong. We begin by setting out an account of rational persuasion. This consists of four jointly sufficient conditions for rational persuasion and is intended to capture the core, uncontroversial cases of such persuasion. We then discuss a series of wrong-making features which are present in methods of influence commonly thought of as _pro tanto_ wrong, (...) such as manipulation and paternalism. It is next shown that these wrong-making features are also present in a range of cases that are, by the jointly sufficient conditions already established, rational persuasion, and so some forms of rational persuasion are _pro tanto_ wrong, including in some ways that have not previously been remarked upon. Finally, we demonstrate that online settings possess a number of features that are especially conducive to wrongful rational persuasion. (shrink)

According to many accounts, propaganda is a variety of politically significant signal with a distinctive connection to irrationality. This irrationality may be theoretical, or practical; it may be supposed that propaganda characteristically elicits this irrationality anew, or else that it exploits its prior existence. The view that encompasses such accounts we will call irrationalism. This essay presents two classes of propaganda that do not bear the sort of connection to irrationality posited by the irrationalist: hard propaganda and propaganda by the (...) deed. Faced with these counterexamples, some irrationalists will offer their account of propaganda as a refinement of the folk concept rather than as an attempt to capture all of its applications. The author argues that any refinement of the concept of propaganda must allow the concept to remain essentially political, and that the irrationalist refinement fails to meet this condition. (shrink)

Many argue that consumers possess a “right to know” when products contain ingredients derived from genetically modified organisms, on the grounds that it would protect consumer autonomy. In this paper, I critically evaluate that claim. I begin by providing a version of the “consumer autonomy” argument, showing that its success relies on ambiguities in the notion of autonomy. I then distinguish four approaches to autonomy and articulate the circumstances under which they would support active disclosure of a product property. I (...) argue that none of these conceptions would support active disclosure of the presence of ingredients derived from genetically modified organisms. (shrink)