Libertarian paternalism describes the idea of nudging—that is, steering individual decision-making while preserving freedom of choice. In medicine, libertarian paternalism has gained widespread attention, specifically with respect to interventions designed to promote healthy behaviours. Some scholars argue that nudges appropriately balance autonomy and paternalistic beneficence, while others argue that nudges inherently exploit cognitive weaknesses. This paper further explores the ethics of libertarian paternalism in public health. The use of nudges may infringe on an individual’s voluntary choice, autonomy and informed consent, (...) but they are ethically justified when there is a clear public health benefit to the manipulation of choice. (shrink)

> The bullshitter may not deceive us, or even intend to do so, either about the facts or about what he takes the facts to be. What he does necessarily attempt to deceive us about is his enterprise. His only indispensably distinctive characteristic is that in a certain way he misrepresents what he is up to. 1 - Harry Frankfurt In both lying and truth-telling, the speaker intends the audience to believe what she says is true; that her enterprise is (...) to inform her audience. In contrast, the speaker who bullshits doesn’t care whether the audience believes what she says, rather she intends her audience to believe or do something else—to think highly of her, to buy what she is selling, or the like. I argue that nudging is incompatible with securing genuine informed consent.2 I assume, but do not argue, that informed consent requires truth-telling during adequate disclosure. When a physician nudges, her intention is to irrationally influence her patient’s choice, not inform. Because of this, nudging cannot be understood as truth-telling ; rather it is essentially bullshit.1 In " Truth be told," Jennifer Blumenthal-Barby and Peter A Ubel argue that not all nudging is incompatible with truth-telling, contending that ‘nudges can be bullshit,’ but that ‘nudging does not require bullshitting.’3 They ask us to consider the following: Vaccination: Consider a physician who wants her patient to get a vaccine. She tells him why the vaccine is important, by providing factually correct information about the vaccine. In other words, she engages in informed disclosure aimed at enhancing the patient’s understanding. At the same time, she also tells the patient that the majority of people his age get the vaccine. In other words, she engages in nudging the patient by …. (shrink)