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)

Manipulative actions come in a bewildering variety of forms: direct and indirect deception, playing on emotions, tempting, inciting, and so on. It is not obvious what feature all these actions share in virtue of which they are all of the same kind and in virtue of which they are all morally wrong. This article argues that all manipulative actions are cases in which the manipulator attempts to lead the victim astray by trying to get her to have emotions, beliefs, or (...) desires that, as the manipulator sees it, are not ideal for the victim. To attempt to lead a person astray in this way is to fail to respect the moral and rational agency of the victim. This analysis captures the fact that actions of many kinds--and with many different psychological effects--can be manipulative, and it tells us what is wrong with acting manipulatively. It also helps distinguish manipulation from non rational persuasion. (shrink)

The Metaphysics of Morals is Kant's major work in applied moral philosophy in which he deals with the basic principles of rights and of virtues. It comprises two parts: the 'Doctrine of Right', which deals with the rights which people have or can acquire, and the 'Doctrine of Virtue', which deals with the virtues they ought to acquire. Mary Gregor's translation, revised for publication in the Cambridge Texts in the History of Philosophy series, is the only complete translation of the (...) whole text, and includes extensive annotation on Kant's difficult and sometimes unfamiliar vocabulary. A new introduction by Roger Sullivan sets the work in its historical and philosophical context. This volume will be of wide interest to students of ethics and of legal and political philosophy. (shrink)

What is that makes an act subject to either praise or blame? The question has often been taken to depend entirely on the free will debate for an answer, since it is widely agreed that an agent’s act is subject to praise or blame only if it was freely willed, but moral theory, action theory, and moral psychology are at least equally relevant to it. In the last quarter-century, following the lead of Harry Frankfurt’s (1971) seminal article “Freedom of the (...) Will and the Concept of a Person,” the interdisciplinary nature of the question has been emphasized by various authors. Going beyond the boundaries of the traditional free will debate, they have attempted to describe the requirements for agent accountability by appeal to theories of personality, rational agency, and ethical choice. The approach has been a breath of fresh air in the often-stagnant free will debate, bringing new considerations to bear and provoking new lines of argument, and it is an approach that we will adopt in this paper. In the following pages, we hope to show that an under-noticed phenomenon of moral psychology, inverse akrasia, exemplified by Huckleberry Finn, has something to contribute to the understanding of agency and accountability. After presenting the phenomenon in section I, we will move in section II to a quick survey of a family of Frankfurt-inspired views and a critique of them based on the phenomenon in sections III and IV. A new theory will be offered in section V, and potential objections addressed in the final section of the paper. (shrink)

In the subsequent pages, I want to develop a distinction between wanting and valuing which will enable the familiar view of freedom to make sense of the notion of an unfree action. The contention will be that, in the case of actions that are unfree, the agent is unable to get what he most wants, or values, and this inability is due to his own "motivational system." In this case the obstruction to the action that he most wants to do (...) is his own will. It is in this respect that the action is unfree: the agent is obstructed in and by the very performance of the action. (shrink)

In their recently published book Nudge (2008) Richard H. Thaler and Cass R. Sunstein (T&S) defend a position labelled as ‘libertarian paternalism’. Their thinking appeals to both the right and the left of the political spectrum, as evidenced by the bedfellows they keep on either side of the Atlantic. In the US, they have advised Barack Obama, while, in the UK, they were welcomed with open arms by the David Cameron's camp (Chakrabortty 2008). I will consider the following questions. What (...) is Nudge? How is it different from social advertisement? Does Nudge induce genuine preference change? Does Nudge build moral character? Is there a moral difference between the use of Nudge as opposed to subliminal images to reach policy objectives? And what are the moral constraints on Nudge? (shrink)

This book provides a comprehensive, systematic theory of moral responsibility. The authors explore the conditions under which individuals are morally responsible for actions, omissions, consequences, and emotions. The leading idea in the book is that moral responsibility is based on 'guidance control'. This control has two components: the mechanism that issues in the relevant behavior must be the agent's own mechanism, and it must be appropriately responsive to reasons. The book develops an account of both components. The authors go on (...) to offer a sustained defense of the thesis that moral responsibility is compatible with causal determinism. (shrink)

This essay has three general themes. The first involves the claim that nudging threatens human agency. My basic response is that human agency is fully retained (because nudges do not compromise freedom of choice) and that agency is always exercised in the context of some kind of choice architecture. The second theme involves the importance of having a sufficiently capacious sense of the category of nudges, and a full appreciation of the differences among them. Some nudges either enlist or combat (...) behavioral biases but others do not, and even among those that do enlist or combat such biases, there are significant differences. The third general theme is the need to bring various concerns (including ethical ones) in close contact with particular examples. A legitimate point about default rules may not apply to warnings or reminders. An ethical objection to the use of social norms may not apply to information disclosure. Here as elsewhere, abstraction can be a trap. We continue to learn about the relevant ethical issues, about likely public reactions to nudging, and about differences across cultures and nations. Future progress will depend on a high level of concreteness, perhaps especially in dealing with the vexing problem of time-inconsistency. (shrink)

Choice architecture is heralded as a policy approach that does not coercively reduce freedom of choice. Still we might worry that this approach fails to respect individual choice because it subversively manipulates individuals, thus contravening their personal autonomy. In this article I address two arguments to this effect. First, I deny that choice architecture is necessarily heteronomous. I explain the reasons we have for avoiding heteronomous policy-making and offer a set of four conditions for non-heteronomy. I then provide examples of (...) nudges that meet these conditions. I argue that these policies are capable of respecting and promoting personal autonomy, and show this claim to be true across contrasting conceptions of autonomy. Second, I deny that choice architecture is disrespectful because it is epistemically paternalistic. This critique appears to loom large even against non-heteronomous nudges. However, I argue that while some of these policies may exhibit epistemically paternalistic tendencies, these tendencies do not necessarily undermine personal autonomy. Thus, if we are to find such policies objectionable, we cannot do so on the grounds of respect for autonomy. (shrink)

In recent years, ‘nudge’ theory has gained increasing attention for the design of population-wide health interventions. The concept of nudge puts a label on efficacious influences that preserve freedom of choice without engaging the influencees’ deliberative capacities. Given disagreements over what it takes genuinely to preserve freedom of choice, the question is whether health influences relying on automatic cognitive processes may preserve freedom of choice in a sufficiently robust sense to be serviceable for the moral evaluation of actions and policies. (...) In this article, I offer an argument to this effect, explicating preservation of freedom of choice in terms of choice-set preservation and noncontrol. I also briefly explore the healthcare contexts in which nudges may have priority over more controlling influences. (shrink)

I investigate whether tobacco health warnings’ interference with autonomy is ethically justifiable in order to deter people from smoking. I dissociate first the informational role and the persuasive role of tobacco health warnings and show that both roles enable typical addicted smokers to better rule themselves, fostering their autonomy. The fact that some messages address people’s non-deliberative faculties is therefore compensated by a larger positive influence on their autonomy. However, misleading messages are not ethically justified and should be avoided. Tobacco (...) health warnings’ effect on autonomy highlights an important difference between libertarian paternalism and classical paternalism. (shrink)

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)

The nudge approach seeks to improve people’s decisions through small changes in their choice environments. Nudge policies often work through psychological mechanisms that deviate from traditional notions of rationality. Because of that, some critics object that nudging treats people as irrational. Such treatment might be disrespectful in itself and might crowd out more empowering policies. I defend nudging against these objections. By defending a nonstandard, ecological model of rationality, I argue that nudging not only is compatible with rational agency but (...) can even support it. Accordingly, a concern with rationality speaks for more rather than less public policy nudging. (shrink)

Research in psychology and behavioral economics shows that individuals’ choices often depend on “irrelevant” contextual factors. This presents problems for normative economics, which has traditionally used preference-satisfaction as its criterion. A common response is to claim that individuals have context-independent latent preferences which are “distorted” by psychological factors, and that latent preferences should be respected. This response implicitly uses a model of human action in which each human being has an “inner rational agent.” I argue that this model is psychologically (...) ungrounded. Although references to latent preferences appear in psychologically based explanations of context-dependent choice, latent preferences serve no explanatory purpose. (shrink)

In this paper I argue that the use of social nudges, policy interventions to induce voluntary cooperation in social dilemma situations, can be defended against two ethical objections which I call objections from coherence and autonomy. Specifically I argue that the kind of preference change caused by social nudges is not a threat to agents’ coherent preference structure, and that there is a way in which social nudges influence behavior while respecting agents’ capacity to reason. I base my arguments on (...) two mechanistic explanations of social nudges; the expectation-based and frame-based accounts. As a concrete example of social nudges I choose the “Don’t Mess With Texas” anti-littering campaign and discuss in some detail how it worked. (shrink)

Nudging is considered a promising approach for behavioural change. At the same time, nudging has raised ethical concerns, specifically in relation to the impact of nudges on autonomous choice. A complexity is that in this debate authors may appeal to different understandings or dimensions of autonomy. Clarifying the different conceptualisations of autonomy in ethical debates around nudging would help to advance our understanding of the ethics of nudging. A literature review of these considerations was conducted in order to identify and (...) differentiate between the conceptualisations of autonomy. In 33 articles on the ethics of nudging, we identified 280 autonomy considerations, which we labelled with 790 unique autonomy codes and grouped under 61 unique super-codes. Finally, we formulated three general conceptualisations of autonomy. Freedom of choice refers to the availability of options and the environment in which individuals have to make choices. Agency involves an individual's capacity to deliberate and determine what to choose. Self-constitution relates to someone's identity and self-chosen goals. In the debate about the ethics of nudging, authors refer to different senses of autonomy. Clarifying these conceptualisations contributes to a better understanding of how nudges can undermine or, on the other hand, strengthen autonomy. (shrink)