4.3 Article

Public health nudges: weighing individual liberty and population health benefits

Journal

JOURNAL OF MEDICAL ETHICS
Volume 47, Issue 11, Pages 756-760

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/medethics-2020-106077

Keywords

public health ethics; coercion; decision-making; informed consent; public policy

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Libertarian paternalism involves nudging individuals while maintaining freedom of choice, particularly in promoting healthy behaviors in medicine. Ethical debates surround the use of nudges, with some arguing they balance autonomy and paternalistic beneficence, while others see them as exploiting cognitive weaknesses. Nudges are considered ethically justified in public health when there is a clear benefit to manipulating choice, despite concerns about infringing on autonomy and informed consent.
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.

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