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)

In this article, we address the relevance of J.S. Mill’s political philosophy for a framework of public health ethics. In contrast to some readings of Mill, we reject the view that in the formulation of public policies liberties of all kinds enjoy an equal presumption in their favor. We argue that Mill also rejects this view and discuss the distinction that Mill makes between three kinds of liberty interests: interests that are immune from state interference; interests that enjoy a presumption (...) in favor of liberty; and interests that enjoy no such presumption. We argue that what is of focal importance for Mill in protecting liberty is captured by the essential role that the value of self-determination plays in human well-being. Finally, we make the case for the plausibility of a more complex and nuanced Millian framework for public health ethics that would modify how the balancing of some liberty and public health interests should proceed by taking the thumb off the liberty end of the scale. Mill’s arguments and the legacy of liberalism support certain forms of state interference with marketplace liberties for the sake of public health objectives without any presumption in favor of liberty. (shrink)

I warmly thank Richard Ashcroft, Luc Bovens, Gerald Dworkin, Brynn Welch, and Alan Wertheimer for their insightful comments on my article. As I do not have the space to discuss all the questions they raise, I will focus on four concerns that run through my commentators’ responses...

In “Nudging and Informed Consent,” ShlomoCohen (2013) attempts to address the common objection against nudges that they are autonomy-thwarting because they foster irrationality. He explicitly focuses on informed consent, which he contrasts with the policy context in which health nudges are usually discussed. I think Cohen’s rich article is a significant contribution to the nudge literature. However, I have some concerns with the way he frames and motivates his inquiry...

In her target article “Shared health governance” (AJOB 11(7): 32-45, 2011) and in her book Health and Social Justice (2009), Jennifer Prah Ruger defends an original model of governance dubbed “Shared Health Governance” (SHG). This model borrows elements from many other models of governance, and one may wonder what is the secret sauce that holds together these diverse ingredients. In response, Ruger would perhaps ultimately turn to public moral norms. My comment raises some concerns about the function and content of (...) these norms in her model and their connection to her claims about shared sovereignty within SHG. (shrink)

The distinction between clinical research and clinical practice directs how we partition medicine and biomedical science. Reasons for a sharp distinction date historically to the work of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, especially to its analysis of the “boundaries” between research and practice in the Belmont Report (1978). Belmont presents a segregation model of the research-practice distinction, according to which research and practice form conceptually exclusive sets of activities and interventions. This (...) model is still the standard in federal regulations today. However, the Commission’s deliberations and conclusions about the boundaries are more complicated, nuanced, and instructive than has generally been appreciated. The National Commission did not conclude that practice needs no oversight comparable to the regulation of research. It debated the matter and inclined to the view that the oversight of practice needed to be upgraded, though the Commission stopped short of proposing new regulations for its oversight, largely for prudential political reasons. (shrink)

Will we, by 2050, be able to feed a rapidly growing population with healthy and sustainably grown food in a world threatened by systemic environmental crises? There are too many uncertainties for us to predict the long-term evolution of the global agri-food system, but we can explore a wide range of futures to inform policymaking and public debate on the future of food. This is typically done by creating scenarios and quantifying them with computer simulation models to get numerical estimates (...) of how different aspects of the global agri-food system might evolve under different hypotheses. Among the many scenarios produced over the last twenty years, one would expect to see the future advocated by the food sovereignty movement, which claims to represent roughly two hundred million self-described “peasants” worldwide. This movement defends a vision of the future based on relocalized, sustainable, and just agri-food systems, self-governed through direct and participatory democratic processes. Yet, food sovereignty is conspicuously absent from quantified scenarios of global food futures. As part of the roundtable, “Ethics and the Future of the Global Food System,” this essay identifies seven obstacles that undermine the creation of food sovereignty scenarios by examining two attempts at crafting such scenarios. (shrink)

There is growing interest in using non-coercive interventions to promote and protect public health, in particular "health nudges." Behavioral economist Richard Thaler and law scholar Cass Sunstein coined the term nudge to designate influences that steer individuals in a predetermined direction by activating their automatic cognitive processes, while preserving their freedom of choice. Proponents of nudges argue that public and private institutions are entitled to use health-promoting nudges because nudges do not close off any options. Opponents reply that the nudgee (...) has no opportunity to deliberate over her choice. The nudger controls the nudgee, who has no real freedom of choice. -/- In my dissertation, I salvage the concept of nudge from the charge that it merely pays lip service to freedom of choice, offer an alternative account of the moral import of nudges for the evaluation of public health policies, and provide an ethical framework for their justified use. -/- My argument proceeds in four steps. First, I argue that nudging mechanisms often involve some form of incomplete deliberation, and do not always bypass deliberation. Second, I maintain that nudges preserve freedom of choice because they preserve the choice-set and are substantially noncontrolling. I show that the debate over nudges is plagued by confusion between real nudges, which are easily resistible and therefore substantially noncontrolling, and influences that are not easily resistible yet activate the same cognitive mechanisms as nudges. Third, I reject the view that nudges are systematically preferable to more controlling influences, even when they interfere with non-consequential liberties. I show that the principle of the least restrictive alternative often invoked in public health ethics is applied with too wide a scope. Fourth, I argue that paternalism is not central to the ethics of public health nudges. Rather, the substantive problem with nudges is that their overall cumulative effect might weaken our decisional capacities or undermine their proper exercise. This is a reason to limit recourse to certain nudges. I finally show, contra certain Kantians and Millians, that we have no perfect duty to engage or enhance decisional capacities. (shrink)

This paper presents a literature review on the ethics of self-tracking technologies which are utilized by users to monitor parameters related to their activity and bodily parameters. By examining a total of 65 works extracted through a systematic database search and backwards snowballing, the authors of this review discuss three categories of opportunities and ten categories of concerns currently associated with self-tracking. The former include empowerment and well-being, contribution to health goals, and solidarity. The latter are social harms, privacy and (...) surveillance, ownership control and commodification of data, autonomy, data-facilitated harm, datafication and interpretability of data, negative impact on relation to self and others, shortcomings of design, negative impact on health perception, and regulation and enforcement of rules. The review concludes with a critical analysis of the existing literature and an overview of a future research agenda that could complement the current work on ethics of self-tracking. (shrink)

ZusammenfassungIm 18. Jahrhundert kommt ein historisch neuer Typus des Festes auf: das Bundesfest als Gründungsakt. Im Zuge der Dekorporierung wird das Fest zum Medium bürgerlicher Assoziation, die allmählich auf das Politische ausgreift. Im Kontext der Verzeitlichung im 18. Jahrhundert entbindet sich das Fest seiner vormaligen Funktion zyklischer Zeitreproduktion und bildet eine futurisch-utopische Form aus. Dabei avanciert der Eid, der entinstitutionalisiert wird und als universales Kohäsionsritual Verbreitung findet, zum zentralen Element einer Dramaturgie feierlicher Kommunion, in der das Fest als epochaler ›Übergangsritus‹ (...) den Zeitenumbruch zu imaginieren und zu forcieren sucht. Von der Ebene bürgerlicher Sozialbeziehungen steigt dieser neue Festtypus mit der Französischen Revolution auf die Ebene politischer Repräsentation auf.In the 18th century a new type of feasts evolve: the covenant festival as a founding act. As the corporative society dissolves, the bourgeoisie uses festivals as an instrument of social cohesion. Those associations gradually promote a political claim. Since modern society develops linear and progressive time patterns, the festivals lose the task of cyclically reproducing time. Instead, the new utopian festivals seek to imagine and to push the turn towards a new age. They therefore fulfill the function of modern ›rites of passage‹. Being detached from institutions and becoming a ritual of universal social cohesion, the oath becomes the crucial element of the festivals’ dramaturgy seeking social fusion. From the social sphere, the bourgeois covenant festivals rise to the level of political representation in the French Revolution. (shrink)

The Condorcet jury theorem (CJT) is based on the assumption of homogeneous voters who imperfectly know the correct policy. We reassess the validity of the CJT when voters are homogeneous and each knows the correct decision with an average probability of more than a half.

Committee decision making is examined in this study focusing on the role assigned to the committee members. In particular, we are concerned about the comparison between committee performance under specialization and non-specialization of the decision makers. Specialization (in the context of project or public policy selection) means that the decision of each committee member is based on a narrow area, which typically results in the acquirement and use of relatively high expertise in that area. When the committee members’ expertise is (...) already determined, specialization only means that the decision of each committee member is based solely on his/her relatively high expertise area. This form of specialization is potentially inferior relative to non-specialization under which the decision of each committee member is based on different areas, not just his/her relatively high expertise area. Given that the expertise of the committee members is already determined but unknown, our analysis focuses on non-specializing individuals whose decision is based on a decision rule that does not require information on the decision-making skills. Under these realistic assumptions, non-specialization is shown to be preferable over specialization, depending on the aggregation rule applied by the committee. The significance of our approach is not limited to the specific results that we obtain. Rather, it should be viewed as a first step toward a deeper examination of the role of individual decision makers in enhancing the performance of collective decision making. (shrink)

In the basic model of Condorcet’s jury theorem and in the literature that follows, an odd-numbered group of voters is assumed so that the simple majority rule can be used. We show that this assumption is not necessary either in Condorcet’s basic model or in the general framework of dichotomous choice. We first apply simple majority rule to an even-numbered homogeneous fixed-size committee. We then provide a justification for using simple majority rule for an even-numbered heterogeneous fixed-size committee when the (...) competence structure of the committee members is not common knowledge. (shrink)

This paper clarifies why editors of academic journals should share with their referees the information about the number of referees they consult and the decision rule they apply. Our analysis also rationalizes the common questionable phenomenon of editors who seem to distort the yes or no recommendations of their referees. The editors request a recommendation of whether to accept or reject the paper as well as an assessment of the paper. The editors need the complete reports to make the appropriate (...) correction of the referees' final recommendations. (shrink)

The current note clarifies why, in committees, the prior probability of a correct collective choice might be of particular significance and possibly should sometimes even be the sole appropriate basis for making the collective decision. In particular, we present sufficient conditions for the superiority of a rule based solely on the prior relative to the simple majority rule, even when the decisional skills of the committee members are assumed to be homogeneous.

This paper identifies a new source that explains environmental behaviour: the presence of future tense marking in language. We predict that languages that grammatically mark the future affect speakers' intertemporal preferences and thereby reduce their willingness to address environmental problems. We first show that speakers of languages with future tense marking are less likely to adopt environmentally responsible behaviours and to support policies to prevent environmental damage. We then document that this effect holds across countries: future tense marking is an (...) important determinant of climate change policies and global environmental cooperation. The results suggest that there may be deep and surprising obstacles for attempts to address climate change. (shrink)

This paper identifies a new source of differences in religiosity: the type of future tense marking in language. We argue that the rewards and punishments that incentivize religious behaviour are more effective for speakers of languages without inflectional future tense. Consistent with this prediction, we show that speakers of languages without inflectional future tense are more likely to be religious and to take up the short-term costs associated with religiosity. What is likely to drive this behaviour, according to our results, (...) is the relatively greater appeal of the religious rewards to these individuals. Our analysis is based on within-country regressions comparing individuals with identical observable characteristics who speak a different language. (shrink)

This volume of Eurasian Studies in Business and Economics includes selected papers from the 24th Eurasia Business and Economics Society (EBES) Conference, held in Bangkok. The theoretical and empirical papers gathered here cover diverse areas of business and management from different geographic regions; yet the main focus is on the latest findings on evolving marketing methods, analytics, communication standards, and their effects on customer value and engagement. The volume also includes related studies that analyze sustainable consumer behavior, and business strategy-related (...) topics such as cross-border restructuring, quality management standards, and the internationalization of SMEs. (shrink)

In this commentary on Yashar Saghai's article "Salvaging the Concept of Nudge" (JME 2013) I discuss his distinction between a 'prod' (which is 'substantially controlling') and a 'nudge' (which is ‘substantially non-controlling’).

In ‘Salvaging the Concept of Nudge’ Yashar Saghai performs an important clarificatory task which certainly advances our philosophical and ethical understanding of nudges in public policy, and in healthcare ethics in particular.1 In this brief commentary I identify some issues which could usefully be taken forward in subsequent discussions.A central difficulty with ethical discussions of nudging is that insufficient care is taken to distinguish two morally important features of nudges. The first, which Saghai very properly concentrates upon, (...) is the mechanism of nudging. Nudges rely on psychological properties of human decision-makers as the way in which their intended effects are brought about. Much of the ethical concern with nudges focuses on just this. Whatever the motive of the nudger, or the objective of the nudge, or the ex ante or ex post ratification of the nudge by the nudge, operating through influence, impulse or non-rational features of the nudgee's decision-making is wrong. The nature of this wrongness can be spelled out in different ways, and which one of these we choose has important implications for the precise ethical argument …. (shrink)

According to much modern social psychology, behavioural economics and common sense, people's actions and beliefs are frequently the result of rapid intuitive thought rather than careful deliberation. Richard Thaler and Cass Sunstein, in their influential book, Nudge, synthesised the literature and used it as the basis for numerous policy ideas.1 Not least, they gave the word ‘nudge’ as a handy term to apply to all sorts of ways of taking advantage of people's psychological quirks without coercing or bribing them. But (...) while Nudge was long on ideas and enthusiasm, it was short on conceptual clarity. The idea of a nudge was inconsistent with some of the policies Thaler and Sunstein endorsed and their account of nudging's relation to freedom and paternalism was flawed.In Salvaging the concept of nudge, Yashar Saghai acts as a friendly critic who thinks nudging has plenty to offer the policy world but sees that it needs both conceptual clarity and ethical defence.2 He wants to show how some of ways of taking advantage of people's psychology could leave them as free as before and he is especially concerned with what I would describe as a question of manipulation: …. (shrink)

This issue of the journal sees a number of exchanges on significant ethical problems. ‘Nudges’ have attracted a good deal of attention recently in the context of the ethics of public health interventions. Martin Wilkinson writes a guest editorial introducing important debate on Yashar Saghai's featured article, Salvaging the concept of nudge . Also, Timothy Murphy locks horns with Katrien Devolder and Ezio Di Nucci on the doctrine of double effect as it applies to research on embryos.One of (...) the exchanges published here involves the legitimacy of research ethics review. Murray Dyck and Gary Allen claim that only in a small minority of cases is research ethics review warranted and that, in the main, responsibility for the ethical conduct of research should lie with the researchers themselves.However, David Hunter Mark Israel (see …. (shrink)

Policy makers are understandably interested—for both political and moral reasons—in following Thaler and Sunstein's recommendation to use ‘choice architecture’ , or other ‘nudges’, to promote desirable behaviour in ways that are allegedly compatible with personal freedom.1 Yashar Saghai's intricate analysis shows that simply maintaining the target's choice-set is insufficient to preserve the target's freedom when the nudge bypasses the target's deliberative capacities—as it is specifically designed to do.2 In his friendly amendment to Thaler and Sunstein's project, Saghai (...) advances a more robust account of nudges in which fewer policies would count as nudges, but those that do count as nudges would be less troublesome. In this commentary, I briefly discuss several issues raised by Saghai's project, some of which go beyond the topic of nudges. How important is definitional salvaging? If a ‘substantially controlling’ influence were more efficacious in promoting healthy behaviours, we would have a trade-off between the efficacy of a policy and its compatibility with freedom. Saghai states that an influence can be morally permissible even if it is ‘substantially controlling’ and, therefore, does not qualify as a nudge. So even on Saghai's definitional project it is not clear how much work it does in distinguishing the morally permissible from the morally impermissible. The …. (shrink)

ḥeleḳ 1. ʻAl moʻade ha-shanah -- ḥeleḳ 2. Derashot ṿe-sugyot ha-Shas.

Ḳeshurim le-Yaʻaḳov -- Oraḥ mishor -- Derekh yashar.