HEC Forum 29 (1):43-57 (2017)
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Abstract |
Techniques from behavioral economics—nudges—may help physicians increase pediatric vaccine compliance, but critics have objected that nudges can undermine autonomy. Since autonomy is a centrally important value in healthcare decision-making contexts, it counts against pediatric vaccination nudges if they undermine parental autonomy. Advocates for healthcare nudges have resisted the charge that nudges undermine autonomy, and the recent bioethics literature illustrates the current intractability of this debate. This article rejects a principle to which parties on both sides of this debate sometimes seem committed: that nudges are morally permissible only if they are consistent with autonomy. Instead, I argue that, at least in the case of pediatric vaccination, some autonomy-undermining nudges may be morally justified. This is because parental autonomy in pediatric decision-making is not as morally valuable as the autonomy of adult patients, and because the interests of both the vaccinated child and other members of the community can sometimes be weighty enough to justify autonomy-infringing pediatric vaccination nudges. This article concludes with a set of worries about the effect of pediatric vaccination nudges on parent-physician relationships, and it calls on the American Academy of Pediatrics to draw on scientific and bioethics research to develop guidelines for the use of nudges in pediatric practice and, in particular, for the use of pediatric vaccination nudges.
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DOI | 10.1007/s10730-016-9311-2 |
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References found in this work BETA
Family Values: The Ethics of Parent-Child Relationships.Harry Brighouse & Adam Swift - 2014 - Princeton University Press.
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Citations of this work BETA
Nudge or Grudge? Choice Architecture and Parental Decision‐Making.Jennifer Blumenthal-Barby & Douglas J. Opel - 2018 - Hastings Center Report 48 (2):33-39.
Nudging in Donation Policies: Registration and Decision-Making.Douglas MacKay & Katherine Saylor - 2021 - In Solveig Lena Hansen & Silke Schicktanz (eds.), Ethical Challenges of Organ Transplantation. Bielefeld, Germany: Transcript Verlag. pp. 65-80.
Nudging Immunity: The Case for Vaccinating Children in School and Day Care by Default.Alberto Giubilini, Lucius Caviola, Hannah Maslen, Thomas Douglas, Anne-Marie Nussberger, Nadira Faber, Samantha Vanderslott, Sarah Loving, Mark Harrison & Julian Savulescu - 2019 - HEC Forum 31 (4):325-344.
Nudging Children and Adolescents Toward Online Privacy: An Ethical Perspective.Mariana Veretilnykova & Leyla Dogruel - 2021 - Journal of Media Ethics 36 (3):128-140.
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