The ethics of health-promoting nudges.

Abstract

The paper aims to provide an overview of current knowledge related to the ethicality of health-promoting nudges and a further elaboration, particularly in terms of linking the interpretation of the findings of the study and the conclusions adopted. A comprehensive narrative review of literature on the topic of interest was undertaken, aiming to contribute to the current debate on the topic of interest. It is practically hard to determine whether or not the nudgee's agency will be eroded by the particular nudge because the line of distinction between emotions or automatic ways of human reasoning and cognitive ways of human reasoning remains blurry, and the various types of nudges fall on a combination of two continuums: the one ranging from transparent to non-transparent and the other ranging from reflective to automatic. Therefore, the majority of nudges are most likely to work as reason-bypassing nonargumentative influences, thus eroding the nudgee's agency. It is time to accept a deviation from the strict commitment to the principle of (individualistic) autonomy in degrees proportional to the incontestably anticipated patient's benefit. In case that patient's best interest is less than clear or the nudging promotes another individual's best interest (not the decider's one), or even the common good, the ethicality of nudging is not always beyond reasonable doubt. In such cases the deviation should be as minimal as possible (i.e. limited to nudges that are transparent or almost transparent and work reflectively or almost reflectively). Nudging may be used against the COVID-19 pandemic.