Seminar: Yashar Saghai, "What’s a Health Nudge?"

Past Event

25 May 2011, 4:00pm - 5:30pm

Lecture Theatre, Oxford Martin School
34 Broad Street (corner of Holywell and Catte Streets), Oxford, OX1 3BD

Abstract: Health nudges have recently become the center of public debate in the UK, in response to policy proposals drafted by the famous “nudge unit” – a team of behavioral economists advising David Cameron. From placing healthy food first and at eye level in cafeterias, increasing regular medication intake thanks to small but salient incentives, to the use of default-options to increase organ donations, nudges are expected to efficaciously, gently, and cheaply steer people toward health-promoting behaviors without forcing them to change their ways.

Surprisingly, however, there is still little consensus on what nudges are in the first place. To some the very notion of nudge seems overly fuzzy, encompassing anything but the use of outright coercion. Moreover, health promoters feel irritated by the alleged novelty of nudges. After all, they have designed, tested, and implemented nudge-like non-coercive interventions for decades, relying on their own sophisticated models of health behavior (Bonell et al. 2011).

In this presentation, I will address the definition of nudges. This question matters because unless we can pin down what nudges are, we cannot assess the claim that health nudges, as a class, are pro tanto morally justified because they preserve freedom to choose and are designed to enhance welfare.

I will first critically review current definitions of nudges stemming from the seminal work of behavioral economist Dick Thaler and law scholar Cass Sunstein. These authors have defined nudges as “any aspect of the choice architecture that alters people’s [irrational] behavior in a predictable way without forbidding any options or significantly changing their economic incentives” (2009, 6). My central claim is that this definition blurs the line between two kinds of typologies that need to be kept distinct. The first is a typology of techniques used to influence individuals (for instance, techniques designed to structure choices, such as framing effects or default settings). The second typology concerns modes of influencing others that are grouped together depending on the degree of control that the individual retains over her own decisions. Within this typology, we usually distinguish coercive from non-coercive forms of influence such as (dis)incentives and rational persuasion. The problem with current definitions of nudges is that they assume that the two kinds of typologies perfectly overlap. A nudge is thus characterized by a set of techniques (first typology) that are assumed to always track a mode of influencing others that has little impact on the degree of control that people retain over their own decisions (second typology).

I will show that this claim is false. For instance, it is not the case that whenever A uses a default to influence B, A’s intervention is to be categorized as a nudge. In certain contexts, A is attempting to strongly disincentivize B’s behavior. This is the case when the social stigma attached to not following the norm embodied in the default is or becomes very strong. Sometimes B thinks that A is recommending to him the action singled out by the default and is rationally persuaded to follow the recommendation because she has good reasons to trust A’s expertise.

The pay-off of disentangling these two kinds of typologies is that nudges appear to clearly belong to the second typology. They form a subcategory of noncoercive interventions, and nudge is a useful concept for mapping part of this broad and largely uncharted territory. In the remaining sections I discuss additional considerations helpful for contextually demarcating nudges from coercion, (dis)incentives, and rational persuasion, and consider the possibility of hybrids between nudges and alternative modes of influencing others (such as (dis)incentives). A concluding section explores the intricate connection between nudging and manipulating.

Bio: Yashar Saghai a PhD candidate at Georgetown University (Kennedy Institute of Ethics and Philosophy Department). His research interests encompass Bioethics, Ethical Theory, Political Philosophy, and the Philosophy of Cognitive Science. His current work is on the ethics of health nudges. Before joining Georgetown, Yashar received a Master's degree in History of Philosophy from the Sorbonne (focusing on Spinoza) and a Graduate Interdisciplinary Certificate in Medical Ethics from the University of Paris XII-Henri Mondor Medical School.