Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Choice Architecture. Show all posts
Showing posts with label Choice Architecture. Show all posts

Tuesday, December 28, 2021

Opt-out choice framing attenuates gender differences in the decision to compete in the laboratory and in the field

J. C. He, S. K. Kang, N. Lacetera
Proceedings of the National Academy of Sciences 
Oct 2021, 118 (42) e2108337118

Abstract

Research shows that women are less likely to enter competitions than men. This disparity may translate into a gender imbalance in holding leadership positions or ascending in organizations. We provide both laboratory and field experimental evidence that this difference can be attenuated with a default nudge—changing the choice to enter a competitive task from a default in which applicants must actively choose to compete to a default in which applicants are automatically enrolled in competition but can choose to opt out. Changing the default affects the perception of prevailing social norms about gender and competition as well as perceptions of the performance or ability threshold at which to apply. We do not find associated negative effects for performance or wellbeing. These results suggest that organizations could make use of opt-out promotion schemes to reduce the gender gap in competition and support the ascension of women to leadership positions.

Significance

How can we close the gender gap in high-level positions in organizations? Interventions such as unconscious bias training or the “lean in” approach have been largely ineffective. This article suggests, and experimentally tests, a “nudge” intervention, altering the choice architecture around the decision to apply for top positions from an “opt in” to an “opt out” default. Evidence from the laboratory and the field shows that a choice architecture in which applicants must opt out from competition reduces gender differences in competition. Opt-out framing thus seems to remove some of the bias inherent in current promotion systems, which favor those who are overconfident or like to compete. Importantly, we show that such an intervention is feasible and effective in the field.

From the Discussion

A practical implication of our studies is that organizations could attenuate the gender gap in competitions by moving from a default, in which applicants must opt in to apply, to a default whereby those who pass a performance and qualification threshold are automatically considered but can choose to opt out. Examples include promotions in organizations, participation into start-up pitch competitions, and innovation or creativity contests. Future work could examine similar interventions that circumvent the self-nomination aspect of opt-in schemes for competitive selection processes. For instance, rather than self-nomination, peer-nomination could attenuate the gender gap. The results of Study 2 also suggest that manipulating or nudging social norms could result in a similar effect.

Saturday, May 30, 2020

Self-Nudging and the Citizen Choice Architect

Samuli Reijula, Ralph Hertwig.
Behavioural Public Policy, 2020
DOI: 10.1017/bpp.2020.5

Abstract

This article argues that nudges can often be turned into self-nudges: empowering interventions that enable people to design and structure their own decision environments—that is, to act as citizen choice architects. Self-nudging applies insights from behavioral science in a way that is practicable and cost-effective but that sidesteps concerns about paternalism or manipulation. It has the potential to expand the scope of application of behavioral insights from the public to the personal sphere (e.g., homes, offices, families). It is a tool for reducing failures of self-control and enhancing personal autonomy; specifically, self-nudging can mean designing one’s proximate choice architecture to alleviate the effects of self-control problems, engaging in education to understand the nature and causes of self-control problems, and employing simple educational nudges to improve goal attainment in various domains. It can even mean self-paternalistic interventions such as winnowing down one’s choice set by, for instance, removing options.  Policy makers could promote self-nudging by sharing knowledge about nudges and how they work. The ultimate goal of the self-nudging approach is to enable citizen choice architects’ efficient self-governance, where reasonable, and the self-determined arbitration of conflicts between their mutually exclusive goals and preferences.

From the Conclusion:

Commercial choice architects have become proficient in hijacking people’s attention and desires (see, e.g., Nestle 2013; Nestle 2015; Cross and Proctor 2014; Wu 2017), making it difficult for consumers to exercise agency and freedom of choice. Even in the best of circumstances, the potential for public choice architects to nudge people toward better choices in their personal and proximate choice environments is limited. Against this background, we suggest that policy makers should consider the possibility of empowering individuals to make strategic changes in their proximate choice architecture. There is no reason why citizens should not be informed about nudges that can be turned into self-nudges and, more generally, about the design principles of choice environments (e.g., defaults, framing, cognitive accessibility). We suggest that self-nudging is an untapped resource that sidesteps various ethical and practical problems associated with nudging and can empower people to make better everyday choices. This does not mean that regulation or nudging should be replaced by self-nudging; indeed, self-nudging can benefit enormously from the ingenuity of the nudging approach and the evidence accumulating on it. But, as the adage goes, give someone a fish, and you need them for a day. Teach someone to fish, and you feed them for a lifetime. We believe that sharing  behavioral insights from psychology and behavioral economics will provide citizens with a the citizen choice architect means for taking back power, giving them more control over the design of their proximate choice environments–in other words, qualifying them as citizen choice architects.

The article is here.

Friday, September 27, 2019

Nudging Humans

Brett M. Frischmann
Villanova University - School of Law
Originally published August 1, 2019

Abstract

Behavioral data can and should inform the design of private and public choice architectures. Choice architects should steer people toward outcomes that make them better off (according to their own interests, not the choice architects’) but leave it to the people being nudged to choose for themselves. Libertarian paternalism can and should provide ethical constraints on choice architects. These are the foundational principles of nudging, the ascendant social engineering agenda pioneered by Nobel Prize winning economist Richard Thaler and Harvard law professor Cass Sunstein.

The foundation bears tremendous weight. Nudging permeates private and public institutions worldwide. It creeps into the design of an incredible number of human-computer interfaces and affects billions of choices daily. Yet the foundation has deep cracks.

This critique of nudging exposes those hidden fissures. It aims at the underlying theory and agenda, rather than one nudge or another, because that is where micro meets macro, where dynamic longitudinal impacts on individuals and society need to be considered. Nudging theorists and practitioners need to better account for the longitudinal effects of nudging on the humans being nudged, including malleable beliefs and preferences as well as various capabilities essential to human flourishing. The article develops two novel and powerful criticisms of nudging, one focused on nudge creep and another based on normative myopia. It explores these fundamental flaws in the nudge agenda theoretically and through various examples and case studies, including electronic contracting, activity tracking in schools, and geolocation tracking controls on an iPhone.

The paper is here.

Sunday, January 20, 2019

The Ethics of Paternalism

Ingrid M. Paulin, Jenna Clark, & Julie O'Brien
Scientific American
Originally published on December 21, 2018

Here is an excerpt:

Choosing what to do and which approach to take requires making a decision about paternalism, or influencing someone’s behavior for their own good. Every time someone designs policies, products or services, they make a decision about paternalism, whether they are aware of it or not. They will inevitably influence how people behave; there's no such thing as a neutral choice.

Arguments about paternalism have traditionally focused on the extreme ends of the spectrum; you either let people have complete autonomy, or you completely restrict undesirable behaviors. In reality, however, there are many options in between, and there are few guidelines about how one should navigate the complex moral landscape of influence to decide which approach is justified in a given situation.

Traditional economists may argue for more autonomy on the grounds that people will always behave in line with their own best interest. In their view, people have stable preferences and are always weighing the costs and benefits of every option before making decisions. Because they know their preferences better than do others, they should be able to act autonomously to maximize their own positive outcomes.

The info is here.

Tuesday, October 16, 2018

Nudge or Grudge? Choice Architecture and Parental Decision‐Making

Jennifer Blumenthal‐Barby and Douglas J. Opel
The Hastings Center Report
Originally published March 28, 2018

Abstract

Richard Thaler and Cass Sunstein define a nudge as “any aspect of the choice architecture that alters people's behavior in a predictable way without forbidding any options or significantly changing their economic incentives.” Much has been written about the ethics of nudging competent adult patients. Less has been written about the ethics of nudging surrogates’ decision‐making and how the ethical considerations and arguments in that context might differ. Even less has been written about nudging surrogate decision‐making in the context of pediatrics, despite fundamental differences that exist between the pediatric and adult contexts. Yet, as the field of behavioral economics matures and its insights become more established and well‐known, nudges will become more crafted, sophisticated, intentional, and targeted. Thus, the time is now for reflection and ethical analysis regarding the appropriateness of nudges in pediatrics.

We argue that there is an even stronger ethical justification for nudging in parental decision‐making than with competent adult patients deciding for themselves. We give three main reasons in support of this: (1) child patients do not have autonomy that can be violated (a concern with some nudges), and nudging need not violate parental decision‐making authority; (2) nudging can help fulfill pediatric clinicians’ obligations to ensure parental decisions are in the child's interests, particularly in contexts where there is high certainty that a recommended intervention is low risk and of high benefit; and (3) nudging can relieve parents’ decisional burden regarding what is best for their child, particularly with decisions that have implications for public health.

The info is here.

Sunday, June 3, 2018

Hostile environment: The dark side of nudge theory

Nick Barrett
politics.co.uk
Originally posted May 1, 2018

Here is an excerpt:

Just as a website can use a big yellow button to make buying a book or signing up to a newsletter inviting, governments can use nudge theory to make saving money for your pension easy and user-friendly. But it can also establish its own dark patterns too and the biggest government dark pattern of all is the hostile environment policy established in 2012 to encourage migrants to leave the country.

The policy meant that without the right paperwork, people were deprived of health services, employment rights and access to housing and effectively excluded from mainstream society. They were not barred. The circumstances were simply created to nudge them into leaving the country.

For six years the hostile environment persecuted the least visible among us. It was only when its effects on the Windrush generation were revealed that the policy’s inherent prejudice became clear to all. What could once be seen as firm but fair suddenly looked cruel and unusual. These measures might have been defensible if the legal migration process hadn’t been turned into a painfully punitive process for anybody arriving from outside of the EU.

The information is here.

Tuesday, March 20, 2018

The Psychology of Clinical Decision Making: Implications for Medication Use

Jerry Avorn
February 22, 2018
N Engl J Med 2018; 378:689-691

Here is an excerpt:

The key problem is medicine’s ongoing assumption that clinicians and patients are, in general, rational decision makers. In reality, we are all influenced by seemingly irrational preferences in making choices about reward, risk, time, and trade-offs that are quite different from what would be predicted by bloodless, if precise, quantitative calculations. Although we physicians sometimes resist the syllogism, if all humans are prone to irrational decision making, and all clinicians are human, then these insights must have important implications for patient care and health policy. There have been some isolated innovative applications of that understanding in medicine, but despite a growing number of publications about the psychology of decision making, most medical care — at the bedside and the systems level — is still based on a “rational actor” understanding of how we make decisions.

The choices we make about prescription drugs provide one example of how much further medicine could go in taking advantage of a more nuanced understanding of decision making under conditions of uncertainty — a description that could define the profession itself. We persist in assuming that clinicians can obtain comprehensive information about the comparative worth (clinical as well as economic) of alternative drug choices for a given condition, assimilate and evaluate all the findings, and synthesize them to make the best drug choices for our patients. Leaving aside the access problem — the necessary comparative effectiveness research often doesn’t exist — actual drug-utilization data make it clear that real-world prescribing choices are in fact based heavily on various “irrational” biases, many of which have been described by behavioral economists and other decision theorists.

The article is here.

Tuesday, January 16, 2018

Should Governments Invest More in Nudging?

Shlomo Benartzi, John Beshears, Katherine L. Milkman, and others
Psychological Science 
Vol 28, Issue 8, pp. 1041 - 1055
First Published June 5, 2017

Abstract

Governments are increasingly adopting behavioral science techniques for changing individual behavior in pursuit of policy objectives. The types of “nudge” interventions that governments are now adopting alter people’s decisions without coercion or significant changes to economic incentives. We calculated ratios of impact to cost for nudge interventions and for traditional policy tools, such as tax incentives and other financial inducements, and we found that nudge interventions often compare favorably with traditional interventions. We conclude that nudging is a valuable approach that should be used more often in conjunction with traditional policies, but more calculations are needed to
determine the relative effectiveness of nudging.

The article is here.

Thursday, November 16, 2017

Is There a Right Way to Nudge? The Practice and Ethics of Choice Architecture

Evan Selinger and Kyle Whyte
Sociology Compass, Vol. 5, No. 10, pp. 923-935

Abstract

What exactly is a nudge, and how do nudges differ from alternative ways of modifying people's behavior, such as fines or penalties (e.g. taxing smokers) and increasing access to information (e.g. calorie counts on restaurant menus)? We open Section 2 by defining the concept of a nudge and move on to present some examples of nudges. Though there is certainly a clear concept of what a nudge is, there is some confusion when people design and talk about nudges in practice. In Sections 3 and 4, then, we discuss policies and technologies that get called nudges mistakenly as well as borderline cases where it is unclear whether people are being nudged. Understanding mistaken nudges and borderline cases allows citizens to consider critically whether they should support “alleged” nudge policies proposed by governments, corporations, and non-profit organizations. There are also important concerns about the ethics of nudging people's behavior. In Section 5 we review some major ethical and political issues surrounding nudges, covering both public anxieties and more formal scholarly criticisms. If nudges are to be justified as an acceptable form of behavior modification in democratic societies, nudge advocates must have reasons that allay anxieties and ethical concerns. However, in Section 6, we argue that nudge advocates must confront a particularly challenging problem. A strong justification of nudging, especially for pluralistic democracies, must show that nudge designers really understand how different people re-interpret the meaning of situations after a nudge has been introduced into the situations. We call this the problem of “semantic variance.” This problem, along with the ethical issues we discussed, makes us question whether nudges are truly viable mechanisms for improving people's lives and societies. Perhaps excitement over their potential of nudges is exaggerated.

The article is here.

Tuesday, February 23, 2016

American attitudes toward nudges

Janice Y. Jung and Barbara A. Mellers
Judgment and Decision Making
Vol. 11, No. 1, January 2016, pp. 62-74

To successfully select and implement nudges, policy makers need a psychological understanding of who opposes nudges, how they are perceived, and when alternative methods (e.g., forced choice) might work better. Using two representative samples, we examined four factors that influence U.S. attitudes toward nudges – types of nudges, individual dispositions, nudge perceptions, and nudge frames. Most nudges were supported, although opt-out defaults for organ donations were opposed in both samples. “System 1” nudges (e.g., defaults and sequential orderings) were viewed less favorably than “System 2” nudges (e.g., educational opportunities or reminders). System 1 nudges were perceived as more autonomy threatening, whereas System 2 nudges were viewed as more effective for better decision making and more necessary for changing behavior. People with greater empathetic concern tended to support both types of nudges and viewed them as the “right” kind of goals to have. Individualists opposed both types of nudges, and conservatives tended to oppose both types. Reactant people and those with a strong desire for control opposed System 1 nudges. To see whether framing could influence attitudes, we varied the description of the nudge in terms of the target (Personal vs. Societal) and the reference point for the nudge (Costs vs. Benefits). Empathetic people were more supportive when framing highlighted societal costs or benefits, and reactant people were more opposed to nudges when frames highlighted the personal costs of rejection.

The article is here.

Sunday, January 4, 2015

The Ethics of Nudging

By Cass Sunstein
Harvard Law School

Abstract:
 
This essay defends the following propositions. (1) It is pointless to object to choice architecture or nudging as such. Choice architecture cannot be avoided. Nature itself nudges; so does the weather; so do spontaneous orders and invisible hands. The private sector inevitably nudges, as does the government. It is reasonable to object to particular nudges, but not to nudging in general. (2) In this context, ethical abstractions (for example, about autonomy, dignity, and manipulation) can create serious confusion. To make progress, those abstractions must be brought into contact with concrete practices. Nudging and choice architecture take diverse forms, and the force of an ethical objection depends on the specific form. (3) If welfare is our guide, much nudging is actually required on ethical grounds. (4) If autonomy is our guide, much nudging is also required on ethical grounds. (5) Choice architecture should not, and need not, compromise either dignity or self-government, though imaginable forms could do both. (6) Some nudges are objectionable because the choice architect has illicit ends. When the ends are legitimate, and when nudges are fully transparent and subject to public scrutiny, a convincing ethical objection is less likely to be available. (7) There is, however, room for ethical objections in the case of well-motivated but manipulative interventions, certainly if people have not consented to them; such nudges can undermine autonomy and dignity. It follows that both the concept and the practice of manipulation deserve careful attention. The concept of manipulation has a core and a periphery; some interventions fit within the core, others within the periphery, and others outside of both.

The entire article is here.