Thursday, November 26, 2015

An Overview of the SIRE Workshop: "Consumer preferences, perceptions and decision-making."

In late October, we held a workshop on “Consumer Preferences, Perceptions and Decision-making” at the University of Stirling. The workshop was funded by the Scottish Institute for Research in Economics (SIRE) and organised by Seda Erdem.

The aim of the workshop was to bring together various experts from academia and policy to discuss consumers’ food choices, food safety behaviours, risk perceptions and decision-making.  We shared experiences from different country settings, lessons learnt, and drew attention to concerns from Scottish policy-makers’ perspective.

The workshop was organised around three main themes:
  1. Preferences and perceptions: Do expectations and experiences affect preferences? How health-related messages are interpreted? What is the place of retailing in food choices
  2. Decision-making: What decision strategies do consumers use? Does symbolic information cause biased decisions? How can we improve decision-making in the food domain?
  3. Public Policy: How should public policy consider consumer preferences? What are the current food and diet issues in Scotland? How can we improve Scottish diet?
The introduction to the day, given by the organiser Seda Erdem, highlighted the need and motivations for studying perceptions, preferences and decision-making and provided example case studies that help inform decision-making, set priorities in different food domains, and support better communication between stakeholders. While some examples focused on the acceptability of novel foods and technologies, others examined perceived perceptions of responsibility for food safety and trust in information sources. Seda’s talk, available here, also touched upon the importance of understanding the way we make choices: do we consider all food options at supermarkets; what are the eye-catching product positions; and, how can we use such information for nudging towards healthy food choices?  

The workshop continued with the following three themes.

Theme 1: Preferences and Perceptions
Our first speaker, Liisa Lähteenmäki from the Department of Management at Aarhus University, spoke on “Health, taste, and novelty in food choices”. Her presentation highlighted a number of issues: (1) health and taste have different dynamics in food choices: health perception is based on information, whereas perceived taste requires no information: however, the pleasantness has an impact on perceived benefit; (2) consumers have expectations about taste, and experiences tend to confirm expectations unless the difference between expectation and experience is wide, and (3) the need for better understanding on how food choices and use of food products develop over time.

The next speaker in this theme was Leigh Sparks from Institute for Retail Studies, University of Stirling. Leigh’s talk was about the “Place of retailing in food choices”. Leigh’s presentation focused on: (1) the complexity of food choices when there are many different types of retailers in the market offering a large number of products; (2) changes in retail market due to their concentration, scale, and market share in the sector; (3) structural differences between retailers, such as  mono-format vs  multi-format; (4) development of “new” shopping environments, such as internet shopping, discounters, and convenience shops, and (5) relationship between these factors and our lifestyles.

Theme 2: Decision-making
Does the inclusion of "Fruit Sugar" on labels affect perceived healthiness? 
Before lunch, we had Michael Siegrist from Institute for Environmental Decisions and Consumer Behaviour at ETH Zurich talking about “Symbolic information causes biased decisions”. The case studies Michael mentioned illustrated some of the limitations associated with decision processes, such as how symbolic information affect perceived healthiness and naturalness of product and influence the likelihood of choices, the impact of moral information on food choices, and ways of improving decision-making in the food domain.  Another interesting finding from Michael’s research was that consumers might not rely on the most important aspects when assessing a food technology or product. This signals the need for better communication of information about (novel) food products and techniques via, for example, information campaigns and changing the food environment.  

While information about foods and technologies aims to improve the communication, they may increase the complexity of food choices. In our last presentation of this theme, Jutta Roosen from the University of Munich investigated the complexity of choice tasks and its consequences on food choices. In particular, non-attendance to information about the product was analysed in a hypothetical setting with the help of an eye-tracker, which measures the number of fixation in areas of interest.  The findings showed differences in the level of consideration when the complexity of the choice task varied.

Theme 3: Public Policy
Our final session of the day was on the public policy and how policy should take consumer preferences into consideration – an important area to ensure better-informed choices and healthier societies. The theme started with presentations from policy-makers at the Food Standards Scotland (FSS) and Food Standards Agency (FSA).

Jacqui McElhiney, Head of Food Protection Science and Surveillance Branch of FSS, kicked off the session by introducing the newly established Food Standards Scotland by Food (Scotland) Act 2015 and food safety issues in Scotland and the ways of tackling these issues.  Focusing on Scotland, the Consumer Forum 2013/14 showed that habits were influenced by personal circumstances (e.g., living alone, childcare). However, the findings signalled that there was resistance to change, especially when the habits were based on previous experience (e.g., “never had issues before never will have”).

Helen Atkinson, a Senior Research Officer from Food Standards Agency, extended the conversation to “The UK evidence base consumer attitudes and behaviour”. Helen set out the trend in consumers’ attitudes and concerns over various food issues by summarising evidence from two social surveys: Public Attitudes Tracker, a survey conducted since 2001 and The Food and You Survey, carried out since 2010.  One of the interesting and common findings of these investigations was that consumers showed a different level of concern over various food issues (as seen in Fig 1), awareness of hygiene standards in eating establishments (see Fig 2)  and awareness of the FSA and trust in it (see Fig 3).

Fig 1. Wider food concerns (Public Attitude Tracker Survey) 
In particular, the results showed that women were consistently more likely to report a concern about food safety issues compared to men, and 16-25-year-olds were consistently less likely to report a concern about most issues. While, staggeringly, 51% of the sample (over 2000 people in the UK) found the amount of sugar in the food concerning in recent years, 49% found food waste, 43% animal welfare, and 43% found food prices concerning. Knowing perceptions over various food issues not only helps us understand target populations for designing better communication interventions, but also provides an opportunity for decision-makers, policy makers, retailers and other stakeholders to revisit issues seemed to be concerning for these target groups.

Fig 2. Ways of knowing about hygiene standards (Public Attitude Tracker Survey)
The survey also teased out the way consumers perceive the hygiene standard of places that they eat out at or buy food from. Surprisingly, the general appearance of premises found to be the most important factor to judge the hygiene standard of out-of-home food premises, followed by the appearance of staff, hygiene certificate, and hygiene stickers. This may also suggest the need for a better way of communicating the hygiene certificates and stickers to consumers, especially when eating out is quite common among consumers (see Fig. 3).

Fig 3. Where did you eat in the past week? (Food and You Survey, 2014)
Our policy discussion was then focused on the Scottish diet, presented by Heather Pearce, the Head of FSS Nutrition Science and Policy and Gillian Purdon, Diet and Nutrition Advisor at FSS. The big question was what needs to change to improve Scottish diet. According to the FSS Dietary Surveillance Programme reviews, worryingly, little or no progress has been done towards the dietary goals in Scotland.  This has been found particularly more problematic in deprived areas. There was also a misbelief about one’s own diet that contributed towards poor diet. According to the 2014 FSA Food and You Survey, 80% of Scottish people thought that their diet was fairly or very healthy.  Other issues raised during the talk related to the excessive consumption of discretionary foods and drinks and the availability of promotions on these foods and drinks (see Fig.4) – notably, discretionary foods and drinks were associated with more promotion than other food types.

Fig 4. The proportion of retail purchase (volume sold) on promotion in Scotland, 2013-14 (Kantar World Panel)

So, how can we promote behaviour change towards healthier diet?  Should we limit access to high-calorie foods? Should we reduce portion sizes, should we change the balance of promotional activity at retail level – if so, how? These were some questions highlighted during the talk and reserved for the panel discussion.

The last talk was delivered by Julie Caswell of the University of Massachusetts on “How the public policy should take consumer preferences into consideration”. Julie took the cases of novel foods regulation and analysis of risk as examples.  One of the interesting observations was the diversity of the approaches to risks, partly due to the complex and multidimensional nature of risks, which results in unintended confusions in the interpretation of regulations. For example, risk-based systems for food safety consider a set of risks at the same time, allows for all factors in decision-making (including public health), are more transparent. However, they are hard enough to establish consistent regulations based on public health risks and depend on data and analysis requirements.

There are significant challenges to the food system for consumers, retailers, policy-makers, academics, and all other stakeholders. One of the valuable lessons learnt from the workshop was that interdisciplinary approach involving various interested parties in the search for answers to food and diet issues contributes to the better communication strategies, as it was aimed in this overview.  

Wednesday, November 25, 2015

Phishing for Phools and the Creation of Novel Desires

With their recent Phishing for Phools, Akerlof and Shiller have written a remarkable book (for a short summary by Centre member Philip Newall click here). The two Nobel laureates suggest that free markets provide incentives for smart people (the Phisherman) who know about individual biases to make use of these biases to get the most money out of individuals (i.e. out of the Phools).
One practice that the Phishermen use is particularly interesting: Phishermen generate novel needs of Phools. Akerlof and Shiller use this ability to explain what Keynes missed in 1930 when he predicted that in 2030, the workweek will plummet to fifteen hours and people will struggle not with financial problems, but with a surfeit of leisure. Akerlof and Shiller suggest that, due to the creation of novel needs, long working hours and difficulties in making ends meet will continue to be with us even if the standard of living goes up as much as it has done in the last century or so.

In his excellent review, Cass Sunstein criticizes Phishing for Phools for being too general. While behavioural economics has shown that there are many different types of biases that individuals can have, Akerlof and Shiller try to generalise and put them all into one basket. Sunstein suggests that we need to distinguish between different cognitive biases and be more specific in order to test concrete hypotheses rather than assuming that phishing equals phishing.

Readers who like to read more about the specifics of how Phishermen can create novel needs, and/or invent consumption goods that satisfy multiple needs, might be interested in a literature within Evolutionary Economics (although I think this literature is better subsumed under the label Behavioural Macroeconomics).

This literature highlights the importance of needs (such as those for food, shelter, entertainment, and social approval), the differential satiation patterns of these needs (e.g. with a high enough income the need for food will be satisfied, but the need for social approval will keep on motivating consumption at all income levels), and learning dynamics (e.g. different ways of associative or cognitive learning). Phishermen make use of this knowledge and, for example, invent consumer products that satisfy needs that are difficult to be satiated such as the needs for social approval, entertainment, and a positive self-image.

One one of the seminal papers in this literature is from 2001 by Ulrich Witt, who was my PhD supervisor, and below are a few selected papers from this literature. With Phishing for Phools in mind, (re-)reading these papers has convinced me that the long-run changes of consumer behaviour when income rises can be an important part of Behavioural Macroeconomics. Understanding the role played by Phishermen in creating novel needs and focusing on non-satiable needs so that we keep on consuming can have important implications for understanding long-run changes of consumption, long-run changes of happiness, as well the normative questions related to the development of consumption and happiness in the next decades.

Chai, A., & Moneta, A. (2010). Retrospectives Engel curves. The Journal of Economic Perspectives, 24(1), 225-240.
Moneta, A., & Chai, A. (2013). The evolution of Engel curves and its implications for structural change theory. Cambridge Journal of Economics

Witt, U. (2001). Learning to consume–A theory of wants and the growth of demand. Journal of Evolutionary Economics, 11(1), 23-36. 

Witt, U. (2011). Economic behavior - evolutionary versus behavioral perspectives. Biological Theory, 6(4), 388-398.

Monday, November 23, 2015

Ethics of Nudging: A bunch of reading

Below gives a sense of the interest in the ethical implications of nudging. I am working my way through as many papers as I can on this topic in preparation for next year's classes and workshops. But more generally, ethical issues are always worth thinking about when devising and evaluating interventions that will impact upon people. Sunstein, in particular, has been responding at length to various ethical critiques of Nudge and if you haven't got time to get through the hundreds of pages below (and I have not read them all yet either!) his recent paper on this is a good and readable way of getting into the debate. Suggestions on other papers and streams of research in this area welcome. Am open to suggestions also for some resource that we could develop on the blog for this aspect of behavioural science and policy - see a reading list I prepared here on the broader policy implications.

Aggarwal et al (2014). “Nudge” in the clinical consultation – an acceptable form of medical paternalism? BMC Medical Ethics 2014, 15:31.

Overall the extremes of autonomy and paternalism are not compatible in a responsive, responsible and moral health care environment, and thus some compromise of these values is unavoidable. Nudge techniques are widely used in policy making and we demonstrate how they can be applied in shared medical decision making. Whether or not this is ethically sound is a matter of continued debate but health care professionals cannot avoid the fact they are likely to be using nudge within clinical consultations. Acknowledgment of this will lead to greater self-awareness, reflection and provide further avenues for debate on the art and science of clinical communication.

Arneson (2015). Nudge and Shove. Social Theory and Practice, Volume 41, Issue 4, October 2015.

This essay reexamines the idea of paternalism and the basis for finding it objectionable in light of recent writings on “libertarian paternalism.” Suggestion: to qualify as paternalistic, an interference that restricts someone’s liberty or interferes with her choice-making with the aim of helping the individual must be contrary to that very individual’s will. A framework for determining the justifiability of paternalistic action is proposed, under the assumption that the individual has a personal prerogative, up to a point, to engage in less than maximally beneficial action. Beyond that point, the content of the will of the individual disposed against interference can extinguish the presumptive wrongness of paternalism.

Ashcroft (2012). Doing good by stealth. J Med Ethics doi:10.1136/medethics-2012-101109

Axtell-Thompson (2012). Nudge Ethics for Health Plans. The American Journal of Bioethics, Volume 12, Issue 2.

Baldwin (2015). Nudge: Three Degrees of Concern. LSE Law - Policy Briefing Paper No. 7.

Nudging is hugely popular with governments but it is a practice that raises both conceptual and controversial issues. Three degrees of nudge can be distinguished and these raise different
concerns. When contemplating nudging, moreover, it is essential to be clear and open about the philosophical basis for such action and to be aware that clashes between different modes of
intervention may threaten not only effectiveness but also the serving of representative and ethical ends.

Baldwin (2014). From Regulation to Behaviour Change: Giving Nudge the Third Degree. The Modern Law Review,  Volume 77, Issue 6, pages 831–857.

Behaviour change strategies such as ‘nudge’ have become hugely popular with administrations on both sides of the Atlantic. The practice of nudging, however, raises conceptual and controversial issues which must be addressed in examining the conditions under which nudging can be used effectively and acceptably. A key to a clear conceptual understanding of nudge-related issues is to distinguish between three degrees of nudge. These three degrees raise different, and identifiable, concerns and it is possible to assess the extent to which these can be responded to in positive terms. The compatibility of nudging with other control devices cannot be assumed and, when contemplating nudging, it is essential to be transparent about its philosophical basis, as well as to be aware that different modes of intervention may operate with clashes of logic that threaten not only effectiveness but also the serving of representative and ethical ends.

Blumenthal-Barby & Burroughs (2012). Seeking Better Health Care Outcomes: The Ethics of Using the “Nudge”. The American Journal of Bioethics, Volume 12, Issue 2.

Policymakers, employers, insurance companies, researchers, and health care providers have developed an increasing interest in using principles from behavioral economics and psychology to persuade people to change their health-related behaviors, lifestyles, and habits. In this article, we examine how principles from behavioral economics and psychology are being used to nudge people (the public, patients, or health care providers) toward particular decisions or behaviors related to health or health care, and we identify the ethically relevant dimensions that should be considered for the utilization of each principle.

Bell (2013). Nudging Without Ethical Fudging: Clarifying Physician Obligations to Avoid Ethical Compromise. The American Journal of Bioethics, Volume 13, Issue 6. (attached)

Borenstein & Arkin (2015). Robotic Nudges: The Ethics of Engineering a More Socially Just Human Being. Science and Engineering Ethics, pp 1-16

Robots are becoming an increasingly pervasive feature of our personal lives. As a result, there is growing importance placed on examining what constitutes appropriate behavior when they interact with human beings. In this paper, we discuss whether companion robots should be permitted to “nudge” their human users in the direction of being “more ethical”. More specifically, we use Rawlsian principles of justice to illustrate how robots might nurture “socially just” tendencies in their human counterparts. Designing technological artifacts in such a way to influence human behavior is already well-established but merely because the practice is commonplace does not necessarily resolve the ethical issues associated with its implementation.

Bovens (2009). The Ethics of Nudge.

Bovens (2013). Why couldn't I be nudged to dislike a Big Mac? J Med Ethics 2013;39:495-496 doi:10.1136/medethics-2012-101110

Brooks (2013). Should We Nudge Informed Consent? The American Journal of Bioethics
Volume 13.

Cohen (2013). Nudging and Informed Consent. The American Journal of Bioethics, Volume 13, Issue 6. (attached)

Libertarian paternalism's notion of “nudging” refers to steering individual decision making so as to make choosers better off without breaching their free choice. If successful, this may offer an ideal synthesis between the duty to respect patient autonomy and that of beneficence, which at times favors paternalistic influence. A growing body of literature attempts to assess the merits of nudging in health care. However, this literature deals almost exclusively with health policy, while the question of the potential benefit of nudging for the practice of informed consent has escaped systematic analysis. This article focuses on this question. While it concedes that nudging could amount to improper exploitation of cognitive weaknesses, it defends the practice of nudging in a wide range of other conditions. The conclusion is that, when ethically legitimate, nudging offers an important new paradigm for informed consent, with a special potential to overcome the classical dilemma between paternalistic beneficence and respect for autonomy.

Disilvestro (2012). What Does Not Budge for Any Nudge? The American Journal of Bioethics,
Volume 12, Issue 2.

Dworkin (2013). Lying and nudging. J Med Ethics 2013;39:496-497 doi:10.1136/medethics-2012-101060

Eyal (2014). Nudging by shaming, shaming by nudging. Int J Health Policy Manag. 2014 Jul; 3(2): 53–56.

Eyal (2008). Motivating Prevention: from Carrots and Sticks to “Carrots” and “Sticks”. AMA Journal of Ethics, Volume 10, Number 11: 756-762.

Fischer (2015). Is Soft Paternalism Ethically Legitimate? - The Relevance of Psychological Processes for the Assessment of Nudge-Based Policies. Cologne Graduate School Working Paper.

In this article we develop a taxonomy of behavioral policy measures proposed by Thaler and Sunstein (2008). Based on this taxonomy, we discuss the ethical legitimacy of these measures. First, we explain two common reservations against nudges (choice architecture) rooted in utilitarian and Kantian ethics. In addition to wellbeing, we identify freedom of action and freedom of will (autonomy) as relevant ethical criteria. Then, using practical examples, we develop a taxonomy that classifies nudges according to the psychological mechanisms they use and separately discuss the legitimacy of several types of behavioral policy measures. We hope to thereby make a valuable contribution to the debate on the ethical legitimacy of behavioral policy making

Glod (2015). How Nudges Often Fail to Treat People According to Their Own Preferences.Social Theory & Practice, Vol. 41 Issue 4, p 599-617. (attached)

I focus on “prima facie problematic” (PFP) nudges to argue that libertarian paternalism often fails in its promise to track target agents’ own normative standards. I argue that PFP nudges are unjustified to significant numbers of people by virtue of autonomy-based defeaters—what I call “self-determination” and “discretion.” I then argue that in many cases, we face informational constraints on what a person’s good really is. In such cases, these nudges may not even benefit a significant number of agents and so fail even to be paternalistic—where “paternalistic” is a success term—for those they fail to benefit.

Gold & Lichetenburg (2012). Don't Call Me “Nudge”: The Ethical Obligation to Use Effective Interventions to Promote Public Health. The American Journal of Bioethics, Volume 12, Issue 2.

Goodwin (2012). Why We Should Reject ‘Nudge’. Politics, Volume 32, Issue 2, pages 85–92.
This article argues that the use of ‘nudge’ tactics in UK policymaking ought to be rejected. Nudge contravenes the coalition government's aspirations to promote ideas such as empowerment, freedom and fairness. Moreover, it is not an effective strategy for bringing about the kind of behavioural changes required to solve society's ‘big problems’– problems around climate change and public health, for example. The article mines political theory in a way that is distinctly absent from the current literature on ‘nudging’ and brings a fresh and insightful perspective to the nudge debate.

Hanna (2015). Libertarian Paternalism, Manipulation, and the Shaping of Preferences. Social Theory and Practice, Volume 41, Issue 4. 

“Libertarian paternalism” aims to harness cognitive biases in order to improve prudential decision-making. Some critics have objected that libertarian paternalism is wrongly manipulative. I argue that this objection is mostly unsuccessful. First, I point out that some strategies endorsed by libertarian paternalists can help people to better appreciate reasons. Second, I develop an account of manipulation according to which an agent manipulates her target by worsening the target’s deliberative position. The means of influence defended by libertarian paternalists—for instance, the judicious use of default rules—are not manipulative in this way.

Hansen & Jespersen (2013). Nudge and the Manipulation of Choice
A Framework for the Responsible Use of the Nudge Approach to Behaviour Change in Public Policy. European Journal of Risk Regulation.

In Nudge (2008) Richard Thaler and Cass Sunstein suggested that public policy-makers arrange decision-making contexts in ways to promote behaviour change in the interest of individual citizens as well as that of society. However, in the public sphere and Academia alike widespread discussions have appeared concerning the public acceptability of nudgebased behavioural policy. Thaler and Sunstein’s own position is that the anti-nudge position is a literal non-starter, because citizens are always influenced by the decision making context anyway, and nudging is liberty preserving and acceptable if guided by Libertarian Paternalism and Rawls’ publicity principle. A persistent and central tenet in the criticism disputing the acceptability of the approach is that nudging works by manipulating citizens’ choices. In this paper, we argue that both lines of argumentation are seriously flawed. We show how the anti-nudge position is not a literal non-starter due to the responsibilities that accrue on policy-makers by the intentional intervention in citizens’ life, how nudging is not essentially liberty preserving and why the approach is not necessarily acceptable even if satisfying Rawls’ publicity principle. We then use the psychological dual process theory underlying the approach as well as an epistemic transparency criterion identified by Thaler and Sunstein themselves to show that nudging is not necessarily about “manipulation”, nor necessarily about influencing “choice”. The result is a framework identifying four types of nudges that may be used to provide a central component for more nuanced normative considerations as well as a basis for policy recommendations.

Huang et al (2012). Nudge Ethics: Just a Game of Billiards? The American Journal of Bioethics, Volume 12, Issue 2.

Hausman & Welch (2010). Debate: to nudge or not to nudge? Journal of Political Philosophy Volume 18, Issue 1, pages 123–136.

Leggett (2012). The politics of behaviour change: nudge, neoliberalism and the state. Policy & Politics, Volume 42, Number 1, pp. 3-19(17). 

Behaviour change is increasingly central to policy and politics. The exemplar of nudge, and its relationship to behavioural economics and psychology, is outlined. Nudge's claim to libertarian paternalism is evaluated in the context of the neoliberal state. A sociological critique of behavioural economic assumptions enables a still wider account of shifting state–citizen relations. Foucauldian analyses of such relations, as well as deliberative 'think' perspectives, are assessed. A more explicitly political, social-democratic model of the behaviour change state is advocated. This would be more attuned to the socioeconomic context of behaviour, and also be prepared to defend citizens against ubiquitous attempts to shape their subjectivity.

Lunze &, Paasche-Orlow (2013). Financial incentives for healthy behavior: ethical safeguards for behavioral economics.American Journal of Preventive Medicine, 44(6):659-65.

McCrudden & King (2015). The Dark Side of Nudging: The Ethics, Political Economy, and Law of Libertarian Paternalism. SSRN working paper.

McPherson & Smith (2008). Nudging for Liberty. Social Science Research Network.

Ménard (2010). A ‘Nudge’ for Public Health Ethics: Libertarian Paternalism as a Framework for Ethical Analysis of Public Health Interventions? Public Health Ethics, 3 (3): 229-238.

Is it possible to interfere with individual decision-making while preserving freedom of choice? The purpose of this article is to assess whether ‘libertarian paternalism’, a set of political and ethical principles derived from the observations of behavioural sciences, can form the basis of a viable framework for the ethical analysis of public health interventions. First, the article situates libertarian libertarianism within the broader context of the law and economics movement. The main tenets of the approach are then presented and particular attention is given to its operationalization through the notion of a ‘nudge’. Essentially, a ‘nudge’ consists in an intervention, which aims to suggest one choice over another by gently steering individual choices in welfare-enhancing directions yet without imposing any significant limit on available choices. Finally, the article concludes that, while it fails as an overreaching framework of ethical analysis, libertarian paternalism nonetheless constitutes a valuable addition to the conceptual toolbox of public health ethics.

Mills (2013). Why Nudges Matter: A Reply to Goodwin. Politics Volume 33, Issue 1, pages 28–36.
This article argues that, contrary to Goodwin's recent arguments, nudges are compatible with the coalition government's stated aspiration to further self-empowerment. This is because, despite its libertarian roots, nudging is compatible with the promotion of personal autonomy and thus can be used to promote self-empowerment in a non-paternalistic fashion. Further, I argue that nudging may play a valid role in tackling large-scale social problems in tandem with other traditional policy measures. Consequently, Goodwin is wrong to reject choice architecture for these reasons.

Moles (2015). Nudging for Liberals. Social Theory and Practice, Volume 41, Issue 4, October 2015. 

In this article I argue that anti-perfectionist liberals can accept nudging in certain areas: in particular, they can accept nudges aimed at helping people to discharge their nonenforceable duties, and to secure personal autonomy. I claim that nudging is not disrespectful since it does not involve a comparative negative judgment on people’s ability to pursue their plans, and that the judgments that motivate nudging are compatible with treating citizens as free and equal. I also claim that despite being sometimes manipulative, nudging is easy to resist and so it can be employed to pursue legitimate goals.

Ploug et al (2012). To nudge or not to nudge: cancer screening programmes and the limits of libertarian paternalism. J Epidemiol Community Health 2012;66:1193-1196 doi:10.1136/jech-2012-201194

Potts et al (2012). When a Nudge Becomes a Shove. The American Journal of Bioethics, Volume 12, Issue 2.

Quigley (2014). Are health nudges coercive? Monash Bioethics Review March 2014, Volume 32, Issue 1, pp 141-158.

Governments and policy-makers have of late displayed renewed attention to behavioural research in an attempt to achieve a range of policy goals, including health promotion. In particular, approaches which could be labelled as ‘nudges’ have gained traction with policy-makers. A range of objections to nudging have been raised in the literature. These include claims that nudges undermine autonomy and liberty, may lead to a decrease in responsibility in decision-making, lack transparency, involve deception, and involve manipulation, potentially occasioning coercion. In this article I focus on claims of coercion, examining nudges within two of the main approaches to coercion—the pressure approach and the more recent enforcement approach. I argue that coercion entails an element of control over the behaviour of agents which is not plausibly displayed by the kinds of serious examples of nudges posited in the literature.

Quigley & Stokes (2015). Nudging and Evidence-Based Policy in Europe: Problems of Normative Legitimacy and Effectiveness. In Alemanno & Sibony (eds.) Nudge and the Law: A European Perspective. Bloomsbury. 

Raihani (2015). Nudge politics: efficacy and ethics. Frontiers in Psychology, 4: 972.

Sanghai (2013). Salvaging the concept of nudge. J Med Ethics, 39:487-493

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.

Schubert (2015). On the ethics of public nudging: Autonomy and Agency. Joint Discussion Paper Series in Economics by the Universities of Aachen · Gießen · Göttingen Kassel · Marburg · Siegen

Nudges, i.e., low-cost interventions that steer people’s behavior without compromising their freedom of choice, are the key contribution of ‘Libertarian Paternalism’ (LP) to public policy. They typically work through either harnessing or responding to people’s cognitive biases and heuristics – which is why they have been criticized for being manipulative and for compromising personal autonomy. We argue, though, that (i) nudging hardly compromises autonomy, properly understood, and that (ii) it rather risks undermining people’s agency, i.e., their ability to engage in creative self-constitution over time. This reorientation has farranging implications for the ethics of behavioral policies in general and LP in particular.

Selinger & Whyte (2011). Is There a Right Way to Nudge? The Practice and Ethics of Choice Architecture. Sociology Compass, Volume 5, Issue 10, pages 923–935.

Cass Sunstein and Richard Thaler’s Nudge: Improving Decisions about Health, Wealth, and Happiness presents an influential account of why ‘choice architecture’ should be used to ‘nudge’ people into making better decisions than they would otherwise make. In this essay we: (1) explain the main concepts that Thaler and Sunstein rely upon to defend their project; (2) clarify the main conceptual problems that have arisen in discussions about nudges; (3) clarify practical difficulties that can arise during nudge practice; (4) review the main ethical and political objections that have been raised against nudging; and (5) clarify why issues related to meaning can pose methodological problems for creating effective choice architecture.

Sunstein (2015). Nudging and Choice Architecture: Ethical Considerations. Yale Journal on Regulation, Forthcoming.

Is nudging unethical? Is choice architecture a problem for a free society? This essay defends seven 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 customs and traditions; so do spontaneous orders and invisible hands. The private sector inevitably nudges, as does the government. It is reasonable to worry about nudges by government and to object to particular nudges, but not to nudging in general. (2) In this context, ethical abstractions (for example, about autonomy, dignity, manipulation, and democratic self-government) can create serious confusion. To make progress, those abstractions must be brought into contact with concrete practices. Nudging and choice architecture take highly 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, even if it comes from government. (4) If autonomy is our guide, much nudging is also required on ethical grounds, in part because some nudges actually promote autonomy, in part because some nudges enable people to devote their limited time and attention to their most important concerns. (5) Choice architecture should not, and need not, compromise either dignity or self-government, but it is important to see that imaginable forms could do both. It follows that when they come from government, choice architecture and nudges should not be immune from a burden of justification, which they might not be able to overcome. (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 ample 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.

Sunstein (2014). The Ethics of Nudging. SSRN Working Paper.

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.

Swindell et al (2010). Beneficent Persuasion: Techniques and Ethical Guidelines to Improve Patients’ Decisions. Annals of Family Medicine, vol. 8 no. 3 260-264.

Physicians frequently encounter patients who make decisions that contravene their long-term goals. Behavioral economists have shown that irrationalities and self-thwarting tendencies pervade human decision making, and they have identified a number of specific heuristics (rules of thumb) and biases that help explain why patients sometimes make such counterproductive decisions. In this essay, we use clinical examples to describe the many ways in which these heuristics and biases influence patients’ decisions. We argue that physicians should develop their understanding of these potentially counterproductive decisional biases and, in many cases, use this knowledge to rebias their patients in ways that promote patients’ health or other values. Using knowledge of decision-making psychology to persuade patients to engage in healthy behaviors or to make treatment decisions that foster their long-term goals is ethically justified by physicians’ duties to promote their patients’ interests and will often enhance, rather than limit, their patients’ autonomy. We describe techniques that physicians may use to frame health decisions to patients in ways that are more likely to motivate patients to make choices that are less biased and more conducive to their long-term goals. Marketers have been using these methods for decades to get patients to engage in unhealthy behaviors; employers and policy makers are beginning to consider the use of similar approaches to influence healthy choices. It is time for clinicians also to make use of behavioral psychology in their interactions with patients.

Vallgarda (2012). Nudge—A new and better way to improve health? Health Policy Volume 104, Issue 2, Pages 200–203.

Nudging, or libertarian paternalism, is presented as a new and ethically justified way of improving people's health. It has proved influential and is currently taken up by the governments in the US, the UK and France. One may question the claim that the approach is new, in any case it has many similarities with the idea of “making healthy choices easier”. Whether the approach is better from an ethical perspective depends on the ethical principles one holds. From a paternalistic perspective there could be no objections, but from a libertarian, there are several. Contrary to what the authors state, libertarian paternalism is an oxymoron.

Wertheimer (2012). Should Nudge be salvaged? J Med Ethics doi:10.1136/medethics-2012-101061

Whitman & Rizzo (2015). The Problematic Welfare Standards of Behavioral Paternalism. Review of Philosophy and Psychology, Volume 6, Issue 3, pp 409-425. 

Behavioral paternalism raises deep concerns that do not arise in traditional welfare economics. These concerns stem from behavioral paternalism’s acceptance of the defining axioms of neoclassical rationality for normative purposes, despite having rejected them as positive descriptions of reality. We argue (1) that behavioral paternalists have indeed accepted neoclassical rationality axioms as a welfare standard; (2) that economists historically adopted these axioms not for their normative plausibility, but for their usefulness in formal and theoretical modeling; (3) that broadly rational individuals might fail to satisfy the axioms for various reasons, making them unpersuasive as normative criteria; and (4) that even if their violation did constitute irrationality, that would not justify paternalists’ choosing among inconsistent preferences to define an individual’s “true” preferences.

Whyte et al (2012). Nudge, Nudge or Shove, Shove—The Right Way for Nudges to Increase the Supply of Donated Cadaver Organs. The American Journal of Bioethics, Volume 12, Issue 2.
Richard Thaler and Cass Sunstein (2008) contend that mandated choice is the most practical nudge for increasing organ donation. We argue that they are wrong, and their mistake results from failing to appreciate how perceptions of meaning can influence people's responses to nudges. We favor a policy of default to donation that is subject to immediate family veto power, includes options for people to opt out (and be educated on how to do so), and emphasizes the role of organ procurement organizations and in-house transplant donation coordinators creating better environments for increasing the supply of organs and tissues obtained from cadavers. This policy will provide better opportunities for offering nudges in contexts where in-house coordinators work with families. We conclude by arguing that nudges can be introduced ethically and effectively into these contexts only if nudge designers collaborate with in-house coordinators and stakeholders.

Wikler & Eyal (2013). Nudges and Noodges: The Ethics of Health Promotion—New York Style. Public Health Ethics (2013) 6 (3): 233-234.
Michael Bloomberg's three terms in New York City's mayoral office are coming to a close. His model of governance for public health influenced cities and governments around the world. What should we make of that model? This essay introduces a symposium in which ethicists Sarah Conly, Roger Brownsword and Alex Rajczi discuss that legacy.

Wilkinson (2013). Nudging and Manipulation. Political Studies, Volume 61, Issue 2, pages 341–355.

Behavioural economics and social psychology have shown that humans have all sorts of psychological quirks. Policy makers have become enthusiastic about taking advantage of these quirks through what Thaler and Sunstein call ‘nudges’. This article asks: when would nudging be manipulative? The article has six parts: (1) publicity and transparency, which claims that Thaler and Sunstein's own attempt to deal with evil nudges is inadequate; (2) manipulation and autonomy, where the nature and wrongness of manipulation is connected to a conception of autonomy; (3) the perversion of the decision-making process – a piecemeal approach, which sorts nudges into easy and hard cases and assesses attempts to pick out certain methods, such as temptation, as manipulative; (4) the perversion of the decision-making process – general accounts, which shows why we do not have a clear, complete and correct account of what such perversion is; (5) intentions and nudging's escape clause, where it is shown that governments that nudge as Thaler and Sunstein would wish do not manipulate because they do not have the intention to manipulate; and (6) consensual manipulation, where it is claimed that manipulation can, with the right consent, be consistent with autonomy.

Yeung (2012). Nudge as Fudge. The Modern Law Review, Volume 75, Issue 1, pages 122–148.

Wednesday, November 18, 2015

November 18th Links

Apologies that blogging has not been as frequent this term but am hoping now to start again more frequently. Suggestions always welcome.

1. Details of our upcoming workshop on economics and psychology of self-control are available here.

2. Our evolving programme for 2016 is available here.

3. Fascinating historical work by Warwick Prof Mark Harrison on KGB use of personalised messages to influence behaviour. It is interesting to study how different regimes use such techniques in different contexts.

4. Anne Case and Angus Deaton's recent PNAS paper documenting increasing all-cause morbidity among mid-life Whites in the US is a striking piece of work. Would be good to do an online journal club on this work and discuss the implications.

5. BIT blogpost updating on pension autoenrolment in the UK. This is arguably the most important policy to date to have been influenced by the literature in behavioural economics and the progress of this is worth tracking for anyone interested in the area.

6. Speaking of BIT - they are hiring again. Currently two Stirling MSc graduates working there.

7. Cass Sunstein's Dublin talk - "Is behavioural science compatible with democracy?"

8. The 2015 CRISP lecture - 'Humanity vs Surveillance' - will take place Mon 23 Nov, 6:30pm

Friday, November 13, 2015

Recent findings on Impatience

Inter-temporal choices are ubiquitous. As the economic literature on time preferences highlights (Frederick et al., 2002), they affect our health, wealth and happiness. In this post, we want to briefly present three recently published studies which help to elucidate the human eagerness to procrastinate, do some things immediately, without waiting for future rewards, or what behavioural studies conceptualize as impatience.

The first distinctive finding is that impatient individuals are more likely to procrastinate. Researchers collected lab and field evidence in a study which measured the propensity of MBA students from the University of Chicago to postpone the accomplishment of different tasks (in number of days) under costly procrastination, for example an online game, and their application to the university. Impatience was measured in a conventional smaller-sooner versus larger-later monetary reward task which infers participants’ short-term discount rates, but the researchers made use of a novel payment mechanism: participants were paid with a check they would have to cash later. 

Figure 1. Two-week discount rates

This allowed them to observe the number of days the students take to cash the checks, and then test its relationship with their procrastinating behaviour in the tasks and with their elicited short-run discount rates. They find that even these highly skilled and financially literate MBA students have time inconsistent behaviour since the majority of them who preferred to receive their payment immediately instead of waiting two weeks for a larger amount (see Figure 1 to check how high were the discount rates!), actually procrastinated and took more than two weeks to turn their payments into cash.

The second finding comes from an experiment with kindergarten children from Austria which suggests that simple defaults can help to attenuate impatience and promote delay of gratification in early childhood. In a control treatment, two units of a previously chosen gift (gummy bears, crazy bands, banana chips, and lollipops) were put on a table in front of the child, and then the child was asked whether it wanted to take one unit immediately or wait and receive both units the next day. In the case of preference for the delayed gratification, both items were put into an envelope and sealed to be distributed to the child the next day. In the default treatment, the two items of the most preferred gift were first put into the envelope so if a child wanted to receive one item immediately, the experimenter took it out of the sealed envelope.

Figure 2. Decisions of children to wait by age group and treatment

While fifty per cent of the kids delay gratification in the control condition, this proportion increases to seventy per cent in the default condition (see Figure 2). The authors also show that the more patient kids had lower body-mass index (BMI). This research builds on the literature of how some interventions, for example educational programs and commitment devices, could make children more forward-looking and less present-biased.

The other finding we want to address is about how economic incentives in the form of food prices interact with impatience to determine obesity. Using data from the National Longitudinal Study of Youth – NLSY, researchers tried to explain why the observed increases in BMI among American citizens have been concentrated in the distribution's right tail. This fact is intriguing because if declining food prices affect consumption decisions homogeneously across individuals, there should be only an increase on average BMI but no change in the variance of the distribution. Interestingly, they show that interacting impatience measures (discount rates) with food prices reveals that the gap between the BMI of impatient and patient individuals is larger in counties with lower food prices.

Figure 3. BMI distribution

These recent findings help us to better understand how impatience is related with procrastination. Also, they highlight whether policies, such as default choices and economic incentives, might be effective to alter behaviour.

Frank H.T. Rhodes Postdoctoral Fellowships

The Cornell Population Center (CPC) invites applicants for the Frank H.T. Rhodes Postdoctoral Fellowships.  The start date for the position will be August 15, 2016 and will be funded for 2 years, subject to a satisfactory first year evaluation.  Selection will be based on scholarly potential, ability to work in multi-disciplinary settings, and the support of a faculty mentor and CPC affiliate at Cornell who will work closely with the post-doctoral associate. Preference will be given to fellows with research interests in areas broadly related to the CPC’s four main foci: families & children; health behaviors & disparities; poverty & inequality; and immigration & diversity. Especially encouraged are applications from candidates whose research has significance for those countries on which the fellowship’s funder focuses – the United States, the Republic of Ireland, Northern Ireland, Vietnam, South Africa, and Bermuda.

The Frank H. T. Rhodes Fellowships stand as a testament to the profound difference Frank Rhodes has made at Cornell by furthering scholarship and research in areas related to poverty alleviation, support for the elderly and disadvantaged children and youth, public health, and human rights. The postdoctoral program is designed to provide support through collaborations with faculty and to assist new scholars in launching their own programs of research. Postdoctoral Associates devote most of their time to independent research, but are expected to be involved in CPC institution building activities, as well. See for more information about the Cornell Population Center.

Postdoctoral associate will have access to university resources and receive an annual salary of $50,000 plus benefits and a modest research/travel account.


Applicants must have a Ph.D. in demography, economics, sociology, or another related social science discipline by August 15, 2016.

Application Instructions

Applications must include: (a) letter of application, (b) curriculum vita, (c) a statement proposing both an individual research project and how the candidate will engage with a CPC faculty affiliate’s on-going research, (d) examples of written work, (e) a letter from a CPC faculty affiliate agreeing to mentor the candidate, and (f) three letters of recommendation. Applicants must apply at: (

Screening of applications begins December 15, 2015, and will continue until the position is filled. For questions, please contact Erin Oates (

Thursday, November 05, 2015

Assessment of Residents’ Attitudes and Satisfaction Before and After Implementation of a Smoke-free Policy in Boston Multiunit Housing

Assessment of Residents’ Attitudes and Satisfaction Before and After Implementation of a Smoke-free Policy in Boston Multiunit Housing

Slawa Rokicki, Gary Adamkiewicz, Shona C. Fang, Nancy A. Rigotti, Jonathan P. Winickoff, Doug E. Levy

Nicotine & Tobacco Research, Forthcoming



In 2012, the Boston Housing Authority (BHA) implemented a smoke-free policy prohibiting smoking within its residences. We sought to characterize BHA resident experiences before and after the smoke-free policy implementation, and compare them to that of residents of the Cambridge Housing Authority (CHA), which had no such policy.


We recruited a convenience sample of nonsmoking residents from the BHA and CHA. We measured residents’ awareness and support of their local smoking policies before and 9-12 months after the BHA’s policy implementation, as well as respondents’ attitudes towards the smoke-free policy. We assessed tobacco smoke exposure (TSE) via saliva cotinine, airborne apartment nicotine, and self-reported number of days smelling smoke in the home. We evaluated predictors of general satisfaction at follow-up using linear regression.


At follow-up, 91% of BHA respondents knew that smoking was not allowed in apartments and 82% were supportive of such a policy in their building. BHA residents believed enforcement of the smoke-free policy was low. Fifty-one percent of BHA respondents indicated that other residents “never” or “rarely” followed the smoke-free rule and 41% of respondents were dissatisfied with policy enforcement. Dissatisfaction with enforcement was the strongest predictor of general housing satisfaction, while objective and self-reported measures of TSE were not predictive of satisfaction. At follow-up, 24% of BHA participants had complained to someone in charge about policy violations.


Resident support for smoke-free policies is high. However, lack of enforcement of smoke-free policies may cause frustration among residents, potentially leading to a decrease in housing satisfaction.