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This timely book makes a forceful argument that the analyses from behavioral economists are incomplete, the policies advocated by libertarian paternalists are misguided and unethical, and both actually reinforce the cognitive biases and dysfunctions that motivate 'nudges' in the first place. In a lighthearted manner, the author points out critical flaws in the way economists model decision-making, how behavioral economics failed to correct them, and how they led to the problems with libertarian paternalism and nudges. Sprinkled throughout with anecdotes, examples, and references to a wide range of scholarly literature, this new volume argues against the use of paternalistic nudges by the government and makes a positive case for individual choice and autonomy. This book is part of White's triptych on individualism and society, which includes The Illusion of Well-Being and The Decline of the Individual.
Thaler and Sunstein offer a groundbreaking discussion of how to apply the science of choice to nudge people toward decisions that can improve their lives without restricting their freedom of choice.
Libertarian Paternalism has been hailed by its proponents as the 'true Third Way'. It attempts to reconcile paternalism and libertarianism, and claims to provide freedom-preserving solutions to some of the most intractable problems faced by contemporary Western societies. The bounded rationality of voters is not ignored, but is exploited for their greater good. The approach is cheap to implement, and, its proponents claim, often very effective. What is there to dislike? In Taking Liberties, Rebonato examines whether the freedom-preserving claims of libertarian paternalism truly stand up to scrutiny; questions the degree of effective decisional autonomy it affords; and raises concerns about the transparency deficit of the programme and about its supposed value-neutrality. Taking Liberties argues that libertarian paternalism fails to respect decisional autonomy exactly if individuals truly are as cognitively impaired as libertarian paternalists claim. If this is the case, exploiting the citizens' decisional deficiencies (even for the own good) poses difficult moral and political issues, which are largely ignored in the libertarian paternalistic literature. If, on the other hand, the cognitive shortcomings of individuals are not as pervasive and 'hard-wired' as the behavioural finance literature seems to suggest – and Rebonato reports convincing evidence to this effect – a completely different programme, aimed at improving the quality of the whole decision process, not just of the outcomes, becomes more desirable and defensible. If we accept that some degree of paternalistic intervention by the state is desirable, Rebonato argues that, paradoxically, a hard, transparent and highly visible form of paternalism may be more desirable – if for no other reason than for the ability it gives voters to reject it. As they engage in this process of acceptance or rejection, Rebonato claims, citizens and voters make use of their critical faculties, engaging in a process that has value over and above a narrow evaluation of the outcomes. The libertarian paternalistic alternative is not attractive: by accepting the supposed cognitive limitations of individuals as inevitable, and by attempting to systematically exploit them, libertarian paternalism can dull our critical faculties, and, in the end, the programme can become a self-fulfilling prophecy. This is not a perspective than any true libertarian should cherish. 'The slumber of reason generates monsters', Goya wrote. Turning these monsters into pleasant dreams without waking up the sleeper may be possible. But is it desirable? In Taking Liberties, Rebonato argues that it is not.
Behavioral nudges are everywhere: calorie counts on menus, automated text reminders to encourage medication adherence, a reminder bell when a driver’s seatbelt isn’t fastened. Designed to help people make better health choices, these reminders have become so commonplace that they often go unnoticed. In Nudging Health, forty-five experts in behavioral science and health policy from across academia, government, and private industry come together to explore whether and how these tools are effective in improving health outcomes. Behavioral science has swept the fields of economics and law through the study of nudges, cognitive biases, and decisional heuristics—but it has only recently begun to impact the conversation on health care. Nudging Health wrestles with some of the thorny philosophical issues, legal limits, and conceptual questions raised by behavioral science as applied to health law and policy. The volume frames the fundamental issues surrounding health nudges by addressing ethical questions. Does cost-sharing for health expenditures cause patients to make poor decisions? Is it right to make it difficult for people to opt out of having their organs harvested for donation when they die? Are behavioral nudges paternalistic? The contributors examine specific applications of behavioral science, including efforts to address health care costs, improve vaccination rates, and encourage better decision-making by physicians. They wrestle with questions regarding the doctor-patient relationship and defaults in healthcare while engaging with larger, timely questions of healthcare reform. Nudging Health is the first multi-voiced assessment of behavioral economics and health law to span such a wide array of issues—from the Affordable Care Act to prescription drugs. Contributors: David A. Asch, Jerry Avorn, Jennifer Blumenthal-Barby, Alexander M. Capron, Niteesh K. Choudhry, I. Glenn Cohen, Sarah Conly, Gregory Curfman, Khaled El Emam, Barbara J. Evans, Nir Eyal, Andrea Freeman, Alan M. Garber, Jonathan Gingerich, Michael Hallsworth, Jim Hawkins, David Huffman, David A. Hyman, Julika Kaplan, Aaron S. Kesselheim, Nina A. Kohn, Russell Korobkin, Jeffrey T. Kullgren, Matthew J.B. Lawrence, George Loewenstein, Holly Fernandez Lynch, Ester Moher, Abigail R. Moncrieff, David Orentlicher, Manisha Padi, Christopher T. Robertson, Ameet Sarpatwari, Aditi P. Sen, Neel Shah, Zainab Shipchandler, Anna D. Sinaiko, Donna Spruijt-Metz, Cass R. Sunstein, Thomas S. Ulen, Kristen Underhill, Kevin G. Volpp, Mark D. White, David V. Yokum, Jennifer L. Zamzow, Richard J. Zeckhauser
This work sets the stage regarding debates about paternalism and health care for years to come. The anthology is organized around four parts: i) The concept of paternalism and theoretical issues regarding the idea of anti-paternalism, ii) strategies for justifying different forms of paternalism, iii) paternalism in psychiatry and psychotherapy, iv) paternalism and public health, and v) paternalism and reproductive medicine. Medical paternalism was arguably one of the main drivers of debates in medical ethics and has led to a wide acknowledgement of the value of patient autonomy. However, more recent developments in health care, such as the increasing significance of public health measures and the commercialization of medical services, have led to new social circumstances and hence to the need to rethink issues regarding paternalism. This work provides an invaluable source for many scholars and practitioners, since it deals in new and original ways with one of the main and oldest issue in health care ethics.​
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