by Laura Dodsworth, The Free Mind
The Terminally Ill Adults (End of Life) Bill, currently before the House of Lords, has been presented by its supporters as a measure rooted in autonomy, dignity and choice. The framing is powerful. Who could be against those values?
But beneath the surface of the language lies another story — about the way we are subtly guided, pushed and pulled toward certain decisions by structures, systems and the very design of our choices. These are what behavioural scientists call nudges. Nudges are not supposed to be coercive — they do not forbid options or impose punishments. They are, as Richard Thaler and Cass Sunstein put it in their book Nudge, “any aspect of the choice architecture that alters people’s behaviour in a predictable way without forbidding any options or significantly changing their economic incentives.”
Nudges work precisely because they are not obvious. They operate below the level of consciousness. They are subtle, otherwise they wouldn’t work. In other words people can’t avoid the influence of nudges, because nudges are not visible or obvious in all cases. They work below the level of consciousness, they are subtle, otherwise they wouldn’t work. It is a contradiction that something can both influence choice and preserve freedom of choice.
Choice architecture can involve defaults, framing, timing, ordering, reminders, messenger effects or even small changes in the environment.
Nudges are now commonplace tactics in business, education, government and all walks of life. And in healthcare, nudges abound.