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Should we nudge people into screening?

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The help-bad-choosers argument says nudges fix deficient choosers; epistemic risk in screening (being wrong in knowledge-making, including false positives) undercuts that defence and even opt-out’s autonomy.

Source

Why we should not "help bad choosers:" screening, nudging, and epistemic risk

Zameska J · Medicine, health care, and philosophy · 2024

doi.org/10.1007/s11019-024-10217-8Read the full paper ↗1 citationscc by

What they did

The author defines nudging as designing choice environments to raise screening uptake, states the HBCA, then introduces epistemic risk as the risk of being wrong in knowledge-producing practices. Value judgments about which errors to tolerate fall on physicians and decision-makers.

What they found

HBCA looks like a strong reason to nudge despite autonomy/consent worries, but epistemic risk makes it doubtful that opting out is fully autonomous and that nudges simply help bad choosers toward their own good.

The limits

What it doesn't show

This is a principle paper about screening programmes, not a trial of a specific nudge. It does not quantify false-positive rates itself.

Key terms

HBCA
Help-bad-choosers argument: appropriate nudges help people with choice-related deficiencies choose better.
Nudging
Deliberate design of choice environments so people pick the architect’s favoured option more often.
Epistemic risk
Risk of being wrong in knowledge-producing practices, including screening errors such as false positives.
Opt-out autonomy
The claim that leaving a default is a fully autonomous choice — doubted here under epistemic risk.

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HBCA says nudges?

Common questions

What is HBCA?

Nudging can help ‘bad choosers’ make choices more in their interests.

What is epistemic risk?

The risk of being wrong during knowledge-producing practices.

Why it blocks HBCA in screening?

Screening errors and value-laden error trade-offs mean nudges are not a clean help to knowers.

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