“Nudges” are features of the ways that choices are presented to agents that influence their disposition to choose one option over another, but without taking options away, and without giving them a reason to choose that option. Rather, they target shallow cognitive mechanisms like biases and heuristics to produce reliable, predictable changes in choosers’ choices. In medical decision-making, for example, physicians can influence patients’ choices by intentionally tailoring the order in which options are presented or the language used to frame information (e.g. “90% chance of survival” vs. 10% chance of mortality”), without thereby taking any options away from them.
Clinical nudging has been proposed as a way for physicians to promote patients’ well-being by steering them toward choices that are actually in their best interest. However, nudges have been criticized on the grounds that they disrespect or undermine choosers’ autonomy by bypassing their rational cognitive processes. It particular, it has been argued that clinical nudging undermines informed consent by interfering with patients’ ability to weigh reasons bearing on their decisions.
Drawing on the philosophy of language and cognitive science, this paper argues that nudges can be used to direct patients’ attention to factors to which they should be attentive. Patients depend on physicians to identify, inform them about, and promote their understanding of salient features of their situation. The paper therefore defends (some) nudges on the basis that they promote informed decision-making by contributing to patients’ appreciation of relevant considerations.