Nudging in Neonatology: Practical Wisdom and Accountability for Reasonableness

Michal Stanak
International Journal of Technology Assessment in Health Care 2019 February 12, : 1-5

OBJECTIVES: The way choice is presented has an impact on decision-making. This is the case also in the context of neonatal intensive care units (NICUs), particularly in the challenging cases that concern the limit of viability. The objective of this article is to examine the role of nudging in the shared decision-making in neonatology and elaborate on the respective moral challenges.

RESULTS: Nudging is not morally neutral. There are two key sources of ethical issues at the heart of nudging. The first one concerns the lack of transparency, while the second concerns the background value judgments that are imminent whenever nudging is used for achieving a particular end. To solve the underlying conflict, a virtue ethics approach combined with the accountability for reasonableness framework is suggested to guide the use of the tool of nudging.

CONCLUSIONS: NICU professionals ought to use the tool of nudging transparently in line with their act of profession and their practically wise judgment.

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