Ploug Thomas, Holm Søren, Brodersen John
Department of Communication and Psychology, Centre for Applied Ethics and Philosophy of Science, Aalborg University Copenhagen, A. C. Meyers Vænge 15, 2450, Copenhagen SV, Denmark,
Med Health Care Philos. 2014 Nov;17(4):641-50. doi: 10.1007/s11019-014-9566-9.
The idea that it is acceptable to 'nudge' people to opt for the 'healthy choice' is gaining currency in health care policy circles. This article investigates whether researchers evaluating Abdominal Aortic Aneurysm Screening Programmes (AAASP) attempt to influence decision makers in ways that are similar to popular 'nudging' techniques. Comparing two papers on the health economics of AAASP both published in the BMJ within the last 3 years, it is shown that the values chosen for the health economics modelling are not representative of the literature and consistently favour the conclusions of the articles. It is argued (1) that this and other features of these articles may be justified within a Libertarian Paternalist framework as 'nudging' like ways of influencing decision makers, but also (2) that these ways of influencing decision makers raise significant ethical issues in the context of democratic decision making.
“轻推”人们选择“健康选项”是可以接受的这一观点，在医疗保健政策圈子里正逐渐流行起来。本文调查评估腹主动脉瘤筛查项目（AAASP）的研究人员，是否试图以类似于流行的“轻推”技巧的方式影响决策者。通过比较过去3年内发表在《英国医学杂志》上的两篇关于AAASP健康经济学的论文发现，健康经济学模型所选用的数值并不代表该领域文献，且始终偏向于文章的结论。有人认为：（1）这些文章的这一特点及其他特点，在自由意志家长主义框架内，可能作为类似“轻推”的影响决策者的方式是合理的，但（2）在民主决策的背景下，这些影响决策者的方式引发了重大的伦理问题。
