OsloMet - Oslo Metropolitan University, Norway.
Nurs Ethics. 2019 Sep;26(6):1601-1610. doi: 10.1177/0969733018779226. Epub 2018 Jun 26.
Nudging is a concept in behavioural science, political theory and economics that proposes indirect suggestions to try to achieve non-forced compliance and to influence the decision making and behaviour of groups and individuals. Researchers in medical ethics are currently discussing whether nudging is ethically permissible in healthcare. In this article, we examine current knowledge about how different decisions (rational and pre-rational decisions, major and minor decisions) are made and how this decision-making process pertains to patients. We view this knowledge in light of the nursing project and the ongoing debate regarding the ethical legitimacy of nudging in healthcare. We argue that it is insufficient to discuss nudging in nursing and healthcare in light of free will and patient autonomy alone. Sometimes, nurses must take charge and exhibit leadership in the nurse-patient relationship. From the perspective of nursing as leadership, nudging becomes a useful tool for directing and guiding patients towards the shared goals of health, recovery and independence and away from suffering. The use of nudging in nursing to influence patients' decisions and actions must be in alignment with the nursing project and in accordance with patients' own values and goals.
推动是行为科学、政治理论和经济学中的一个概念，它提出了间接的建议，试图实现非强制性的服从，并影响群体和个人的决策和行为。医学伦理学家目前正在讨论在医疗保健中推动是否在道德上是允许的。在本文中，我们研究了关于不同决策（理性和前理性决策、主要和次要决策）是如何做出的，以及这一决策过程与患者的关系的现有知识。我们根据护理项目和关于医疗保健中推动的伦理合法性的持续辩论来看待这些知识。我们认为，仅仅根据自由意志和患者自主性来讨论护理和医疗保健中的推动是不够的。有时，护士必须在护患关系中承担责任并表现出领导力。从护理作为领导力的角度来看，推动成为一种有用的工具，可以引导和指导患者朝着健康、康复和独立的共同目标前进，远离痛苦。在护理中使用推动来影响患者的决策和行动必须符合护理项目，并符合患者自己的价值观和目标。
