Ludwig Boltzmann Institute for Health Technology Assessment and Department of Philosophy,University of Vienna.
Int J Technol Assess Health Care. 2019 Jan;35(1):5-9. doi: 10.1017/S0266462318003732. Epub 2019 Feb 12.
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.
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.
NICU professionals ought to use the tool of nudging transparently in line with their act of profession and their practically wise judgment.
呈现选择的方式会对决策产生影响。这在新生儿重症监护病房（NICU）的情况下也是如此，特别是在涉及生存极限的具有挑战性的情况下。本文的目的是探讨在新生儿学中的共同决策中推动的作用，并详细阐述各自的道德挑战。
推动并不是道德中立的。在推动的核心有两个关键的道德问题来源。第一个涉及缺乏透明度，而第二个涉及每当推动被用于实现特定目标时就会出现的潜在背景价值判断。为了解决潜在的冲突，建议采用美德伦理方法并结合合理性问责框架来指导推动工具的使用。
新生儿重症监护病房的专业人员应该根据自己的职业行为和实际明智的判断，透明地使用推动工具。
