Is nudging patients ethical? Podcast with Jenny Blumenthal-Barby and Scott Halpern
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
48 min
5 speakers
8 chapters
transcribed 7 hours ago
Transcript
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What is the definition of a “nudge” and how does it differ from coercion or incentives?
The JerryPow podcast is brought to you by Archstone Foundation, improving the health and well-being of older Californians and their caregivers.
Welcome to the Jerry Pal podcast. This is Eric Radera. This is Alex Smith. And Alex, who do we have on today?
We are delighted to welcome Jenny Blumenthal Barbie, who is professor of medical ethics at the Baylor College of Medicine. Welcome to the Jerry Powell podcast, Jenny.
Thank you.
And we are delighted to welcome Scott Halpern, who's professor of medicine, medical ethics, and health policy at the University of Pennsylvania. Welcome to the JerryPound Podcast, Scott.
Thanks, Eric, and Alex.
Yeah, I think it's interesting, Alex. You had a tough decision. Which of our guests would you introduce first? So many decisions we have to make on every single podcast, every single day. How do you decide if it's a good or bad choice? So we're going to be talking about decision making, decisional architecture, nudges. Um, and I think a lot of this came out of uh Denny just published a great. Book called Good Ethics and Bad Choices, The Relevance of Behavioral Economics for Medical Ethics. So we're gonna be talking about that, some of the work that Scott has done too. Um, but before we do, we always start off with a song choice. Who has a song request?
Uh I've got a I've got one for you, Alex. What do you think about um Don't Think Twice, It's Alright by Bob Dylan?
All right. Wha wh this will be the third time, so I'm gonna do it on piano this time just to change it up. W why this song?
Well, the fact that others have requested it before speaks to what an amazing song it is, first
of all. Let's see. Let's see how we can nudge each other during this podcast. That's a
cognitive bias, right? Isn't that one of the
I think that was no norms to appeal to something?
Appeals to the norms. Most of our guests. This is kind of what nudging is all about,
right? Like just the you know, we we want people to think. But not too much, not twice.
I'm I'm pretty sure how Alex asked the question about which song is he steers people to Bob Dylan. Does he
Wow. I don't know. I'm worried now that by the end of this podcast, Jenny and Scott will be the interviewers. They're gonna take over the Jared Bell podcast because they will have nudged us out of the way. Yeah. Exactly I'd just like to make
the claim that rational people do not need to be nudged toward Bob Dylan. It just happens organically.
Okay, Alex, before we give it all away.
Right, right, right. The song. Yes, before we get too far into it.
When ain't no use in wonderful. Anything you don't know by now. It ain't no use in sitting wonder why. You don't never do. Anyhow. When your rooster crows at the Break it all. Out your window and I'll be gone. You're the reason I'm traveling on And don't think twice it's alright.
Outstanding.
Mixing it up with the piano. I like it, Alex.
Mixing it up a little, I don't know.
Well, um let's dive into the topic. Um I'm hoping first Just to describe a little bit of what these big terms mean. And then I'd love to hear from both of you how you got interested in in particular behavioral economics, nudging, and kind of choice architecture. Before we talk about how you got interested, what the heck are those things? What what's behavioral economics?
I'm gonna let Scott explain what behavioral economics is.
Oh wow.
That was a little more than a nudge there.
Yeah, that
was a
scud.
How did Jenny Blumenthal‑Barby become interested in behavioral economics and medical ethics?
That was a shuff.
Transparent, a transparent nudge.
Yeah. Aren't you like supposed to appeal to his ego? Isn't that right?
Scott is like an expert on behavioral economics in as a field. So I'm gonna let him explain what it is.
All right. Well, please chime in, Jenny. Um you know, behavioral economics is really a melding of uh subfields of the broader disciplines of both economics and psychology. Uh it's an important component of behavioral science writ large and the in the general. концепт Is that Ви Have lots of influences on our decisions all around us that are foreseeably influential on the choices that we make. And the common thread in all behavioral economic interventions is that they
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Chapters
8 chapters
1
What is the definition of a “nudge” and how does it differ from coercion or incentives?
0:01–4:37
2
How did Jenny Blumenthal‑Barby become interested in behavioral economics and medical ethics?
4:37–11:53
3
What are the main findings from Scott Halpern’s advance‑directive default studies?
11:53–18:39
4
How can clinicians use decision‑aid framing and defaults to promote patient‑centered care?
18:39–24:35
5
When do nudges become ethically problematic or overly paternalistic?
24:35–31:05
6
What role do social‑norm messages and messenger effects play in influencing patient choices?
31:05–36:07
7
If you had a magic wand, what single change would improve how providers apply behavioral economics?
36:07–42:41
8
What are the key take‑aways and practical recommendations for using nudges responsibly in geriatrics and serious illness care?
42:41–48:57
Speakers
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