Defense Date

10-24-2024

Graduation Date

Winter 12-20-2024

Availability

Immediate Access

Submission Type

dissertation

Degree Name

PhD

Department

Health Care Ethics

School

McAnulty College and Graduate School of Liberal Arts

Committee Chair

Gerard Magill

Committee Member

Joris Gielen

Committee Member

Peter Osuji

Keywords

Nudges, Healthcare, Clinical Ethics, Organizational Ethics, Autonomy

Abstract

“The Ethical Contributions of Nudges to Healthcare” examines the ethical use, implications, and rationale for using nudges in healthcare. The use of nudges in healthcare are being empirically examined. This leaves much to be examined from the ethical perspective. To examine the ethical perspective, the dissertation lays out how nudges interact with and enhance the biomedical principles of autonomy and beneficence. The dissertation then turns to clinical ethics. Nudges, more specifically the framing effect, are paired with trust in the patient-physician relationship to discern how best to aid a patient in his or her medical decision-making. The dissertation then investigates how healthcare organizations can use, evaluate, and implement nudges. The chapter continues by applying nudges to various hospital departments and explores how nudges can be used across medical disciplines. Nudges are applicable across medical disciplines and should be used prudently to aid individuals in decision-making. Using nudges in medicine can be problematic when healthcare institutions rely on canonical texts that allow or prohibit specific medical treatments. These foundational texts can limit nudging’s main principle of maintaining all available options. Maintaing all available options is difficult given the limit on which treatments are licit. This is true for active, voluntary euthanasia. Healthcare institutions that follow Islamic and Catholic ethics cannot offer this procedure to their patients. The dissertation then takes a step back and examines how nudges can be used in an educational way at the end of life. The dissertation investigates the role they play in distinguishing deep, continuous palliative sedation from active, voluntary euthanasia. Lastly, the dissertation takes a speculative turn and looks at how medicine and nudging may look when they are paired together in the context of human enhancement and transhumanism. The underpinnings of human enhancement and transhumanism represent a shift in medicine and its goals. Partnering them with a value laden concept such as nudging can accelerate this shift even more while neglecting other important values.

Language

English

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