Habits, nudges, and consent.

In any health care crisis, the first priority is to improve the patient’s condition. But this priority is not absolute as it is normally subject to the patient’s (or someone on her behalf) approval. This can sometimes lead to serious difficulties when the patient on epistemological (the patient may be ignorant or misinformed), political (the patient may have political objections to a particular treatment or medical professional), emotional (the patient may be just too scared), ethical (see ‘political’), personal (the patient may want to die or suffer), or religious (see ‘political’) grounds – refuses treatment. The compatibility of successful medical treatment and patient’s consent – and the extent to which medical paternalism can be justified is one of the great challenges of contemporary medical ethics. It has been recently suggested (Cohen, forthcoming) that we can make progress on this issue by showing that the choice architecture of nudges (Thaler & Sunstein, 2008) is compatible with informed consent, so that we can obtain