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Behaviorally Informed Health Policy? Patient Autonomy, Active Choosing, and Paternalism

Forthcoming, Nudging Health: Health Law and Behavioral Economics (John Hopkins University Press 2015)

17 Pages Posted: 6 Dec 2014  

Cass R. Sunstein

Harvard Law School; Harvard University - Harvard Kennedy School (HKS)

Date Written: December 3, 2014

Abstract

Many people have insisted on an opposition between active choosing and paternalism, and in some cases, they are right to do so. But in many contexts, the opposition is illusory, because people do not want to choose actively. Nanny states forbid people from choosing, but they also forbid people from choosing not to choose. If and to the extent that health insurers, employers, hospitals and doctors forbid that choice, they are acting paternalistically, and that particular form of paternalism might be unjustified. It is true that active choosing has a central place in a free society, and it needs to play a large role in the health care system. But for those involved in that system, as for everyone else, the same concerns that motivate objections to paternalism in general can be applied to paternalistic interferences with people’s choice not to choose. These points have implications for health insurance, for food safety, for wellness programs, and for the idea of "patient autonomy."

Suggested Citation

Sunstein, Cass R., Behaviorally Informed Health Policy? Patient Autonomy, Active Choosing, and Paternalism (December 3, 2014). Forthcoming, Nudging Health: Health Law and Behavioral Economics (John Hopkins University Press 2015). Available at SSRN: https://ssrn.com/abstract=2533700 or http://dx.doi.org/10.2139/ssrn.2533700

Cass R. Sunstein (Contact Author)

Harvard Law School ( email )

1575 Massachusetts Ave
Areeda Hall 225
Cambridge, MA 02138
United States
617-496-2291 (Phone)

Harvard University - Harvard Kennedy School (HKS) ( email )

79 John F. Kennedy Street
Cambridge, MA 02138
United States

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