Nudging and obesity: How to get rid of paternalism?

Abstract

This paper reflects upon the conditions how ‘nudging’ can change individual health choices without being paternalisticand therefore can be defined as an instrument of social justice? So many problems we are facing in today’s nursing aresituated at the intersection of autonomy and heteronomy, i.e. why well informed and autonomous people make unhealthylifestyle choices. If people do not choose what they want, this is not simply caused by their lack of character or capability,but also by the fact that absolute autonomy is impossible; also autonomous individuals are ‘contaminated’ byheteronymous aspects, by influences from ‘outside’. In an earlier article I made an analysis of my neologism ‘oughtonomy’to support the thesis that when it comes down to human existence, autonomy and heteronomy are intertwined, more thanthey are merely opposites.Although nudging might be of help in many nursing settings, we should evaluate it with the same criticism as we judgeupon paternalism. Despite the potential of nudging for nursing, there is a risk to put the nurse again in the position of thepaternalistic outsider who knows how people should behave. But maybe the awareness of the oughtonomous decisions weall make in our lives, can help us to understand why people act mindless in some situations or why we choose what wechoose. Knowing this is one thing, giving people the authority of an expert to know what is better off for others, another.Despite the potential of the last, the former concept does not legitimate paternalistic interferences in patient’s lifestyle.