To nudge or not to nudge: cancer screening programmes and the limits of libertarian paternalism
- 1Centre for Applied Ethics and Philosophy of Science, Department of Communication, Aalborg University Copenhagen, Ballerup, Denmark
- 2Centre for Social Ethics and Policy, School of Law, University of Manchester, Manchester, UK
- 3Center for Medical Ethics, Faculty of Medicine, University of Oslo, Oslo, Norway
- 4The Research Unit and Section for General Practice, Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- Correspondence to Dr Thomas Ploug, Centre for Applied Ethics and Philosophy of Science, Department of Communication, Aalborg University Copenhagen, Lautrupvang 2B, 2750 Ballerup, Denmark;
Contributors TP had the initial idea which was refined in discussion with JB and SH. TP wrote the first draft on the basis of JB's work on the Danish breast cancer screening programme. All authors worked on revisions of the manuscript. The authors cover slightly different areas of expertise spanning from Medical Ethics to Cancer-Screening Programmes.
- Accepted 20 May 2012
- Published Online First 5 July 2012
‘Nudging—and the underlying idea ‘libertarian paternalism’—to an increasing degree influences policy thinking in the healthcare sector. This article discusses the influence exerted upon a woman's choice of participation in the Danish breast screening programme in light of ‘libertarian paternalism’. The basic tenet of ‘libertarian paternalism’ is outlined and the relationship between ‘libertarian paternalism’ and informed consent investigated. Key elements in the process of enrolling women into the Danish mammography screening programme are introduced. It is shown that for several reasons the influence exerted upon women's choices of participation cannot be justified within a welfare-enhancing libertarian paternalistic framework. The article suggests that screening programmes alternatively adopt a liberty-enhancing approach and considers the practical implications of this alternative.
- libertarian paternalism
- informed consent
- mass screening
- breast neoplasms
- public health policy
- general practice
- preventive medicine
- public health
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.