Medicine, Health Care and Philosophy

, Volume 17, Issue 4, pp 641–650 | Cite as

Scientific second-order ’nudging’ or lobbying by interest groups: the battle over Abdominal Aortic Aneurysm Screening Programmes

Scientific Contribution


The idea that it is acceptable to ‘nudge’ people to opt for the ‘healthy choice’ is gaining currency in health care policy circles. This article investigates whether researchers evaluating Abdominal Aortic Aneurysm Screening Programmes (AAASP) attempt to influence decision makers in ways that are similar to popular ‘nudging’ techniques. Comparing two papers on the health economics of AAASP both published in the BMJ within the last 3 years, it is shown that the values chosen for the health economics modelling are not representative of the literature and consistently favour the conclusions of the articles. It is argued (1) that this and other features of these articles may be justified within a Libertarian Paternalist framework as ‘nudging’ like ways of influencing decision makers, but also (2) that these ways of influencing decision makers raise significant ethical issues in the context of democratic decision making.


Nudging Abdominal aorta aneurysm screening Libertarian paternalism Deliberative democracy Conflict of interest disclosure 


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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  1. 1.Department of Communication and Psychology, Centre for Applied Ethics and Philosophy of ScienceAalborg University CopenhagenCopenhagen SVDenmark
  2. 2.Centre for Social Ethics and Policy, School of LawUniversity of ManchesterManchesterUK
  3. 3.Center for Medical Ethics, Faculty of MedicineUniversity of OsloOsloNorway
  4. 4.Centre for Applied EthicsAalborg UniversityAalborgDenmark
  5. 5.The Research Unit and Section for General Practice, Department of Public Health, Faculty of Health SciencesUniversity of CopenhagenCopenhagenDenmark

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