A new study has found that behavioral nudges, such as presenting one option as a default in an important life decision, can be effective even when the person knows they are being nudged.
Researchers define behavioral nudges as ways of influencing choices without limiting options or making some choices more costly. Investigators at Carnegie Mellon University note that some policymakers and critics of behavioral interventions argue that nudging people toward an option without their awareness is unethical.
Critics also say the defaults only work because people are not aware they are being manipulated. If they knew they were being nudged, they would resist the influence of the default up to the point of deliberately rejecting it.
But a team of researchers led by Carnegie Mellon University behavioral economist George Loewenstein, Ph.D., found that warning people that they were about to be nudged, or informing them after the fact and allowing them to change their decisions, did not significantly diminish the effectiveness of the default option.
“People think that defaults — or nudges — exploit psychological weaknesses because they are covert, or not obvious. They also think that defaults will not work if people are aware that they are being nudged,” said Loewenstein. “These findings can help to address concerns that behavioral interventions are deceitful or manipulative.”
For the study, researchers had 758 participants complete an online form about hypothetical end-of-life care choices — their preferences for medical treatment for times when they are near death or too ill to express their wishes.
First, the participants had to choose from one of three overall goals for end of life care: To prolong life, maximize comfort, or allow medical professionals or surrogates to decide on treatment.
Next, they were presented with five specific medical treatments to prolong life, such as CPR, dialysis, and intensive care unit admission. For each they had to indicate a preference for pursuing the treatment, declining it, or leaving the decision to a surrogate or health professional.
Default options were randomly assigned to either accept or reject life-prolonging treatments. Half of the participants were told about the use of defaults before they completed the forms and the other half after. Then, all participants completed steps one and two again, but without any defaults set.
The researchers found that preferences for comfort in the general directive were so fixed that they were not affected by defaults or the disclosure of defaults. However, defaults for specific treatments influenced final choices whether the intervention was disclosed ahead of time or not.
“Policymakers want to influence people’s behavior in a way they can defend on TV. They commonly rely on tax incentives, but those are often less effective and much costlier than changing defaults,” said David Hagmann, a graduate student in CMU’s Department of Social and Decision Sciences.
“Our findings show that behavioral nudges are effective not because they are deceptive, and therefore can be employed without ethical concerns. But this is only true if the default chosen is the one that is actually best for the individual.”
“The findings from this study are also noteworthy because many decisions are repeated over time,” added Cindy L. Bryce, Ph.D., an associate professor of health policy and management, medicine, and clinical and translational science at the University of Pittsburgh.
“Transparency in the beginning allows individuals to confirm or clarify their preferences over time, rather than react to newly discovered information based on the way choice was presented. That’s true for advance directives, where people can revisit and modify their selections for medical care, and it’s also true for everyday lifestyle-related choices, like choosing to drink more water or to exercise regularly.”