International Journal of Health Policy and Management

International Journal of Health Policy and Management

Radically Questioning the Principle of the Least Restrictive Alternative: A Reply to Nir Eyal; Comment on “Nudging by Shaming, Shaming by Nudging”

Document Type : Commentary

Author
Yashar Saghai
Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD, USA
10.15171/ijhpm.2014.106
Abstract
In his insightful editorial, Nir Eyal explores the connections between nudging and shaming. One upshot of his argument is that we should question the principle of the least restrictive alternative in public health and health policy. In this commentary, I maintain that Eyal’s argument undermines only a rather implausible version of the principle of the least restrictive alternative and I sketch two reasons for rejecting the mainstream and more plausible version of this principle.
Keywords
Least Restrictive Alternative
Nudge
Public Health Ethics
Subjects
1. Eyal N. Nudging by shaming, shaming by nudging. Int J Health Policy Manag 2014; 3: x–x. doi: 10.15171/ijhpm.2014.68
2. Sunstein CR, Thaler RH. Nudge: Improving Decisions About Health, Wealth, and Happiness. 1st edition. New Haven, CT: Yale University Press; 2008. doi: 10.1007/s10602-008-9056-2
3. Deonna J, Rodogno R, Teroni F. In Defense of Shame: the Faces of an Emotion. New York: Oxford University Press; 2011.
4. Childress J, Faden R, Gaare R, Gostin LO, Kahn J, Bonnie R, et al. Public health ethics: Mapping the terrain. J Law Med Ethics  2002; 30: 169–77.
5. Coggon, J. What Makes Health Public? A Critical Investigation of Moral, Legal, and Political Claims in Public Health. Cambridge, UK: Cambridge University Press; 2012.
6. Gostin, L. Public Health Law: Power, Duty, Restraint. Revised and expanded 2nd edition. Berkley and Los Angeles, CA: University of California Press; 2008
7. Nuffield Council on Bioethics. Public Health: Ethical Issues. London, UK: Nuffield Council of Bioethics; 2007.
7. Powers M, Faden R, Saghai Y. Liberty, Mill, and the framework of public health ethics. Public Health Ethics 2012; 5:  6-15. doi: 10.1093/phe/phs002
8. Saghai Y. Public health nudges and the principle of the least restrictive alternative. Behavioral Economics, Law, and Health Policy [video]. Harvard Law School, May 2, 2014. Available from: http://petrieflom.law.harvard.edu/events/details/2014-annual-conference
 

  • Received Date 21 September 2014
  • Revised Date 22 October 2014
  • Accepted Date 24 October 2014
  • First Published Date 01 November 2014
  • Published Date 01 November 2014