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  • Reverend James Squire

Nudge Theory, Bioethics, and the Unvaccinated



Nudge Theory essentially says that people are moved by information that sends a different message to a targeted group such as the unvaccinated. A simple example is the speed signs on highways where the flashing speed sign reminds us to slow down. We are not required to slow down, but I and a good many other people, will slow down automatically.


There are two issues that need to be addressed to encourage the bioethical decision making to get a vaccine that we have not seen mentioned.


First, we know that the vaccines are paid for by the government and are free. We need to juxtapose that free cost with the cost of hospitalization for those who are hospitalized because of catching the Delta Variant. Most vaccinated people do not end up in the hospital, but it is an almost certain destination for the unvaccinated. The average daily cost of treatment in an ICU on a ventilator is $10,794. No one has mentioned that the government doesn’t absorb that cost; the patient and their insurance pays for that treatment. Healthcare is a debated issue in our country, but suffice it to say that even with great healthcare, the patient will likely have a hefty bill, particularly if the policy has a limit on coverage.


We should get that cost out there for the public to see and understand the financial penalty that may come their way. Since our members of Congress have the best healthcare available, it is ironic that this issue is not in their awareness. If they care for the well-being of their constituents, they should get that information out to them that their hospitalization bills are their responsibility. As I have mentioned in another post, people were nudged to pay their taxes in England by sending out to everyone what their neighbors were paying as opposed to a threatening letter mandating that they pay. It worked. The taxes poured in. They have a Nudge Theory Committee in England for this reason.


Keep in mind that David Callahan makes the point in his book, The Cheating Culture, that if people have to choose between doing the hard right thing or having their money affected in a negative way that they will choose money over ethics. A combination of Nudge Theory and Bioethics should make this reality their case for getting vaccinated. I am of the opinion that we will have the same result that England had in getting taxes paid. The unvaccinated will get vaccinated for it is in their monetary interest. This will work much better than the suggestion that the local governments should pay people $100 to get the vaccine. It is a no brainer if they compare $100 to the thousands of dollars they may owe the hospital if they have to stay in the ICU which is the destination for most Delta Variant patients.


Second, I am getting a bit weary of the likes of Rand Paul and others who criticize the CDC for changing the guidelines. Money or back to school clothes will make the Nudge Point here. If you go to the grocery store or out to dinner, the cost has changed. It has gone up. Nobody is saying that they don’t understand why this change is happening. They know that this is going to occur as the economy recovers and supply chains reestablish themselves. They don’t like it, but they understand it. Hence, they reluctantly accept it.

But here is the fundamental flaw that Paul and others don’t comprehend. You would think that an eye doctor such as Paul would get it. SCIENCE HAS A FLUIDITY TO IT. TIME AND CIRCUMSTANCES CHANGE AN APPROACH. SCIENCE IS NOT STATIC.


It would be like Paul has a patient who needs a new prescription for lenses. He isn’t going to rant and rave and say, “your eyes shouldn’t change.” Science says they will. He will no longer be able to attack Dr. Fauci who does understand how science works with comments like, “You said masks weren’t necessary a month agon. Now they are.” Fauci always replies with, “The data has changed. That is what happens with science.”


If the CDC made this point clearer, they wouldn’t be on the defensive which they are on now as we realize that everyone must return to mask wearing.


But perhaps a better nudge example is the parents who are getting ready to send their children back to school masked. They realize that Johnny or Jane have outgrown their clothing and their shoes which use to fit before summer arrived. Is Dr. Paul prepared to say, “Your children shouldn’t need new clothes or shoes. They should not outgrow what they were wearing at the beginning of the summer.”


That’s a Nudge Point that everyone including Dr. Paul could Understand and curtail the criticism of Dr. Fauci and the CDC.


Nudge Theory essentially says that you can’t change the behavior of others with a direct rational approach. That hasn’t worked. Nudge Theory combined with bioethics uses a different approach that has a deeper understanding of what really motivates others and brings new examples to correct irresponsible behavior. Yes, I would like to see Dr. Rand Paul, an eye doctor, confronted by his patients who need new lenses because their vision changed in the same way that we need new mask protocols. That exchange would warm my heart.

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