Nudging is considered a promising approach for behavioural change. At the same time, nudging has raised ethical concerns, specifically in relation to the impact of nudges on autonomous choice. A complexity is that in this debate authors may appeal to different understandings or dimensions of autonomy. Clarifying the different conceptualisations of autonomy in ethical debates around nudging would help to advance our understanding of the ethics of nudging. A literature review of these considerations was conducted in order to identify and differentiate between the conceptualisations of autonomy. In 33 articles on the ethics of nudging, we identified 280 autonomy considerations, which we labelled with 790 unique autonomy codes and grouped under 61 unique super-codes. Finally, we formulated three general conceptualisations of autonomy. Freedom of choice refers to the availability of options and the environment in which individuals have to make choices. Agency involves an individual's capacity to deliberate and determine what to choose. Self-constitution relates to someone's identity and self-chosen goals. In the debate about the ethics of nudging, authors refer to different senses of autonomy. Clarifying these conceptualisations contributes to a better understanding of how nudges can undermine or, on the other hand, strengthen autonomy.

Despite a broad consensus on the ethical dimensions of the teaching profession, and long-standing efforts to align teacher education with wider trends in professional education, little is known about how teacher candidates are being prepared to face the ethical challenges of contemporary teaching. This article presents the results of an international survey on ethics content and curriculum in initial teacher education (ITE). Involving five Organisation for Economic Co-Operation and Development (OECD) countries—the United States, England, Canada, Australia, and the Netherlands—the study’s findings shed light on teacher educators’ perspectives on the contribution of ethics content to the education of future teachers and provide a snapshot of how well existing programs line up with their aspirations. The results showed that 24% of the ITE programs surveyed contain at least one mandatory stand-alone ethics course. The meaning of the results vis-à-vis opportunities for expanding ethics education in preservice teaching programs is also discussed.

This article reviews educational efforts to promote a responsible conduct of research (RCR) that were reported in scientific publications between 1990 and early 2020. Unlike previous reviews that were exploratory in nature, this review aimed to test eleven hypotheses on effective training strategies. The achievement of different learning outcomes was analyzed independently using moderator analysis and meta-regression, whereby 75 effect sizes from 30 studies were considered. The analysis shows that the achievement of different learning outcomes ought to be investigated separately. The attainment of knowledge strongly benefited from individualized learning, as well as from the discussion and practical application of ethical standards. Contrarily, not covering ethical standards tended to be a feature of successful courses, when looking at other learning outcomes. Overall, experiential learning approaches where learners were emotionally involved in thinking about how to deal with problems were most effective. Primarily intellectual deliberation about ethical problems, often considered the “gold standard” of ethics education, was significantly less effective. Several findings from previous reviews, e.g., the preferability of mono-disciplinary groups, could not be replicated with multivariate analysis. Several avenues for future research efforts are suggested to advance knowledge on the effectiveness of research integrity training.

In this paper, we critically review three assumptions that govern the debate on the legitimacy of nudging interventions as a policy instrument: (1) nudges may violate autonomous decision-making; (2) nudges lend themselves to easy implementation in public policy; and (3) nudges are a simple and effective mean for steering individual choice in the right direction. Our analysis reveals that none of these assumptions are supported by recent studies entailing unique insights into nudging from three disciplinary outlooks: ethics, public administration and psychology. We find that nudges are less of a threat to autonomous choice than critics sometimes claim, making them ethically more legitimate than often assumed. Nonetheless, because their effectiveness is critically dependent on boundary conditions, their implementation is far from easy. The findings of this analysis thus suggest new opportunities for identifying when and for whom nudge interventions are preferable to more conventional public policy arrangements.

Influenza is a major cause of morbidity and mortality among residents of nursing homes.1 Many nursing homes therefore aim at high vaccination rates. To meet this aim some homes use tacit consent policies, in which the vaccine is given unless residents or their proxies state that they do not want it. Such policies deviate from standard (express) consent procedures, which require that vaccination occurs only if the resident or his or her proxy gives consent. Is this deviation from standard informed consent procedures justified? We explored consent procedures and vaccination rates in Dutch nursing homes to determine the effects of current practice. Participants, methods, and resultsIn October 2000, we sent a questionnaire to all (353) nursing homes in the Netherlands for completion by one of the nursing home physicians. Doctors were asked to provide exact vaccination rates or, if that was not possible, to estimate the rate within 10% ranges (90-100%, 80-90%, etc). The questionnaire also asked about vaccination and consent policies. We analysed data using SPSS-9. Differences were considered significant if P < 0.05.We received 245 completed questionnaires. Eighteen nursing homes seemed to have shut down or merged into other institutions. We therefore counted the response rate as 73% (245/335). The average vaccination rate (based on exact information) in nursing homes was 86%. When we combined exact and estimated data, 120 homes (49%) had a vaccination rate of 90% or higher (table).Ninety eight homes had a written vaccination policy. These institutions had lower vaccination rates than homes without written policies. Only 53 (22%) nursing homes asked healthcare workers to be vaccinated.In all, 106 institutions followed tacit consent procedures for all residents. Nursing homes with tacit consent procedures had higher vaccination rates than institutions that required express consent from all residents (mean rate 89% v 82%, P < 0.001) CommentWe have shown that homes that use tacit consent have higher vaccination rates than those which require express consent, but the difference may not be sufficient to justify use of such a policy. Tacit consent implies that residents and their proxies are informed about vaccination and are vaccinated unless they refuse. This procedure deviates from standard informed consent procedures 2 and therefore raises ethical problems. If tacit consent is presumed, the health professional will often not be certain whether the person received the relevant information or whether the information was adequately understood. Moreover, it is unclear that a voluntary choice was made.There is a potentially strong collective argument for aiming at high vaccination rates and hence for preferring tacit consent.3 High immunisation rates may result in herd immunity, which increases protection for all residents, including the weakest patients. Moreover, it may reduce the risk of an influenza outbreak that will disrupt daily institutional life and care. However, there are some problems with this argument. Firstly,...