Behavioral psychology  influences consumer habits, and plays a role in medicine. In health care, behavioral design and choice architecture are powerful tools used to influence the practice of health professionals and the behaviors of patients. This includes default settings on ventilators, drug formularies and where instructions are placed on sterile surgical supply packages. However, when behavioral architecture changes how health care decisions are made, how should professionals and patients respond?

Ethics in Health Care

Explore the AMA Journal of Ethics for articles, podcasts and polls that focus on ethical issues that affect physicans, physicians-in-training and their patients.

It is vital that health care communities understand choice architecture and harness it in ways that encourage ethical practice of evidence-based medicine, maximize efficiency, reduce burnout, improve patient outcomes and strengthen the patient-physician relationship.

The September issue of AMA Journal of Ethics® (@JournalofEthics) addresses questions related to health care applications of behavioral architecture, including nudges, to motivate  specific outcomes. You may also  earn CME credit.

Articles include:

  1. How Should Clinicians’ Performance Be Assessed When Health Care Organizations Implement Behavioral Architecture That Generates Negative Consequences?” 

    1. Interventions’ influences on decision making situate clinician performance evaluations in key ways.

  2. Is It Justifiable to Make Self-Determination Illusory to Motivate a Specific Health Outcome?

    1. A nudge is an intervention designed to prompt a person to “voluntarily” make a choice intended by those who altered an environment or situation to yield that choice.


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  3. Believing in Overcoming Cognitive Biases.” 

    1. Like all humans, health professionals are subject to cognitive biases that can render diagnoses and treatment decisions vulnerable to error.

  4. Designing Nudges for Success in Health Care.” 

    1. Nudges can improve patient outcomes, but decisions need to be made about where they fit in the flow of health service delivery.

In the journal’s September podcast, Mitesh Patel, MD, director of the Penn Medicine Nudge Unit in Philadelphia, discusses nudges, how they can be used effectively in health care, and how to identify and avoid the potential ethical pitfalls of guiding behavior.

Dr. Patel is also the Ralph Muller presidential associate professor of medicine and health care management in the Perelman School of Medicine and Wharton School at the University of Pennsylvania.

Listen to previous episodes of the podcast, “Ethics Talk,” or subscribe in iTunes or other services.

The AMA Journal of Ethics CME module, “Sharing Ethics Consultation Notes With Patients Through Online Portals,” is designated by the AMA for a maximum of 1 AMA PRA Category 1 Credit™.

Additionally, the CME module, “Ethics Talk: Nudges, Pushes, and the Ethical Challenge of Behavioral Architecture,” is designated by the AMA for a maximum of 0.50 AMA PRA Category 1 Credit™.

The offerings are part of the AMA Ed Hub™, an online learning platform that brings together high-quality CME, maintenance of certification, and educational content—in one place—with relevant learning activities, automated credit tracking and reporting for some states and specialty boards.

Learn more about AMA CME accreditation. 

The journal’s editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians. Submit a manuscript for publication.

The 2020 John Conley Ethics Essay Contest and the Conley Art of Medicine Contest are now open for submission. Read the essay prompt and see visual media requirements on the AMA Journal of Ethics website.

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Prioritizing Equity video series: Mental Health & COVID-19

Apply to become a theme issue editor to help the journal develop theme issues on interested and neglected topics.

Visit the journal’s COVID-19 Ethics Resource Center for articles, podcasts, and videos relevant to the ethical challenges of the current pandemic.

Upcoming issues of the AMA Journal of Ethics will focus on caring for Native Americans as well as risk management ethics. Sign up to receive email alerts when new issues are published.

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