STAT: End-of-life decisions can be difficult. This doctor thinks ‘nudges’ can help

For tax payments, “nudges” have helped municipalities increase revenues and decrease collection-related costs. For energy consumption, “nudges” have helped homeowners save money and utilities preserve capacity.

But in health care, the technique has been slower to catch on.

First described by the pioneering economists Richard Thaler and Cass Sunstein (who is also a legal scholar), a “nudge” is a way of framing a set of choices to essentially steer people toward a particular option without shutting out other options.

Dr. Scott Halpern, a critical care physician at University of Pennsylvania who studies the ethics and effectiveness of nudges in health care, believes the technique can play a greater role in improving the patient experience. This is especially true, he said, for those living with serious illnesses, and who often struggle to make sound decisions at times of great emotional and physical complexity.

Halpern, who is founding director of Penn’s Palliative and Advanced Illness Research Center, spoke with STAT recently by phone, from his office in Philadelphia. This conversation has been condensed and edited.