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A Nudge in the Right Direction? Towards a Sociological Engagement with Libertarian Paternalism

Published online by Cambridge University Press:  04 April 2012

Patrick Brown*
Department of Sociology and Anthropology, University of Amsterdam E-mail:


Interventions framed through a behavioural lens, particularly ‘Nudge’, are gaining credence in US and UK policy circles, not least around healthcare. Key tenets of this ‘libertarian paternalist’ approach are discussed and related to sociological theory. The influential position of nudge begs sociological engagement, indeed its recognition of ‘choice architecture’ is partially congruent with sociological conceptions of structure-embedded agency. Though recognising the significance of norms, the analysis of nudge fails to appreciate their depth in terms of time, materiality and the socio-cultural. The potency and variable consequences of these social factors are emphasised through Bourdieu's concepts of habitus and field. This framework alongside various sociological approaches to risk and uncertainty are proposed as potentially fruitful paths of critical engagement.

Copyright © Cambridge University Press 2012

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Ajzen, I. and Fishbein, M. (1980) Understanding Attitudes and Predicting Social Behavior, Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
Akerlof, G. and Shiller, R. (2009) Animal Spirits: How Human Psychology Drives the Economy, and Why it Matters for Global Capitalism, Princeton, NJ: Princeton University Press.Google Scholar
Alaszewski, A. and Brown, P. (2007) ‘Risk, uncertainty and knowledge’, Health, Risk and Society, 9, 110.Google Scholar
Anderson, J. (2010) ‘Book review of: Thaler, R. and Sunstein, C. (2008) Nudge: Improving Decisions about Health, Wealth and Happiness’, Economics and Philosophy, 26, 3, 369–76.Google Scholar
Archer, M. (2000) Being Human: The Problem of Agency, Cambridge: Cambridge University Press.Google Scholar
BBC (2010) ‘Can cash incentives encourage better health choices?’, [accessed 29.09.2010].Google Scholar
Beck, U. (1992) Risk Society: Towards a New Modernity, London: Sage.Google Scholar
Beisswanger, A., Stone, E., Hupp, J. and Allgaier, J. (2003) ‘Risk taking in relationships: differences in deciding for oneself versus for a friend’, Basic and Applied Social Psychology, 25, 2, 121–35.Google Scholar
Bentham, J. (1791) The Panopticon: or, The Inspection House, Vol. II, London: Payne.Google Scholar
Bevan, G. and Hood, C. (2006) ‘What's measured is what matters: targets and gaming in the English public health care system’, Public Administration, 84, 3, 517–38.Google Scholar
Bourdieu, P. and Wacquant, L. (1992) An Invitation to Reflexive Sociology, Evanston: University of Chicago Press.Google Scholar
Brown, P. (2008) ‘Legitimacy chasing its own tail: theorising clinical governance through a critique of instrumental reason’, Social Theory and Health, 6, 2, 184–99.Google Scholar
Brown, P. and Vickerstaff, S. (2011) ‘Health subjectivities and labour market participation: pessimism and older workers’ attitudes and narratives around retirement in the UK’, Research on Aging, 33, 5, 529–50.Google Scholar
Chung, C. and Meyers, S. (1999) ‘Do the poor pay more for food? An analysis of grocery store availability and food price disparities’, Journal of Consumer Affairs, 33, 276–96.Google Scholar
Crawshaw, P. and Bunton, R. (2009) ‘Logics of practice in the “risk environment”’, Health, Risk and Society, 11, 3, 269–82.Google Scholar
Cummins, S. and Macintyre, S. (2002) ‘A systematic study of an urban foodscape: the price and availability of food in greater Glasgow’, Urban Studies, 39, 2115–30.Google Scholar
Douglas, M. (1992) Risk and Blame: Essays in Cultural Theory, London: Routledge.Google Scholar
Douglas, M. (2006) A History of Grid and Group Cultural Theory, Toronto: University of Toronto.Google Scholar
Dressler, W. (1991) Stress and Adaptation in the Context of Culture: Depression in a Southern Black Community, Albany: State University of New York Press.Google Scholar
Gellner, E. (1988) ‘Trust, cohesion, and the social order’, in Gambetta, D. (ed.), Trust: Making and Breaking Cooperative Relations, Oxford: Blackwell, pp. 142–57.Google Scholar
Gigerenzer, G. (2008) ‘Why heuristics work’, Perspectives on Psychological Science, 3, 1, 20–9.Google Scholar
Gray, J. (2009a) ‘The original modernizers’, in Gray, J. (ed.), Gray's Anatomy: Selected Writings, London: Allen Lane, pp. 263–74.Google Scholar
Gray, J. (2009b) ‘We simply do not know’, London Review of Books, 31, 22, 1314.Google Scholar
Groopman, J. (2010) ‘Health care: who knows best?’, The New York Review of Books, 11 February.Google Scholar
Hammond, K. (2007) Beyond Rationality: The Search for Wisdom in Troubled Times, Oxford: Oxford University Press.Google Scholar
Hood, C. (2010) ‘Can we? Administrative limits revisited’, Public Administration Review, 70, 527–34.Google Scholar
Hopkins Tanne, J. (2010) ‘Michele Obama launches programme to combat US childhood obesity’, British Medical Journal, 349, c948.Google Scholar
House of Lords Science and Technology Committee (2011), Behaviour Change, London: Stationery Office.Google Scholar
Husserl, E. (1970) The Crisis of European Sciences and Transcendental Phenomenology: An Introduction to Phenomenological Philosophy, Evanston: Northwestern.Google Scholar
Japp, K. and Kusche, I. (2008) ‘Systems theory and risk’, in Zinn, J. (ed.), Social Theories of Risk and Uncertainty, Oxford: Blackwell, pp. 76105.Google Scholar
John, P., Smith, G. and Stoker, G. (2009) ‘Nudge Nudge, Think Think: two strategies for changing civic behaviour’, The Political Quarterly, 80, 3, 361–9.Google Scholar
Jones, R., Pykett, J. and Whitehead, M. (2011) ‘The geographies of soft paternalism in the UK: the rise of the avuncular state and changing behaviour after neoliberalism’,Geography Compass, 5, 1, 5062.Google Scholar
Kay, J. (2010) ‘A bird in the hand can make a lot of sense’, Financial Times, 25 August.Google Scholar
Keynes, J. M. (1936) The General Theory of Employment, Interest and Money, London: Prometheus.Google Scholar
Lansley, A. (2010) A New Approach to Public Health, London: Department of Health, [accessed 20.08.2010].Google Scholar
Marteau, T., Oliver, A. and Ashcroft, R. (2009) ‘Changing behaviour through state intervention: when does an acceptable nudge become an unacceptable shove?’, British Medical Journal, 337, a2543, 121–2.Google Scholar
Murray, R. (2008) ‘The fall and rise again of social factors in psychosis’, conference paper, Mediterranean Maudsley Forum, Palermo, Italy, 24 September.Google Scholar
O'Malley, P. (1992) ‘Risk, power and crime prevention’, Economy and Society, 21, 361–74.Google Scholar
O'Neill, J. (1995) The Poverty of Post-Modernity, London: Routledge.Google Scholar
Ormerod, P. (2010) ‘A network is as good as a nudge for a Big Society’, Financial Times, 16 September.Google Scholar
Petersen, A. (1997) ‘Risk, governance and the new public health’, in Petersen, A. and Bunton, R. (eds.), Foucault, Health and Medicine, London: Routledge, pp. 189206.Google Scholar
Qizilbash, M. (2009) ‘Well-being, preference formation and the danger of paternalism’, Papers on Economics and Evolution 2009–18, Jena: Max Planck Institute of Economics, Evolutionary Economics Group.Google Scholar
Rose, N. (1996) ‘The death of the social? Re-figuring the territory of government’, Economy and Society, 25, 327–56.Google Scholar
Simon, H. (1982) Models of Bounded Rationality: Behavioral Economics and Business Organization, Cambridge, MA: MIT Press.Google Scholar
Slovic, P. (2000) The Perception of Risk, London: Earthscan.Google Scholar
Solbjør, M., Skolbekken, J.-A., Sætnan, A. R., Hagen, A. I. and Forsmo, S. (2010) ‘Mammography screening and trust: the case of interval breast cancer’, BSA Medical Sociology, conference, Durham University, 2 September.Google Scholar
Stoker, G. and Moseley, A. (2010) ‘Motivation, behaviour and the microfoundations of public services’, 2020 Public Services Commission, Manchester, [accessed 20.8.2010].Google Scholar
Strong, P. (1984) ‘The academic encirclement of medicine?’, Sociology of Health and Illness, 6, 339–58.Google Scholar
Strong, P. (2006) ‘Sociological imperialism and the profession of medicine – a critical examination of the thesis of medical imperialism’, in Murcott, A. (ed.), Sociology and Medicine: Selected Essays by P.M.Strong, Aldershot: Ashgate, pp. 83118.Google Scholar
Sunstein, C. (1991) ‘Preferences and politics’, Philosophy and Public Affairs, 20, 334.Google Scholar
Sunstein, C. and Thaler, R. (2003) ‘Libertarian paternalism is not an oxymoron’, University of Chicago Law Review, 70, 1153–216.Google Scholar
Szmukler, G. (2009) ‘Financial incentives for patients in the treatment of psychosis’, Journal of Medical Ethics, 35, 224–8.Google Scholar
Thaler, R. and Sunstein, C. (2008) Nudge: Improving Decisions about Health, Wealth and Happiness, London: Penguin.Google Scholar
Titmuss, R. (1971) ‘The gift of blood’, Society, 8, 3, 1826.Google Scholar
Tversky, A. and Kahnemann, D. (1981) ‘The framing of decisions and the psychology of choice’, Science, 211, 4481, 453–8.Google Scholar
van der Pol, M. and Cairns, J. (2002) ‘A comparison of the discounted utility model and hyperbolic discounting models in the case of social and private intertemporal preferences for health’, Journal of Economic Behaviour and Organization, 49, 1, 7996.Google Scholar
Wilkinson, I. (2010) Risk, Vulnerability and Everyday Life, London: Routledge.Google Scholar
Zinn, J. (2008) ‘Risk society and reflexive modernisation’, in Zinn, J. (ed.), Social Theories of Risk and Uncertainty, Oxford: Blackwell, pp. 1851.Google Scholar