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Ethical Issues in the Use of Nudges to Obtain Informed Consent for Biomedical Research

Abstract: While the use of nudges in public health initiatives and in obtaining informed consent to medical treatment recently has received considerable attention and support, there has been little consideration of their use by researchers seeking informed consent from individuals to serve as research participants. Particularly when study success and continued funding are contingent on achieving enrollment and retention goals, researchers may be tempted to employ nudges in ways that raise ethical concerns. This article considers what types of nudges might be employed and whether they are ethically appropriate. To what extent may nudges be used to induce individuals to agree to participate in research without unduly compromising their autonomy? In what ways, if any, should ethical rules about the use of nudges vary depending on the nature of the research endeavor and on the potential risks and benefits of the study? And how well can institutional review boards control the use of nudges in the informed consent process?

Key words: human subjects research, informed consent, nudges