Motivational Barriers to Care and the Ethics of Encouragement.

Abstract

In this paper I argue that by using methods of encouragement, derived from the fields of social psychology, cognitive neuroscience, and behavioral economics, healthcare workers can potentially provide their patients with tools for increasing adherence to their treatment plans. I claim that the shared decision-making model can, and should, be enriched to include a component that encourages patients to follow through with their plans. It is commonsense that it is one thing to decide on a plan, and quite another to stick to it. Even if a plan is one's own, people often backslide with respect to their prior commitments. I appeal to the extensive literatures on decision-making, delay discounting, and willpower to provide some empirically verified tools for motivating patients. Importantly, I argue that contrary to appearances, motivating others to act with respect to their commitments expresses a respect for autonomy and is non-paternalistic.