We need a robust ethical framework to curb the state's use of behavioural science




Summary

Since the advent of the covid-19 era in early 2020, many countries across the world have deployed behavioural science interventions – often referred to as ‘nudges’ – to strengthen their communication strategies and thereby increase compliance with the pandemic restrictions and subsequent vaccine rollout. These state-sponsored psychological methods of persuasion raise important ethical questions. Focusing on the UK, this article will highlight how some behavioural interventions have evoked ethical concerns as a result of their reliance upon the strategic elevation of emotional distress to promote adherence to unprecedented public health directives, their disregard for the principle of informed consent, and their often-covert mode of action. Despite the pressing need to examine these ethical issues, there is accumulating evidence that those in positions of power and influence in the UK are very reluctant to engage in such a dialogue. The priorities for further investigation will be highlighted, with the ultimate aim of embedding the state’s future use of behavioural science within an acceptable ethical framework.



Behavioural-science interventions: definition and prevalence

According to a Cabinet Office and Institute for Government ‘MINDSPACE’ report published in 2010, behavioural-science ‘nudges’ provide ‘low cost, low pain ways of “nudging” citizens … into new ways of acting by going with the grain of how we think and act’. Exploiting the fact that human beings spend 99 per cent of their time on automatic pilot, making moment-by-moment decisions without conscious reflection, these techniques – often operating below our level of conscious awareness – can exert a powerful influence upon our behaviour.


The persuasion strategies of behavioural-science have long been used by both the state and the private sector to encourage people to make the ‘right’ decisions. The extent of their deployment gained impetus with the advent of the ‘Behavioural Insights Team’ (BIT) in 2010. Beginning as a seven-person unit working with the UK government, the BIT has rapidly expanded to become a ‘social purpose company’ operating in many countries across the world. Behavioural scientists are currently embedded in most UK government departments and in many other countries, and there are intentions for further expansion across Europe.


Although the activities of state-employed nudgers became more visible at the start of the covid-19 era in early 2020 – when a Scientific Pandemic Insights Group on Behaviour (SPI-B) was appointed, advising government about how to maximise the impact of its pandemic communications strategy – the tentacles of behavioural science have also extended into other areas of day-to-day life. For example, small-business owners in the UK have been targeted in an effort to recoup debts associated with the Loan Charge, sometimes with tragic consequences; an All Parliament Group Report concluded that pressure exerted on taxpayers ‘by using 30 behavioural insights in communications’ contributed to at least one of the seven subsequent suicides amongst those targeted. Also, a recent document describing the collaboration between Sky TV and the BIT details how the broadcaster will utilise behavioural science to promote a green agenda to ‘shift the behaviour of millions of people to deliver our net zero gaols’ by using dramas to ‘boost social acceptability of pro-environment choices’.



The nudges raising the most ethical concerns

Multiple Government actions throughout the covid-19 era have evoked questions about their moral legitimacy, perhaps the most blatant being coercion in the form of mask and vaccine mandates. The (slightly) less blatant strategies underpinned by behavioural science have also raised ethical concerns, the three most alarming nudges being fear inflation (or ‘affect’ in the language of behavioural science), shaming (‘ego’) and peer pressure (‘norms’).


Through the mechanism of the ‘mood-congruence effect’, emotions will powerfully influence memory, attention and the way we make sense of environmental cues. Thus, when a person is fearful there will be selective recall of past scary events, an attentional focus on present danger and a propensity to interpret environmental stimuli in a threatening way. The minutes of the SPI-B (the Government’s sub-group of behavioural-science experts) dated 20th March 2020 strongly suggest that the decision to inflate the fear levels of British citizens was a strategic one:


The perceived level of personal threat needs to be increased among those who are complacent' by ‘using hard-hitting emotional messaging’.


Subsequently, throughout the covid-19 era, media communications were characterised by non-contextualised daily death statistics, inflated predictions of future casualties of the virus, recurrent footage of dying patients in Intensive Care Units, and scary slogans like, ‘IF YOU GO OUT, YOU CAN SPREAD IT, PEOPLE WILL DIE’. The mandating of face coverings in June 2020 perpetuated these elevated fear levels.


The ‘ego’ nudge exploits the human tendency to inherently strive to maintain a positive self-image, aided by cognitive biases – such as the ‘fundamental attribution era’ – whereby we take credit for good outcomes but blame others for bad ones. Throughout the covid-19 messaging campaign, adherence to the restrictions was promoted as synonymous with virtue, with the consequence that any deviation was likely to evoke shame. Examples of these nudges in action included: slogans such as, ‘STAY HOME, PROTECT THE NHS, SAVE LIVES’; TV advertisements where an actor tells us, ‘I wear a face covering to protect my mates’; the pre-orchestrated Clap-for-Carers ritual encouraging weekly shows of appreciation for NHS staff; ministers telling students not to ‘kill your gran’; and close-up images of acutely unwell hospital patients with the voice-over, ‘Can you look them in the eyes and tell them you’re doing all you can to stop the spread of coronavirus?’


Similar shaming strategies have been deployed to promote the vaccination of children and young adults, a NHS document advising healthcare staff to tell young people ‘Normality can only return for you & others with your vaccination’. A recent advertising campaign targeting the 5-11 age group invited ‘superheroes’ to the vaccination centre.


Being part of a deviant minority is typically an uncomfortable experience. The ‘norms’ nudge exploits this intrinsic desire to follow the crowd by strategically increasing people’s awareness of the prevalent views and behaviour of the majority, thereby exerting peer pressure and scapegoating to promote compliance. This method of persuasion was exemplified throughout the covid era when ministers and scientific experts repeatedly made comments such as, ‘The vast majority of people are obeying the rules’ and, ‘Over 90% of adults have already been vaccinated’.


Normative pressure is strengthened if there is a visible indicator of conformity rooted in communities. Widespread masking, after the mandate in summer 2020, enabled the instant differentiation of the rule breakers from the rule followers and further ramped up the discomfort associated with non-compliance.



The sources of ethical concern

There are four major areas of ethical concern arising from the behaviour-science nudges deployed during the covid era.


First, the methods per se are a source of alarm. A government strategically inflicting emotional distress on its citizens as a way of achieving compliance with its agenda does not sit well with what one might reasonably expect from a civilised Western democracy. Indeed, it can be argued that, in some respects, such tactics resemble those used by totalitarian regimes where the state inflicts pain on a subset of its population in an attempt to eliminate beliefs and behaviour they perceive to be deviant.


Another ethical consideration associated with the methods arises from their unintended consequences. Elevated levels of fear will have discouraged people from attending hospital with non-covid illnesses and is likely to have significantly contributed to the tens-of-thousands of non-covid excess deaths. The loneliness of older people may have been exacerbated by the heightened levels of community anxiety, potentially leading to premature death. And it is plausible that the state-sponsored shaming and scapegoating of those deviating from the directives of the dominant covid narrative will have been primarily responsible for the vilification of the unvaccinated minority.


The second source of ethical concern derives from the lack of any attempt to acquire the informed consent of the British people prior to the mass implementation of these psychological methods of persuasion. Obtaining informed consent of the recipient prior to any medical or psychological intervention has always been a cornerstone of ethical clinical practice. Professor David Halpern (the BIT Chief Executive and prominent member of SPI-B) explicitly recognised the significance of this issue. The previously-mentioned MINDSPACE document – of which Professor Halpern is a co-author - states that, ‘Policymakers wishing to use these tools … need the approval of the public to do so’ (p74). More recently, in Professor Halpern’s book, Inside the Nudge Unit, he is even more emphatic about the importance of consent: ‘If Governments … wish to use behavioural insights, they must seek and maintain the permission of the public’ (p375).


Third, the perceived legitimacy of using subconscious ‘nudges’ to influence people may also depend upon the behavioural goals that are being pursued. It is questionable whether the deployment of fear, shame and peer pressure to achieve compliance with unprecedented and non-evidenced covid-19 restrictions would have found favour with the British people, while they would more likely find them acceptable if the goal was – for example – to reduce violent crime.


Fourth, ethical questions arise from the lack of transparency; many of the nudges employed impact on their targets below their level of awareness. This is in contrast to the more conventional methods of government persuasion, which rely mainly on information provision and rational argument. This covert mode of action lends weight to the accusation that these behavioural science strategies are manipulative.



The views of stakeholders

It has been rare for behavioural scientists and psychologists involved in state-sponsored nudging during the covid era to openly discuss the ethical basis of their work. Only a very small number have spoken out against the dominant covid narrative and expressed concerns about the way fear was ramped up as a strategic part of the Government’s communication strategy. Dr Gavin Morgan – an educational psychologist and SPI-B member – told the investigative journalist, Laura Dodsworth, that ‘They went overboard with the scary message to get compliance’ and confirmed there was no exit plan from the fear narrative (Dodsworth, 2021). Another (anonymous) SPI-B member informed Dodsworth, ‘The use of fear has definitely been ethically questionable’. This unidentified spokesperson also expressed the view that ‘propaganda has reached sinister levels’ and described the Government’s use of fear as both ‘dystopian’ and ‘like a weird experiment’. This opinion was echoed by Dr Simon Ruda (a former BIT member) who, in January 2022, said, ‘The most egregious and far-reaching mistake made in responding to the pandemic has been the level of fear willingly conveyed on the public’.


These rare critical voices apart, stakeholder have shown a remarkable reluctance to discuss the ethical implications of recommending the often-covert deployment of fear, shame and peer pressure as a means of persuasion. One organisation that rejects the notion that the use of nudges within the Government’s covid communication strategy raises ethical issues that warrant open and thorough discussion is the British Psychological Society (BPS). The BPS is the professional body for practising psychologists in the UK. According to its Code of Ethics, psychologists should respect ‘consent’ and ‘self-determination’, while always ensuring ‘the avoidance of harm and the prevention of abuse or misuse of their contribution to society’.


Mindful of their role as guardians of ethical psychological practice, over the last two years many people have written to the BPS expressing concerns about the activities of state-sponsored psychologists. One such example was my letter, co-signed by 46 psychologists and therapists, submitted on the 21st January 2021. Six months later, the then chair of the BPS ethics committee responded emphatically rejecting the suggestion that nudging, as deployed throughout the pandemic, was ethically dubious. Specifically, the BPS argued that: the psychological strategies deployed were ‘indirect’ rather than covert; the application of psychology in this instance fell outside the realm of individual health decisions (so the ethical requirement to obtain informed consent was not an issue); levels of fear within the general population were proportionate to the objective risk posed by the virus; and the psychologists’ role in the pandemic response demonstrated ‘social responsibility and the competent and responsible employment of psychological expertise’.


A further attempt to trigger a comprehensive independent inquiry by a Commons select committee into the state’s use of behavioural science did not succeed. The UK Government’s reluctance to address the ethical basis of nudging was also demonstrated by the omission of any mention of behavioural science in the draft terms of reference for the forthcoming inquiry into the covid-19 pandemic, published on the 10th March 2022.


Other stakeholders, centrally involved in the development of the Government’s covid communications strategy, have outright denied any responsibility for the strategic deployment of fear, shame and scapegoating. Presumably in response to having read the letters to the BPS and the Commons select committee, on the 31st January 2022 the communications department of the BIT commented, ‘None of the examples you reference were actually our work or anything we worked on at all, and we categorically do not believe in using fear as a tactic’ (personal communication).


Similarly, Professor Ann John (co-chair of the SPI-B) – in an interview with the Science & Technology Committee on the 30th March 2022 – stated, ‘We never advised on upping the level of fear … we absolutely advised that fear does not work’. In the same forum, when asked which ethical framework her SPI-B group was operating within, she said, ‘Although we present the advice, where policy decisions are made the Government have an advisory group on ethics’. The identity and output of the said advisory group remain unclear.



Future research into the ethics of state-sponsored behavioural science

Optimally, the Government’s future use of behavioural science (in the public health domain and others areas) will be guided by, and remain consistent with, an explicit ethical framework. To achieve this ambitious aim, two broad objectives will need to be met.


First, there is a need to clarify the key structures and processes involved in the decision-making around how behavioural-science interventions were utilised during the covid era. As already discussed, there has been a lack of transparency regarding where the responsibility lies for the Government’s covid-19 communication strategy, and the nudges used to drive it. Specifically, it is important to:


- Quantify the extent of state-sponsored behavioural science: How many WTEs are currently employed each government department and at what cost to taxpayers?


- Determine (via freedom-of-information requests and close inspection of minutes from the relevant stakeholder forums) where the key decisions regarding the content and tone of the media campaign were made: How influential were the behavioural scientists and psychological experts embedded in the SPI-B, the BIT and in other government departments? How much autonomy was given to the commercial advertisers in devising the type and style of messaging?


- Determine what ethical framework (if any) was used by UK Government when developing their covid-19 communications strategy: Was there a dedicated group of ethics advisors and – if so – what principles and process did they use?


Second, to develop a bespoke set of ethical guidelines and/or processes to inform and constrain how the state uses behavioural science in the future. As a minimum, any such protocol should incorporate ways of: achieving the informed consent of those targeted; evaluating the acceptability or otherwise of the methods used; determining an acceptable level of transparency; and clarifying what kind of goals could be appropriately pursued using these methods.


In developing appropriate guidance for the state’s use of nudging, a number of existing ethical frameworks can be drawn upon. For example, the Seedhouse Grid (Seedhouse, 1998), developed to promote ethical decision-making in healthcare, and a conceptual framework for propaganda, a seven-category model for distinguishing between consensual and manipulative forms of ‘organised persuasive communication’.



Concluding comments

For the last 30 months the British Government has inflicted an unrelenting onslaught of psychological manipulation on their own citizens, deploying often-covert forms of behavioural-science techniques. It is imperative that we learn as much as possible from this unprecedented period of state-sponsored persuasion and develop a fit-for-purpose ethical framework so as to protect against any future attempts by the administration to induce us to do ‘the right thing’ using morally unacceptable strategies.


Ref:

Seedhouse, D. (1998). Ethics: The heart of healthcare. Chichester: Wiley




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