Behavioral Insights Team

The Behavioral Insights Team (BIT) (a.k.a. The Nudge Unit) is a United Kingdom-based analytics group that began as a government intelligence unit in 2010, but branched out around the world, calling itself a “global social purpose company” that tests and implements “simple yet powerful changes.”¹⁾ BIT works with dozens of banks and governments as well as many media and education groups all over the world.

• BIT Blog
• BIT Podcasts
• BIT Publications
• BIT Tools

Among BITs affialates are

• Cass Sunstein - Harvard University law professor and co-author of the book Nudge.
• Daniel Goldstein - principle research at Microsoft Research.
• Elizabeth Linos - Assistant professor of public policy at UC Berkeley
• Gus O'Donnell - Member of the House of Lords and former head of the UK's Civil Service
• Richard Thaler - Professor of behavioral science and economics at the Chicago Booth School of Business and co-author of the book Nudge.
• An assortment of professors from the world's best known universities.

One of the longstanding projects of the BIT is the Gender & Behavioral Insights (GABI) research program working to improve gender equality.

• Using social norms to increase tax payments.
• Increasing fine payments through text messages.

• Jan 18, 2022 - Ethical concerns arising from the Government’s use of covert psychological ‘nudges’²⁾

PANDA - July 12, 2022 by Gary Sidley, first published on Coronababble

Who is responsible for inflicting unethical behavioural-science ‘nudges’ on the British people?

The state’s strategic deployment of fear, shame and peer pressure – or ‘affect, ‘ego’ and ‘norms’ in the language of behavioural science – throughout the covid-19 pandemic, as a means of ‘nudging’ people’s compliance with restrictions and the vaccine rollout has been widely criticised. Ethical concerns about the Government’s use of these psychological techniques in their messaging campaign arise from several aspects of this form of influence: the wilful infliction of emotional distress on the general population as a means of increasing conformity; the failure to seek informed consent from those targeted; the contentious and non-evidenced public health policies which these strategies helped to implement; and the fact that ‘nudges’ commonly exert their influence below a person’s level of consciousness, thereby fueling the accusation that they are manipulative. But who is primarily responsible for inflicting these morally dubious, and often damaging, behavioural-science ‘nudges’ on British citizens?

There are four groups of stakeholders who could feasibly be responsible for these egregious actions:

  British Psychological Society (BPS)
  Behavioural Insights Team (BIT)
  Scientific Pandemic Insights Group on Behaviours (SPI-B)
  Elected politicians and their civil servants

To date, all four seem to be shirking any responsibility. Indeed, when probed, the responses of these collectives resemble a duplicitous hybrid of a police officer’s, ‘Move along, nothing to see here’, and the reggae musician Shaggy denying his misdemeanours with the mantra, ‘It wasn’t me’.

Let’s consider, in turn, each group of actors who might be responsible. ³⁾

At COP26, the UN climate change conference in Glasgow last year, a series of debates held in conjunction with Albert set out the terms of acceptable broadcasting. Broadcasters were encouraged to sign a pledge to make environmentalism central to their activities. This included a commitment to ‘reach more of our audiences with content that helps everyone understand and navigate the path to net zero, and inspires them to make greener choices’; to ‘develop processes that help us to consider climate themes when… commissioning, developing and producing content’; and to ‘recognise the importance of fair and balanced representations of visions for a sustainable future’.

What broadcasters have agreed to is a promise to ensure the correct message filters through to an unsuspecting public. Sky, together with the Behavioural Insights Team (or ‘Nudge Unit’ as it was known when it was set up in 2010 by David Cameron’s government), claims that 75 per cent of people support ‘TV broadcasters “nudging” viewers to think about the environment, whether that’s through documentaries, advertising or increasing the coverage of environmental issues in the news’.

Channel 4’s Krishnan Guru-Murthy has recently been announced as chair of the albert news consortium. He has been enlisted to ‘explore how the climate change conversation is represented on screen’. Broadcasters must now take into consideration whether their output fits with Albert’s principles. So much for impartiality.

By buying into Albert’s mission, the broadcast media have agreed to combine forces to make sure their output, from soap operas to news, sport to children’s cartoons, puts the planet into programme content. ‘Collectively, our industry reaches millions of people every single day. That represents an unprecedented opportunity to shift mindsets… It’s a chance to shape society’s response to climate change,’ says Albert.

The broadcasters agree: ‘We believe broadcasters have a clear role and responsibility to encourage lifestyle changes,’ said Dana Strong, CEO of Sky Group. As an example of where this leads, in the run-up to COP26, the producers of Casualty, Coronation Street, Doctors, Emmerdale, EastEnders, Holby City and Hollyoaks worked together on a climate-change storyline. ⁴⁾

Nudging the news - Artillery Row By Laura Dodsworth and Toby Young 21 December, 2021

Can the news be impartial when broadcasters are encouraged — by the UK government’s behavioural scientists — to “nudge” viewers to support a contentious policy?

During COP26, Sky released a video with the opening lines: “We cannot understate the urgency. But faced with issues of such enormity, what role can we play?”

That was a rhetorical question, obviously, since the issue wasn’t really up for discussion. Sky announced that it was collaborating with the “independent Behavioural Insights Team” to nudge viewers into supporting Net Zero. The Behavioural Insights Team (BIT) — colloquially known as the “Nudge Unit” — was one–third owned by the Cabinet Office until the shares were sold to NESTA earlier this month. A company which was part owned by the government could not fairly be described as “independent” at that juncture.

Sky’s chief executive commuted to work from her home in Philadelphia by private jet

The collaboration between a major UK broadcaster and the Nudge Unit to promote one of the most controversial policies today is deeply alarming. The report, The Power of TV: Nudging Viewers to Decarbonise their Lifestyles, jointly published by BIT and Sky, shows little regard for the obligation imposed on broadcasters by Ofcom’s Broadcasting Code to maintain “due impartiality” across all their output, particularly when it comes to news and current affairs. It also neglects the requirement that broadcasters expose viewers to a wide range of different views when it comes to “matters of major political and industrial controversy and major matters relating to current public policy”.

Instead, BIT and Sky recommend that all UK broadcasters adopt a hard editorial bias when it comes to the promotion of the Government’s controversial Net Zero policy — and goes on to say that Sky itself is complying with the policy, which is an odd boast given that its chief executive, Dana Strong, commuted to work from her home in Philadelphia by private jet for the first part of this year. ⁵⁾

Ontario College of Physicians recommends ‘medication’ and ‘psychotherapy’ to encourage COVID vaccination

Toronto Lifesite News - October 6, 2022 'It is also important that physicians work with their patients to manage anxieties related to the vaccine and not enable avoidance behavior.'

To combat so-called “avoidance behavior,” the College of Physicians and Surgeons of Ontario (CPSO) is now encouraging its doctors to prescribe drugs or recommend psychotherapy to patients who have refused to receive the experimental COVID-19 vaccines.

“It is also important that physicians work with their patients to manage anxieties related to the vaccine and not enable avoidance behavior,” reads the CPSO’s official website.

“For example, for extreme fear of needles (trypanophobia) or other cases of serious concern, responsible use of prescription medications and/or referral to psychotherapy may be available options. Overall, physicians have a responsibility to allow their patients to be properly informed about vaccines and not have those anxieties empowered by an exemption,” adds the CPSO.

The CPSO guidelines were first brought to the attention of the public by Saskatchewan-based Twitter user Nadine Ness, who called the recommendation “horrific.” “The College of Physicians and Surgeons in Ontario is basically telling doctors to prescribe drugs or refer patients to a psychiatrist if they don’t want the vaccine,” Ness tweeted on Tuesday. “This is horrific. Yet another reason for lowered trust in our health care system.” ⁶⁾

• The College of Physicians and Surgeons in Ontario is basically telling doctors to prescribe drugs or refer patients to a psychiatrist if they don’t want the vaccine. This is horrific. Yet another reason for lowered trust in our health care system. https://t.co/O0ifmgKrTD pic.twitter.com/YYOjR2cHHZ
• — Nadine Ness (@NadineGNess) October 5, 2022

At the time of Ness’ screenshot, the CPSO website did not include the specific example of a patient with a “fear of needles,” but instead simply read that in “cases of serious concern, responsible use of prescription medications and/or referral to psychotherapy are available options.” ⁷⁾

Pandemic-Related Practice Issues

*Patients are asking me to write notes supporting a medical exemption from COVID-19 vaccines — what do I need to know?

Patients may ask you to write notes or complete forms exempting them from getting vaccinated. If you are asked by your patient to provide information supporting a medical exemption from receiving a COVID-19 vaccine, your patient must have a legitimate medical condition that would warrant an exemption.

The National Advisory Committee on Immunization (NACI), the Ministry of Health, and some public health units have provided guidance regarding contraindications for COVID-19 vaccines. The Ministry of Health has also provided guidance about medical exemptions in the Medical Exemptions to COVID-19 Vaccination document, and guidance for specific allergy populations in the COVID-19 Vaccination: Allergy Form document.

Generally speaking, there are very few acceptable medical exemptions to the COVID-19 vaccination (examples include an allergist/immunologist-confirmed severe allergy or anaphylactic reaction to a previous dose of a COVID-19 vaccine or to any of its components that cannot be mitigated, or a diagnosed episode of myocarditis/pericarditis after receipt of an mRNA vaccine).

Given the rarity of these exceptions, and in light of the fact that vaccines have been proven to be both safe and effective, any notes written for patients who qualify for a medical exemption need to clearly specify:

• the reason they cannot be vaccinated against COVID-19 (i.e., document clear medical information that supports the exemption); and
• the effective time period for the medical reason (i.e., permanent or time-limited).

While physicians are generally required to complete third party medical reports for patients when requested, the circumstances of the pandemic support physicians declining to write notes or complete forms when the patient making the request does not have a medical condition that warrants an exemption. If you find yourself in this situation, clearly and sensitively explain to your patient that you cannot provide them with a note or form, along with the reasons why. 

It is also important that physicians work with their patients to manage anxieties related to the vaccine and not enable avoidance behaviour. In cases of serious concern, responsible use of prescription medications and/or referral to psychotherapy are available options. Overall, physicians have a responsibility to allow their patients to be properly informed about vaccines and not have those anxieties empowered by an exemption.

What do I do if a patient has an expired health card or a red and white health card?

Due to COVID-19, the Ministry of Health has extended recently expired health cards (on or after March 1, 2020) and red and white health cards so that they remain valid. You should still be accepting these health cards from Ontario residents at this time until the extension period ends on September 30, 2022. If a patient does not have a valid Ontario health card, you should not turn them away. You can use the billing codes identified by the Ministry of Health for those without OHIP or another provincial health plan.

COVID-19 Vaccines

Having a fully vaccinated health-care profession is critical to minimizing the risk of COVID-19 transmission and/or outbreaks in offices, clinics and hospitals. Even if you do not feel sick, asymptomatic infection and subsequent transmission is possible. The COVID-19 vaccine reduces your chance of becoming infected and is one of the best ways to control the spread of the virus, and so getting vaccinated is an essential step to protecting your own health, the health of your patients, and the community at large.

This pandemic offers physicians an opportunity to lead by example. By getting vaccinated, physicians can help relieve the strain on our health-care system and support the health, safety, and well-being of the people of Ontario.

While the College recognizes that some physicians cannot get vaccinated due to medical contraindications, those physicians can still provide strong leadership on COVID-19 prevention and continue to advocate for full vaccination of all those eligible.

I’ve read about some drugs that might prove beneficial in treating COVID-19: Should I be prescribing these drugs as a precautionary measure? Can I prescribe them for myself or family?

No. Many of these drugs have an intended use and prescribing them as a precautionary measure has or may contribute to drug shortages, compromising care for others. Should these or other drugs prove useful in combating COVID-19, their use will need to be carefully managed to support those who need them the most.

At a time where resources may be scarce, actions like those mentioned above dramatically depart from the core values of medical professionalism, undermine the public trust in the profession at a time where the public is most vulnerable, and may contravene the College’s Physician Treatment of Self, Family Members, or Others Close to Them policy.

What should I be thinking about as I engage on social media about issues relating to the pandemic?

Physicians are reminded to be aware of how their actions on social media or other forms of communication could be viewed by others, especially during a pandemic. Your comments or actions can lead to patient/public harm if you are providing an opinion that does not align with information coming from public health or government. It is essential that the public receive a clear and consistent message.

The College’s Social Media policy⁸⁾ sets expectations for physicians to conduct themselves in a professional manner while using social media and to consider the potential impact of their conduct in the online environment on the reputation of the profession and the public trust. The policy also includes expectations for physicians sharing health-related information online. Additional guidance and resources can be found in the Advice to the Profession: Social Media document ⁹⁾. ¹⁰⁾

How behavioural insights can help improve responses to COVID-19

NSW Government

The Coronavirus (COVID-19) pandemic continues to be challenging for everyone around the world. NSW customers seek useful, timely information and guidance to inform their decisions and planning. NSW Behavioural Insights Unit working to help people make smart COVID-19 choices

The NSW Behavioural Insights Unit partnered with government agencies to help the people of NSW make informed choices, comply with social distancing rules, and stay COVID safe together. Social communications help to stop the spread

All over the world, people have had to rapidly adopt new behaviours to reduce the spread of COVID-19. Effective communication has been vital to public health campaigns. What we did

We provided insights to inform the NSW Government’s communications advertising campaign aimed at stopping the spread of COVID-19.

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