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Cass Sunstein and Richard Thaler's Nudge: Improving Decisions about Health, Wealth, and Happiness presents an influential account of why 'choice architecture' should be used to 'nudge' people into making better decisions than they would otherwise make. In this essay we: (1) explain the main concepts that Thaler and Sunstein rely upon to defend their project; (2) clarify the main conceptual problems that have arisen in discussions about nudges; (3) clarify practical difficulties that can arise during nudge practice; (4) review the main ethical and political objections that have been raised against nudging; and (5) clarify why issues related to meaning can pose methodological problems for creating effective choice architecture.

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Richard Thaler and Cass Sunstein (2008) contend that mandated choice is the most practical nudge for increasing organ donation. We argue that they are wrong, and their mistake results from failing to appreciate how perceptions of meaning can influence people's responses to nudges. We favor a policy of default to donation that is subject to immediate family veto power, includes options for people to opt out (and be educated on how to do so), and emphasizes the role of organ procurement organizations and in-house transplant donation coordinators creating better environments for increasing the supply of organs and tissues obtained from cadavers. This policy will provide better opportunities for offering nudges in contexts where in-house coordinators work with families. We conclude by arguing that nudges can be introduced ethically and effectively into these contexts only if nudge designers collaborate with in-house coordinators and stakeholders.

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Recent debates about the Grameen Bank's microlending practices depict participating female borrowers as having fundamentally empowering or disempowering experiences. I argue that this discursive framework may be too reductive: it can conceal how technique and technology simultaneously facilitate relations of dependence and independence; and it can diminish our capacity to understand and assess innovative development initiatives.

In response to a growing movement within higher education to provide interdisciplinary educational programs, this study describes the creation of an interdisciplinary graduate certificate program in healthcare policy and management. Building on prior research, we surveyed healthcare executives to examine their perceptions about the need for such a program and the importance of core subject areas. Drawing on our findings as well as the literature on "interactional expertise" and "wicked problems," we provide a detailed method for