Abstract
In their article “The Concept of Voluntary Consent,” Robert
Nelson and colleagues (2011) argue for two necessary and
jointly sufficient conditions for voluntary action: intentionality,
and substantial freedom from controlling influences.
They propose an instrument to empirically measure voluntariness,
the Decision Making Control Instrument.
I argue that (1) their conceptual analysis of intentionality
and controlling influences needs expansion in light of the
growing use of behavioral economics principles to change
individual and public health behaviors (growing in part by
the designation of “The Science of Behavior Change” as
a new National Institutes of Health [NIH] Roadmap Activity);
and (2) that their measure of voluntariness that relies
on self-perceived intentionality and extent of control is
unreliable, given findings from behavioral economics and
cognitive science that show that our perceptions about the
intentionality and control of our own and others’ decisions
and actions are remarkably skewed and un-insightful.