BEHAVIORAL INTERVENTIONS IN PUBLIC HEALTH: A REGULATORY FRAMEWORK OF SUFFICIENCY AND EQUITY FOR CHILEAN LAW

Authors

DOI:

https://doi.org/10.22370/rcs.2026.88.5334

Keywords:

Health policy, Health sufficiency, Normal functioning, Autonomy, Dignity

Abstract

The growing use of behavioral interventions in health policy, particularly within systems marked by structural inequalities, has reignited the debate over the normative limits of the State’s persuasive power. This article analyzes the normative and legal criteria that determine the legitimacy of nudging techniques in health policy, assessing their compatibility with the standard of health sufficiency, distributive equity, and autonomy in the face of behavioral manipulation. The findings indicate that the legitimacy of nudging requires its grounding in the threshold of normal functioning and the protection of individuals’ range of opportunities, as well as its subjection to legal standards of instrumental necessity, proportionality, transparency, equity, and judicial review. The analysis further establishes the normative priority of boosting as an expression of minimal intrusion upon deliberative autonomy. It is concluded that nudging is justifiable only when it operates as a mechanism that enables agency within a robust regulatory framework capable of preventing manipulation and the deepening of health inequalities.

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References

BIBLIOGRAFÍA CITADA

ALEMANNO, Alberto y SPINA, Alessandro (2014): “Nudging Legally: On the Checks and Balances of Behavioral Regulation”, en: International Journal of Constitutional Law (Vol. 12, Nº 2), pp. 429-456. Disponible en: https://doi.org/10.1093/icon/mou033 [Fecha de última consulta: 12.03.2026].

APPELUIS, Lisann; BRANDMAIER, Andreas M.; DALLACKER, Mattea y HERTWIG, Ralph (2025): “Opt-out Defaults Do Not Increase Organ Donation Rates”, en: Public Health (November 2024, N°236), pp. 436-440. Disponible en: https://doi.org/10.1016/j.puhe.2024.08.009 [Fecha de última consulta: 12.03.2026].

BUSCH, Jacob; MADSEN, Emilie Kirstine; FAGE-BUTLER, Antoinette Mary; KJÆR, Marianne y LEDDERER, Loni (2021): “Dilemmas of Nudging in Public Health: An Ethical Analysis of a Danish Pamphlet”, en: Health Promotion International (Vol. 36, Nº 4), pp. 1140-1150. Disponible en: https://doi.org/10.1093/heapro/daaa146 [Fecha de última consulta: 12.03.2026].

CIALDINI, Robert B. y GOLDSTEIN, Noah J. (2004): “Social Influence: Compliance and Conformity”, en: Annual Review of Psychology (Vol. 55), pp. 591-621. Disponible en: https://doi.org/10.1146/annurev.psych.55.090902.142015 [Fecha de última consulta: 12.03.2026].

COHEN, Shlomo (2013): “Nudging and Informed Consent”, en: The American Journal of Bioethics (Vol. 13, Nº 6), pp. 3-11. Disponible en: https://doi.org/10.1080/15265161.2013.781704 [Fecha de última consulta: 12.03.2026].

DANIELS, Norman (2001): “Justice, Health, and Healthcare”, en: The American Journal of Bioethics (Vol. 1, Nº 2), pp. 2-16. Disponible en: https://doi.org/10.1162/152651601300168834 [Fecha de última consulta: 12.03.2026].

DANIELS, Norman (2008): Just Health: Meeting Health Needs Fairly (Cambridge, Cambridge University Press).

GOYDER, E. C.; MAHESWARAN, R. y READ, S. (2016): “Associations between Neighbourhood Environmental Factors and the Uptake and Effectiveness of a Brief Intervention to Increase Physical Activity: Findings from Deprived Urban Communities in an English City”, en: Journal of Public Health (Vol. 39, Nº 1), pp. 132-138. Disponible en: https://doi.org/10.1093/pubmed/fdv213 [Fecha de última consulta: 12.03.2026].

HANSEN, Pelle Guldborg; SKOV, Laurits Rohden y SKOV, Katrine Lund (2016): “Making Healthy Choices Easier: Regulation versus Nudging”, en: Annual Review of Public Health (Vol. 37), pp. 237-251. Disponible en: https://doi.org/10.1146/annurev-publhealth-032315-021537 [Fecha de última consulta: 12.03.2026].

HAUSMAN, Daniel M. y WELCH, Brynn (2010): “Debate: To Nudge or Not to Nudge”, en: Journal of Political Philosophy (Vol. 18, Nº 2), pp. 123-136. Disponible en: https://doi.org/10.1111/j.1467-9760.2009.00351.x [Fecha de última consulta: 12.03.2026].

HERTWIG, Ralph y GRÜNE-YANOFF, Till (2017): “Nudging and Boosting: Steering or Empowering Good Decisions”, en: Perspectives on Psychological Science (Vol. 12, Nº 6), pp. 973-986. Disponible en: https://doi.org/10.1177/1745691617702496 [Fecha de última consulta: 12.03.2026].

HERZOG, Stefan M. y HERTWIG, Ralph (2025): “Boosting: Empowering Citizens with Behavioral Science”, en: Annual Review of Psychology (Vol. 76), pp. 851-881. Disponible en: https://doi.org/10.1146/annurev-psych-020924-124753 [Fecha de última consulta: 12.03.2026].

JOHNSON, Eric J. y GOLDSTEIN, Daniel (2003): “Do Defaults Save Lives?”, en: Science (Vol. 302, Nº 5649), pp. 1338-1339. Disponible en: https://doi.org/10.1126/science.1091721 [Fecha de última consulta: 12.03.2026].

KAHNEMAN, Daniel (2011): Thinking, Fast and Slow (Nueva York, Farrar, Straus and Giroux).

MARMOT, Michael (2005): “Social Determinants of Health Inequalities”, en: The Lancet (Vol. 365, Nº 9464), pp. 1099-1104. Disponible en: https://doi.org/10.1016/S0140-6736(05)71146-6 [Fecha de última consulta: 12.03.2026].

MILLS, Stuart (2020): “Personalized Nudging”, en: Behavioural Public Policy, pp. 1-10. Disponible en: https://doi.org/10.1017/bpp.2020.7 [Fecha de última consulta: 12.03.2026].

NUFFIELD COUNCIL ON BIOETHICS (2007): Public Health: Ethical Issues (Londres, Nuffield Council on Bioethics).

OCDE (2019): The Heavy Burden of Obesity: The Economics of Prevention (París, OECD Health Policy Studies). Disponible en: https://doi.org/10.1787/67450d67-en [Fecha de última consulta: 12.03.2026].

OCDE (2024): LOGIC: Good Practice Principles for Mainstreaming Behavioural Public Policy (París, OECD). Disponible en: https://doi.org/10.1787/6cb52de2-en [Fecha de última consulta: 12.03.2026].

RAWLS, John (1999): A Theory of Justice, edición revisada (Cambridge, Massachusetts, Belknap Press of Harvard University Press).

RAZ, Joseph (1986): The Morality of Freedom (Oxford, Oxford University Press).

SAGHAI, Yashar (2013): “Salvaging the Concept of Nudge”, en: Journal of Medical Ethics (Vol. 39, Nº 8), pp. 487-493. Disponible en: https://doi.org/10.1136/medethics-2012-100727 [Fecha de última consulta: 12.03.2026].

SCHMIDT, Andreas T. y ENGELEN, Bart (2020): “The Ethics of Nudging: An Overview”, en: Philosophy Compass (Vol. 15, Nº 4), e12658. Disponible en: https://doi.org/10.1111/phc3.12658 [Fecha de última consulta: 12.03.2026].

SHANG, Huijing; XIONG, Lingfang; CHEN, Kefan; TIAN, Renqiong; TU, Jing y SHANG, Xianhui (2025): “Ethical Dimensions of Healthcare Nudges: A PRISMA-ScR-Guided Scoping Review and Framework for Responsible Behavioral Governance”, en: Frontiers in Public Health (Vol. 13), 1716466. Disponible en: https://doi.org/10.3389/fpubh.2025.1716466 [Fecha de última consulta: 12.03.2026].

SIMON, Herbert A. (1955): “A Behavioral Model of Rational Choice”, en: The Quarterly Journal of Economics (Vol. 69, Nº 1), pp. 99-118. Disponible en: https://doi.org/10.2307/1884852 [Fecha de última consulta: 12.03.2026].

STUBER, Josine M.; BEULENS, Joline W. J.; LAKERVELD, Jeroen; KIEVITSBOSCH, Loes W. y MACKENBACH, Joreintje D. (2022): “Nudging Customers towards Healthier Food and Beverage Purchases in a Real-Life Online Supermarket: A Multi-Arm Randomized Controlled Trial”, en: BMC Medicine (Vol. 20, Nº 10). Disponible en: https://doi.org/10.1186/s12916-021-02205-z [Fecha de última consulta: 12.03.2026].

SUNSTEIN, Cass R. (2014): Why Nudge?: The Politics of Libertarian Paternalism (New Haven, Yale University Press).

TAILLIE, Lindsey Smith; BERCHOLZ, Marcela; POPKIN, Barry; REBOLLEDO, Natalia; REYES, Marcela y CORVALÁN, Camila (2024): “Decreases in Purchases of Energy, Sodium, Sugar, and Saturated Fat 3 Years after Implementation of the Chilean Food Labeling and Marketing Law: An Interrupted Time Series Analysis”, en: PLOS Medicine (Vol. 21, Nº 9), e1004463. Disponible en: https://doi.org/10.1371/journal.pmed.1004463 [Fecha de última consulta: 12.03.2026].

TAILLIE, Lindsey Smith; RIVERA, Juan; POPKIN, Barry; NG, Shu Wen y CORVALÁN, Camila (2020): “An Evaluation of Chile's Law of Food Labeling and Advertising on Sugar-Sweetened Beverage Purchases from 2015 to 2017”, en: PLOS Medicine (Vol. 17, Nº 2), e1003042. Disponible en: https://doi.org/10.1371/journal.pmed.1003042 [Fecha de última consulta: 12.03.2026].

THALER, Richard H. y SUNSTEIN, Cass R. (2008): Nudge: Improving Decisions about Health, Wealth, and Happiness (New Haven, Yale University Press).

TVERSKY, Amos y KAHNEMAN, Daniel (1974): “Judgment under Uncertainty: Heuristics and Biases”, en: Science (Vol. 185, Nº 4157), pp. 1124-1131. Disponible en: https://doi.org/10.1126/science.185.4157.1124 [Fecha de última consulta: 12.03.2026].

TVERSKY, Amos y KAHNEMAN, Daniel (1981): “The Framing of Decisions and the Psychology of Choice”, en: Science (Vol. 211, Nº 4481), pp. 453-458. Disponible en: https://doi.org/10.1126/science.7455683 [Fecha de última consulta: 12.03.2026].

VAN ROEKEL, Henrico; REINHARD, Joanne y GRIMMELIKHUIJSEN, Stephan (2021): “Improving Hand Hygiene in Hospitals: Comparing the Effect of a Nudge and a Boost on Protocol Compliance”, en: Behavioural Public Policy, pp. 1-23. Disponible en: https://doi.org/10.1017/bpp.2021.15 [Fecha de última consulta: 12.03.2026].

WALDRON, Jeremy (2014): “It’s All for Your Own Good”, en: New York Review of Books. Disponible en: https://www.nybooks.com/articles/2014/10/09/cass-sunstein-its-all-your-own-good/ [Fecha de última consulta: 27.06.2026].

WANSINK, Brian (2004): “Environmental Factors That Increase the Food Intake and Consumption Volume of Unknowing Consumers”, en: Annual Review of Nutrition (Vol. 24), pp. 455-479. Disponible en: https://doi.org/10.1146/annurev.nutr.24.012003.132140 [Fecha de última consulta: 12.03.2026].

YEUNG, Karen (2017): “‘Hypernudge’: Big Data as a Mode of Regulation by Design”, en: Information, Communication & Society (Vol. 20, Nº 1), pp. 118-136. Disponible en: https://doi.org/10.1080/1369118X.2016.1186713 [Fecha de última consulta: 12.03.2026].

ZÚÑIGA FAJURI, Alejandra (2011): “Justicia y racionamiento sanitario en el Plan AUGE: dilemas bioéticos asociados a la distribución de recursos escasos”, en: Acta Bioethica (Vol. 17, Nº 1), pp. 73-84. Disponible en: https://doi.org/10.4067/S1726-569X2011000100008 [Fecha de última consulta: 12.03.2026].

NORMAS JURÍDICAS CITADAS

Ley N°20.606, sobre composición nutricional de los alimentos y su publicidad, Diario Oficial, 06 de julio de 2012.

Published

2026-07-28

Issue

Section

Research articles

How to Cite

BEHAVIORAL INTERVENTIONS IN PUBLIC HEALTH: A REGULATORY FRAMEWORK OF SUFFICIENCY AND EQUITY FOR CHILEAN LAW. (2026). Revista De Ciencias Sociales, 88, 367-408. https://doi.org/10.22370/rcs.2026.88.5334