Infectious diseases figure prominently as (counter)examples in debates on how to conceptualize “disease.” But crucial epidemiological distinctions are often not heeded in the debate, and pathological and clinical perspectives focusing on individual patients are favored at the expense of perspectives from epidemiology focusing on populations. In clarifying epidemiological concepts, this paper highlights the distinct contributions infectious disease epidemiology can make to the conception of “disease,” and the fact that this is at least tacitly recognized by medical personnel and philosophers. Crucially, (...) infectious disease epidemiology can help elucidate how carrying and transmitting infectious, communicable entities is a disease, even if the carriers themselves are not directly affected by symptoms detrimental to them. (shrink)

The COVID-19 pandemic has brought the long-standing public health practice of contact tracing into the public spotlight. While contact tracing and case investigation have been carefully designed to protect privacy, the huge volume of tracing which is being carried out as part of the pandemic response in the United States is highlighting potential concerns around privacy, legality, and equity. Contact tracing during the pandemic has gained particular attention for the new use of digital technologies—both on the consumer side in the (...) form of Exposure Notification applications, and for public health agencies as digital case management software systems enable massive scaling of operations. While the consumer application side of digital innovation has dominated the news and academic discourse around privacy, people are likely to interact more intensively with public health agencies and their use of digital case management systems. Effective use of digital case management for contact tracing requires revisiting the existing legal frameworks, privacy protections, and security practices for management of sensitive health data. The scale of these tools and demands of an unprecedented pandemic response are introducing new risks through the collection of huge volumes of data, and expanding requirements for more adept data sharing among jurisdictions. Public health agencies must strengthen their best practices for data collection and protection even in the absence of comprehensive or clear guidance. This requires navigating a difficult balance between rigorous data protection and remaining highly adaptive and agile. (shrink)

As COVID-19 continues to spread, a variety of COVID-19 tracking apps have been introduced to help contain the pandemic. Deployment of this technology poses serious challenges of effectiveness, technological problems and risks to privacy and equity. The ethical use of CTAs depends heavily on the protection of voluntariness. Voluntary use of CTAs implies not only the absence of a legal obligation to employ the app but also the absence of more subtle forms of coercion such as enforced exclusion from certain (...) social and work activities. The protection of individual rights to voluntary use can be enhanced through an ethics by design approach in the development of CTAs that treat the introduction of CTAs for what it is: a complete novelty that is being tested for the first time in democracies. (shrink)

Digital contact tracing is used in different countries to help contain the COVID-19 pandemic. It raises challenging empirical and ethical questions due to its complexity and widespread effects calling for a broader approach in ethical evaluation. However, existing approaches often fail to include all relevant value perspectives or lack reference to empirical data on the artifact in question. In this paper, we describe the development of an interdisciplinary framework to analyze digital contact tracing from an empirical and ethical perspective. Starting (...) with an analysis of methodological tensions in the attempt to analyze digital contact tracing, we, firstly, set out three methodological premises regarding (a) a specific view of technology, (b) a fruitful normative perspective, and (c) ways to gather empirical knowledge about the object under investigation. Secondly, we inspect consequences of these premises to develop our research methodology. In doing so, we argue for a postphenomenological perspective on technology, solidarity as an important concept to guide the ethical perspective, and an empirical approach based on qualitative social science research and the concept of affordances. We illustrate these considerations by referring to our analysis of the German Corona-Warn-App as an instance of contact tracing based on the Exposure Notification Framework by Google and Apple. We then discuss the implications of using such a framework, including considerations concerning future developments of technologies similar to or inspired by the current concepts of contact tracing. (shrink)

We conducted a systematic literature review on the ethical considerations of the use of contact tracing app technology, which was extensively implemented during the COVID-19 pandemic. The rapid and extensive use of this technology during the COVID-19 pandemic, while benefiting the public well-being by providing information about people’s mobility and movements to control the spread of the virus, raised several ethical concerns for the post-COVID-19 era. To investigate these concerns for the post-pandemic situation and provide direction for future events, we (...) analyzed the current ethical frameworks, research, and case studies about the ethical usage of tracing app technology. The results suggest there are seven essential ethical considerations—privacy, security, acceptability, government surveillance, transparency, justice, and voluntariness—in the ethical use of contact tracing technology. In this paper, we explain and discuss these considerations and how they are needed for the ethical usage of this technology. The findings also highlight the importance of developing integrated guidelines and frameworks for implementation of such technology in the post- COVID-19 world. (shrink)