This paper explores ethical debates associated with the UK COVID-19 contact tracing app that occurred in the public news media and broader public policy, and in doing so, takes ethics debate as an object for sociological study. The research question was: how did UK national newspaper news articles and grey literature frame the ethical issues about the app, and how did stakeholders associated with the development and/or governance of the app reflect on this? We examined the predominance of different ethical (...) issues in news articles and grey literature, and triangulated this using stakeholder interview data. Findings illustrate how news articles exceptionalised ethical debate around the app compared to the way they portrayed ethical issues relating to ‘manual’ contact tracing. They also narrowed the debate around specific privacy concerns. This was reflected in the grey literature, and interviewees perceived this to have emerged from a ‘privacy lobby’. We discuss the findings, and argue that this limited public ethics narrative masked broader ethical issues. (shrink)

In this paper, I approach the power of digital platforms by using the republican concept of domination. More specifically, I argue that the traditional, agent-relative interpretation of domination, in the case of digital domination, is best supplemented by a more radical version, on which republicans ought to give priority to structural elements. I show how radical republicanism draws attention to (1) the economic rationales and the socio-technical infrastructures that underlie and support digital platforms and to (2) the forms of influence (...) that are directed at cognitive dimensions, such as habituation and routinisation, which are particularly relevant for the power of digital platforms. These insights also imply that republicans have reason to favour a more structural response to digital platforms over more direct and individualised forms of control that fit with a ‘standard’ republican approach, such as securing exit options and requiring user consent. (shrink)

Zusammenfassung In der öffentlichen Debatte über die Corona-Warn-App kann der Solidaritätsbegriff als wichtiger, aber inhaltlich umstrittener normativer Bezugspunkt gelten. So stehen hier unterschiedliche Solidaritätsrekurse mit heterogenen Voraussetzungen, normativen Implikationen und praktischen Konsequenzen nebeneinander, die einer medizinethischen Untersuchung bedürfen. Vor diesem Hintergrund ist es Ziel des Beitrags, _erstens_ die Bandbreite der Verwendungsweisen des Solidaritätsbegriffs in der öffentlichen Debatte zur Corona-Warn-App anschaulich zu machen sowie _zweitens_ die Voraussetzungen und normativen Implikationen dieser Verwendungsweisen herauszuarbeiten und einer ethischen Bewertung zu unterziehen. Dazu stelle ich (...) nach einer kurzen Einführung in die Corona-Warn-App und einer Vergegenwärtigung der Grundzüge des Solidaritätskonzepts vier Beispiele aus der öffentlichen Debatte zur Corona-Warn-App dar, die mit Blick auf die zugrundeliegende Identifikation, die Solidaritätsgruppe, den solidarischen Beitrag sowie das normative Ziel erhebliche Unterschiede aufweisen. Sie unterstreichen die Notwendigkeit weiterführender Maßstäbe, um ihre Legitimität zu bewerten. Dazu greife ich auf vier normative Kriterien einer kontextsensitiven, moralisch gehaltvollen Solidaritätskonzeption zurück (Solidaritätsoffenheit, gestaltbare Inklusivität, Angemessenheit des solidarischen Beitrags, normative Abhängigkeit) und evaluiere auf dieser Grundlage die vorgestellten Solidaritätsrekurse ethisch. Für alle dargestellten Solidaritätsrekurse lassen sich in der Folge kritische Rückfragen formulieren. Dabei werden einerseits die Potenziale und Limitationen von Solidaritätsrekursen in öffentlichen Debatten deutlich. Andererseits werden Schlussfolgerungen möglich, wann eine Tracing-App tatsächlich als solidarische Technologie zur Pandemiebekämpfung verstanden werden kann. (shrink)

The public health measures implemented in response to the COVID-19 pandemic have resulted in a substantially increased shared reliance on private infrastructure and digital services in areas such as healthcare, education, retail, and the workplace. This development has (i) granted a number of private actors significant (informational) power, and (ii) given rise to a range of digital surveillance practices incidental to the pandemic itself. In this paper, we reflect on these secondary consequences of the pandemic and observe that, even though (...) collateral data disclosure and additional activity monitoring appears to have been generally socially accepted as inevitable consequences of the pandemic, part and parcel of a larger conglomeration of emergency compromises, these increased surveillance practices were not directly justified by appeals to solidarity and public health in the same way that the instigating public health measures were. Based on this observation, and given the increased reliance on private actors for maintaining the digital space, we argue that governments have a duty to (i) seek and ensure that there are justifications for collateral data disclosure and activity monitoring by private actors in the context of (future) public health emergencies like the COVID-19 pandemic, and (ii) regulate and provide accountability mechanisms for and oversight over these private surveillance practices on par with governmental essential services that engage in surveillance activities. (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)

The article introduces the concept of "surveillance-capitalist biopolitics" to problematize the recent expansion of "data extractivism" in health care and health research. As we show, this trend has accelerated during the ongoing Covid pandemic and points to a normalization and institutionalization of self-tracking practices, which, drawing on the "quantified self", points to the emergence of a "quantified collective". Referring to Foucault and Zuboff, and by analyzing key examples of the leading "Big Tech" companies (e.g., Alphabet and Apple), we argue that (...) contemporary forms of digital biopolitics are privatized, opaque, flexible, and not limited to the state. Instead, especially through the integration of wearable technologies, the biopolitical regulation of bodies is increasingly mediated by private tech companies. These companies rely on a questionable narrative of participation, responsibility, and care despite owning, and ultimately controlling, access to intimate health data and the proprietary algorithms mediating this data. The article shows that the proliferation of "surveillance-capitalist biopolitics" ultimately strengthens not only market power but also the epistemic and infrastructural power of the dataowning and gadget-producing firms. Finally, against an exclusively repressive and negative reading of biopolitics, and to effectively counter the forms of power emerging from surveillance-capitalist biopolitics, we propose four dimensions that are central to its democratizationnamely privacy/individual sovereignty, democratic deliberation, pluralism, and epistemic equality. -/- DOI: 10.1007/s41358-021-00309-9. (shrink)

Over the past few years, there has been a proliferation of artificial intelligence strategies, released by governments around the world, that seek to maximise the benefits of AI and minimise potential harms. This article provides a comparative analysis of the European Union and the United States’ AI strategies and considers the visions of a ‘Good AI Society’ that are forwarded in key policy documents and their opportunity costs, the extent to which the implementation of each vision is living up to (...) stated aims and the consequences that these differing visions of a ‘Good AI Society’ have for transatlantic cooperation. The article concludes by comparing the ethical desirability of each vision and identifies areas where the EU, and especially the US, need to improve in order to achieve ethical outcomes and deepen cooperation. (shrink)

Mobile phone-based applications (apps) can promote faster targeted actions to control COVID-19. However, digital contact tracing systems raise concerns about data security, system effectiveness, and their potential to normalise privacy-invasive surveillance technologies. In the absence of mandates, public uptake depends on the acceptability and perceived legitimacy of using technologies that log interactions between individuals to build public health capacity. We report on six online deliberative workshops convened in New South Wales to consider the appropriateness of using the COVIDSafe app to (...) enhance Australian contact tracing systems. All groups took the position (by majority) that the protections enacted in the app design and supporting legislation were appropriate. This support is contingent on several system attributes including: the voluntariness of the COVIDSafe app; that the system relies on proximity rather than location tracking; and, that data access is restricted to local public health practitioners undertaking contact tracing. Despite sustained scepticism in media coverage, there was an underlying willingness to trust Australian governing institutions such that in principle acceptance of the new contact tracing technology was easy to obtain. However, tensions between the need to prove system effectiveness through operational transparency and requirements for privacy protections could be limiting public uptake. Our study shows that informed citizens are willing to trade their privacy for common goods such as COVID-19 suppression. But low case numbers and cautionary public discourses can make trustworthiness difficult to establish because some will only do so when it can be demonstrated that the benefits justify the costs to individuals. (shrink)

Zu Beginn der Pandemie im Frühjahr 2020, und nach einem weitreichenden Lockdown, ruhten große Erwartungen auf Corona-Warn-Apps, um einen erneuten Lockdown zu verhindern. Diese Erwartungen haben sich nicht erfüllt; stattdessen wurden in Deutschland als Reaktion auf erneute Wellen von COVID-19 weitere Kontaktbeschränkungen verordnet. Wie hätte die digitale Kontaktverfolgung wirksamer gestaltet werden können? Wir argumentieren, dass es ein Spannungsfeld zwischen der Datensparsamkeit und einer wirksamen Bekämpfung der Pandemie besteht. Im Gegensatz zur deutschen Corona-Warn-App wäre eine Variante der App, in der pseudonymisierte (...) Kennungen zentral gespeichert werden, in der Lage gewesen, die Effektivität der Kontaktverfolgung entscheidend zu erhöhen. Schließlich argumentieren wir, dass das Spannungsfeld zwischen Datensparsamkeit und einer wirksamen Pandemiebekämpfung sich jedoch nicht in einen Wertekonflikt übersetzt, weil zentrale Systeme uns trotz ihrer erhöhten Wirksamkeit nicht vor deutlich gravierendere Probleme beim Datenschutz stellen als dezentrale Systeme. Zentrale Möglichkeiten der digitalen Kontaktverfolgung wären daher ethisch gerechtfertigt, um auf weitere Wellen von COVID-19 oder auf zukünftige Epidemien effektiv zu reagieren. (shrink)

At the beginning of the COVID-19 pandemic, high hopes were placed on digital contact tracing. Digital contact tracing apps can now be downloaded in many countries, but as further waves of COVID-19 tear through much of the northern hemisphere, these apps are playing a less important role in interrupting chains of infection than anticipated. We argue that one of the reasons for this is that most countries have opted for decentralised apps, which cannot provide a means of rapidly informing users (...) of likely infections while avoiding too many false positive reports. Centralised apps, in contrast, have the potential to do this. But policy making was influenced by public debates about the right app configuration, which have tended to focus heavily on privacy, and are driven by the assumption that decentralised apps are “privacy preserving by design”. We show that both types of apps are in fact vulnerable to privacy breaches, and, drawing on principles from safety engineering and risk analysis, compare the risks of centralised and decentralised systems along two dimensions, namely the probability of possible breaches and their severity. We conclude that a centralised app may in fact minimise overall ethical risk, and contend that we must reassess our approach to digital contact tracing, and should, more generally, be cautious about a myopic focus on privacy when conducting ethical assessments of data technologies. (shrink)

The datafication and digitalization of health and medicine has engendered a proliferation of new collaborations between public health institutions and data corporations like Google, Apple, Microsoft and Amazon. Critical perspectives on these new partnerships tend to frame them as an instance of market transgressions by tech giants into the sphere of health and medicine, in line with a “hostile worlds” doctrine that upholds that the borders between market and non-market spheres should be carefully policed. This article seeks to outline the (...) limitations of this common framing for critically understanding the phenomenon of the Googlization of health. In particular, the mobilization of a diversity of non-market value statements in the justification work carried out by actors involved in the Googlization of health indicates the co-presence of additional worlds or spheres in this context, which are not captured by the market vs. non-market dichotomy. It then advances an alternative framework, based on a multiple-sphere ontology that draws on Boltanski and Thevenot’s orders of worth and Michael Walzer’s theory of justice, which I call a normative pragmatics of justice. This framework addresses both the normative deficit in Boltanski and Thevenot’s work and provides an important emphasis on the empirical workings of justice. Finally, I discuss why this framework is better equipped to identify and to address the many risks raised by the Googlization of health and possibly other dimensions of the digitalization and datafication of society. (shrink)

Background Big data and AI applications now play a major role in many health contexts. Much research has already been conducted on ethical and social challenges associated with these technologies. Likewise, there are already some studies that investigate empirically which values and attitudes play a role in connection with their design and implementation. What is still in its infancy, however, is the comparative investigation of the perspectives of different stakeholders. Methods To explore this issue in a multi-faceted manner, we conducted (...) semi-structured interviews as well as focus group discussions with patients and clinicians. These empirical methods were used to gather interviewee’s views on the opportunities and challenges of medical AI and other data-intensive applications. Results Different clinician and patient groups are exposed to medical AI to differing degrees. Interviewees expect and demand that the purposes of data processing accord with patient preferences, and that data are put to effective use to generate social value. One central result is the shared tendency of clinicians and patients to maintain individualistic ascriptions of responsibility for clinical outcomes. Conclusions Medical AI and the proliferation of data with import for health-related inferences shape and partially reconfigure stakeholder expectations of how these technologies relate to the decision-making of human agents. Intuitions about individual responsibility for clinical outcomes could eventually be disrupted by the increasing sophistication of data-intensive and AI-driven clinical tools. Besides individual responsibility, systemic governance will be key to promote alignment with stakeholder expectations in AI-driven and data-intensive health settings. (shrink)

Digital data help data scientists and epidemiologists track and predict outbreaks of disease. Mobile phone GPS data, social media data, or other forms of information updates such as the progress of epidemics are used by epidemiologists to recognize disease spread among specific groups of people. Targeting groups as potential carriers of a disease, rather than addressing individuals as patients, risks causing harm to groups. While there are rules and obligations at the level of the individual, we have to reach a (...) stage in the development of data analytics where groups are protected as entities. This chapter offers a deeper examination of harms to the groups. (shrink)

In April 2020, close to the start of the first U.K. COVID-19 lockdown, the U.K. government announced the development of a COVID-19 contact tracing app, which was later trialled on the U.K. island, the Isle of Wight, in May/June 2020. United Kingdom surveys found general support for the development of such an app, which seemed strongly influenced by public trust. Institutions developing the app were called upon to fulfil the commitment to public trust by acting with trustworthiness. Such calls presuppose (...) that public trust associated with the app can emerge if the conditions for trustworthiness are met and that public trust is simplistic, i.e., linearly the sum of each member of the publics’ individual – U.K. government trust relationship. Drawing on a synthesis of the trust literature and fifteen interviews with members of the public trialling the app on the Isle of Wight, this paper aims to explore what trust mechanisms and relationships are at play when thinking about public trust in the context of the U.K. COVID-19 app. We argue that public trust is a complex social phenomenon and not linearly correlated with institutional trustworthiness. As such, attention needs to widen from calls for trustworthy infrastructures as a way to build public trust, to a deeper understanding of those doing the trusting; in particular, what or whom do people place their trust in when considering whether using the app and why. An understanding of this will help when trying to secure public trust during the implementation of necessary public health measures. (shrink)

While the technologies that enable Artificial Intelligence (AI) continue to advance rapidly, there are increasing promises regarding AI’s beneficial outputs and concerns about the challenges of human–computer interaction in healthcare. To address these concerns, institutions have increasingly resorted to publishing AI guidelines for healthcare, aiming to align AI with ethical practices. However, guidelines as a form of written language can be analyzed to recognize the reciprocal links between its textual communication and underlying societal ideas. From this perspective, we conducted a (...) discourse analysis to understand how these guidelines construct, articulate, and frame ethics for AI in healthcare. We included eight guidelines and identified three prevalent and interwoven discourses: (1) AI is unavoidable and desirable; (2) AI needs to be guided with (some forms of) principles (3) trust in AI is instrumental and primary. These discourses signal an over-spillage of technical ideals to AI ethics, such as over-optimism and resulting hyper-criticism. This research provides insights into the underlying ideas present in AI guidelines and how guidelines influence the practice and alignment of AI with ethical, legal, and societal values expected to shape AI in healthcare. (shrink)

The scale and asymmetry of commercial technology firms’ power over people through data, combined with the increasing involvement of the private sector in public governance, means that increasingly, people do not have the ability to opt out of engaging with technology firms. At the same time, those firms are increasingly intervening on the population level in ways that have implications for social and political life. This creates the potential for power relations of domination, and demands that we decide what constitutes (...) the legitimacy to act on the public. Business ethics and private law are not designed to answer these questions, which are primarily political. If people have lost the right to disengage with commercial technologies, we may need to hold the companies that offer them to the same standards to which we hold the public sector. This paper first defines the problem and demonstrates that it is significant and widespread, and then argues for the development of an overarching normative framework for what constitutes non-domination with regard to digital technologies. Such a framework must involve a nuanced idea of political power and accountability that can respond not only to the legality of corporate behaviour, but to its legitimacy. (shrink)

The emergence of a global industry of digital health platforms operated by Big Tech corporations, and its growing entanglements with academic and pharmaceutical research networks, raise pressing questions on the capacity of current data governance models, regulatory and legal frameworks to safeguard the sustainability of the health research ecosystem. In this article, we direct our attention toward the challenges faced by the European General Data Protection Regulation in regulating the potentially disruptive engagement of Big Tech platforms in health research. The (...) General Data Protection Regulation upholds a rather flexible regime for scientific research through a number of derogations to otherwise stricter data protection requirements, while providing a very broad interpretation of the notion of “scientific research”. Precisely the breadth of these exemptions combined with the ample scope of this notion could provide unintended leeway to the health data processing activities of Big Tech platforms, which have not been immune from carrying out privacy-infringing and socially disruptive practices in the health domain. We thus discuss further finer-grained demarcations to be traced within the broadly construed notion of scientific research, geared to implementing use-based data governance frameworks that distinguish health research activities that should benefit from a facilitated data protection regime from those that should not. We conclude that a “re-purposing” of big data governance approaches in health research is needed if European nations are to promote research activities within a framework of high safeguards for both individual citizens and society. (shrink)