Usher Institute/Edinburgh Global Health Academy, The University of Edinburgh, Edinburgh, UK.
J Glob Health. 2020 Dec;10(2):020103. doi: 10.7189/jogh.10.020103.
The COVID-19 pandemic has put health systems, economies and societies under unprecedented strain, calling for innovative approaches. Scotland's government, like those elsewhere, is facing difficult decisions about how to deploy digital technologies and data to help contain, control and manage the disease, while also respecting citizens' rights. This paper explores the ethical challenges presented by these methods, with particular emphasis on mobile apps associated with contact tracing. Drawing on UK and international experiences, it examines issues such as public trust, data privacy and technology design; how changing disease threats and contextual factors can affect the balance between public benefits and risks; and the importance of transparency, accountability and stakeholder participation for the trustworthiness and good-governance of digital systems and strategies. Analysis of recent technology debates, controversial programmes and emerging outcomes in comparable countries implementing contact tracing apps, reveals sociotechnical complexities and unexpected paradoxes that warrant further study and underlines the need for holistic, inclusive and adaptive strategies. The paper also considers the potential role of these apps as Scotland transitions to the 'new normal', outlines challenges and opportunities for public engagement, and poses a set of ethical questions to inform decision-making at multiple levels, from software design to institutional governance.
新冠疫情给卫生系统、经济和社会带来了前所未有的压力,需要创新的应对方法。苏格兰政府与其他地区的政府一样,正面临着艰难的决策,即如何部署数字技术和数据,以帮助控制、管理疾病,同时尊重公民的权利。本文探讨了这些方法带来的伦理挑战,特别强调了与接触者追踪相关的移动应用程序。本文借鉴了英国和国际经验,研究了公众信任、数据隐私和技术设计等问题;疾病威胁和背景因素的变化如何影响公共利益和风险之间的平衡;以及透明度、问责制和利益相关者参与对于数字系统和策略的可信度和良好治理的重要性。对最近的技术辩论、有争议的项目和类似国家实施接触者追踪应用程序的新兴结果的分析揭示了社会技术的复杂性和意想不到的悖论,这需要进一步研究,并强调了需要采取整体、包容和适应的策略。本文还考虑了这些应用程序在苏格兰向“新常态”过渡时的潜在作用,概述了公众参与的挑战和机遇,并提出了一系列伦理问题,以便在从软件设计到机构治理的多个层面上为决策提供信息。