The ethics of wastewater surveillance for public health

ABSTRACT

The COVID-19 pandemic has fuelled interest in the use of wastewater analysis for public health surveillance. Hydrologists, engineers, environmental scientists, microbiologists, public health experts and those in other disciplines have been tasked with the implementation of national-scale surveillance and the resultant data have been used for decision making at the highest levels of government. The widespread surveillance of communities is not without its concerns, however. This paper explores the ethics of surveillance drawing on the literature and our experiences with wastewater analysis. Consent is not typically required for wastewater surveillance, which can exacerbate perceptions of risk and undermine public trust. Seemingly innocuous communication of surveillance data can stigmatise communities and perpetuate inequities. There are tensions between the desire for the rapid delivery of information and the time needed to build confidence in surveillance data. There are also limitations and uncertainties in the science of wastewater surveillance, and these add to the pressures of communication for and with decision makers. Media representations can be problematic and perpetuate social stigma. On a positive note, the transdisciplinary nature of wastewater surveillance presents an opportunity to work across and beyond traditional disciplinary boundaries to address the ethics of surveillance, which, we expect, will be especially important as wastewater surveillance becomes further mainstreamed, particularly under the auspices of surveillance capitalism.