'Staying in the lane' of public health? Boundary-work in the roles of state health officials and experts in COVID-19 policymaking.

The state-level COVID-19 response in the United States necessitated collaboration between governor' offices, health departments and numerous other departments and outside experts. To gain insight into how health officials and experts contributed to advising on COVID-19 policies, we conducted semi-structured interviews with 25 individuals with a health specialisation who were involved in COVID-19 policymaking, taking place between February and December 2022. We found two diverging understandings of the role of health officials and experts in COVID-19 policymaking: the role of 'staying in the lane' of public health in terms of the information that they collected, their advocacy for policies and their area of expertise and the role of engaging in the balancing of multiple considerations, such as public health, feasibility and competing objectives (such as the economy) in the crafting of pandemic policy. We draw on the concept of boundary-work to examine how these roles were constructed. We conclude by considering the appropriateness as well as the ethical implications of these two approaches to public health policymaking.

Designing robots that do no harm: understanding the challenges of Ethics for Robots.

This article describes key challenges in creating an ethics "for" robots. Robot ethics is not only a matter of the effects caused by robotic systems or the uses to which they may be put, but also the ethical rules and principles that these systems ought to follow-what we call "Ethics for Robots." We suggest that the Principle of Nonmaleficence, or "do no harm," is one of the basic elements of an ethics for robots-especially robots that will be used in a healthcare setting. We argue, however, that the implementation of even this basic principle will raise significant challenges for robot designers. In addition to technical challenges, such as ensuring that robots are able to detect salient harms and dangers in the environment, designers will need to determine an appropriate sphere of responsibility for robots and to specify which of various types of harms must be avoided or prevented. These challenges are amplified by the fact that the robots we are currently able to design possess a form of semi-autonomy that differs from other more familiar semi-autonomous agents such as animals or young children. In short, robot designers must identify and overcome the key challenges of an ethics for robots before they may ethically utilize robots in practice.

The ethics of COVID-19 vaccine mandates for healthcare workers: Public health and clinical perspectives.

COVID-19 vaccine uptake among healthcare workers (HCWs) remains of significant public health concern due to the ongoing COVID-19 pandemic. As a result, many healthcare institutions are considering or have implemented COVID-19 vaccine mandates for HCWs. We assess defenses of COVID-19 vaccine mandates for HCWs from both public health and professional ethics perspectives. We consider public health values, professional obligations of HCWs, and the institutional failures in healthcare throughout the COVID-19 pandemic which have impacted the lived experiences of HCWs. We argue that, despite the compelling urgency of maximizing COVID-19 vaccine uptake among HCWs, the ethical case for COVID-19 vaccine mandates for HCWs in the United States is complex, and, under current circumstances, inconclusive. Nevertheless, we recognize that COVID-19 vaccine mandates for HCWs have already been and will continue to be implemented across many healthcare institutions. Given such context, we provide suggestions for implementing COVID-19 vaccine mandates for HCWs.

Causation and Injustice: Locating the injustice of racial and ethnic health disparities.

The COVID-19 pandemic has had a disproportionate impact on the health of Black Americans, Latinx or Hispanic Americans, and American Indians. These disparities are deeply unjust, in part, because they are the causal result of racism at both the interpersonal and structural levels. This paper argues, however, that establishing a causal connection between racism and health disparities is not the only way to explain the injustice of these disparities. The COVID-19 health disparities are arguably unjust because health equity is a "free-standing" demand of justice, an obligation of reparative justice, a remedy to structural injustice, and part of dismantling pernicious racial concepts. Identifying multiple accounts of injustice may lower the evidentiary bar for our normative claims and help us to identify alternative policy pathways for ending health inequity.

Assessing the Governance of Digital Contact Tracing in Response to COVID-19: Results of a Multi-National Study.

This paper describes the results of a multi-country survey of governance approaches for the use of digital contact tracing (DCT) in response to the COVID-19 pandemic. We argue that the countries in our survey represent two distinct models of DCT governance, both of which are flawed. The "data protection model" emphasizes privacy protections at the expense of public health benefit, while the "emergency response model" sacrifices transparency and accountability, prompting concerns about excessive governance surveillance. The ethical and effective use of DCT in the future requires a new governance approach that is better suited to this novel use of mobile phone data to promote public health."

Governing the Access to COVID-19 Tools Accelerator: towards greater participation, transparency, and accountability.

The Access to COVID-19 Tools Accelerator (ACT-A) is a multistakeholder initiative quickly constructed in the early months of the COVID-19 pandemic to respond to a catastrophic breakdown in global cooperation. ACT-A is now the largest international effort to achieve equitable access to COVID-19 health technologies, and its governance is a matter of broad public importance. We traced the evolution of ACT-A's governance through publicly available documents and analysed it against three principles embedded in the founding mission statement of ACT-A: participation, transparency, and accountability. We found three challenges to realising these principles. First, the roles of the various organisations in ACT-A decision making are unclear, obscuring who might be accountable to whom and for what. Second, the absence of a clearly defined decision making body; ACT-A instead has multiple centres of legally binding decision making and uneven arrangements for information transparency, inhibiting meaningful participation. Third, the nearly indiscernible role of governments in ACT-A, raising key questions about political legitimacy and channels for public accountability. With global public health and billions in public funding at stake, short-term improvements to governance arrangements can and should now be made. Efforts to strengthen pandemic preparedness for the future require attention to ethical, legitimate arrangements for governance.

Artificial Intelligence in Service of Human Needs: Pragmatic First Steps Toward an Ethics for Semi-Autonomous Agents.

The ethics of robots and artificial intelligence (AI) typically centers on "giving ethics" to as-yet imaginary AI with human-levels of autonomy in order to protect us from their potentially destructive power. It is often assumed that to do that, we should program AI with the true moral theory (whatever that might be), much as we teach morality to our children. This paper argues that the focus on AI with human-level autonomy is misguided. The robots and AI that we have now and in the near future are "semi-autonomous" in that their ability to make choices and to act is limited across a number of dimensions. Further, it may be morally problematic to create AI with human-level autonomy, even if it becomes possible. As such, any useful approach to AI ethics should begin with a theory of giving ethics to semi-autonomous agents (SAAs). In this paper, we work toward such a theory by evaluating our obligations to and for "natural" SAAs, including nonhuman animals and humans with developing and diminished capacities. Drawing on research in neuroscience, bioethics, and philosophy, we identify the ways in which AI semi-autonomy differs from semi-autonomy in humans and nonhuman animals. We conclude on the basis of these comparisons that when giving ethics to SAAs, we should focus on principles and restrictions that protect human interests, but that we can only permissibly maintain this approach so long as we do not aim at developing technology with human-level autonomy.