Digital contact tracing and exposure notification: ethical guidance for trustworthy pandemic management.

There is growing interest in contact tracing apps (CT apps) for pandemic management. It is crucial to consider ethical requirements before, while, and after implementing such apps. In this paper, we illustrate the complexity and multiplicity of the ethical considerations by presenting an ethical framework for a responsible design and implementation of CT apps. Using this framework as a starting point, we briefly highlight the interconnection of social and political contexts, available measures of pandemic management, and a multi-layer assessment of CT apps. We will discuss some trade-offs that arise from this perspective. We then suggest that public trust is of major importance for population uptake of contact tracing apps. Hasty, ill-prepared or badly communicated implementations of CT apps will likely undermine public trust, and as such, risk impeding general effectiveness.

Applying a Precautionary Approach to Mobile Contact Tracing for COVID-19: The Value of Reversibility.

The COVID-19 pandemic presents unprecedented challenges to public health decision-making. Specifically, the lack of evidence and the urgency with which a response is called for, raise the ethical challenge of assessing how much (and what kind of) evidence is required for the justification of interventions in response to the various threats we face. Here we discuss the intervention of introducing technology that aims to trace and alert contacts of infected persons-contact tracing (CT) technology. Determining whether such an intervention is proportional is complicated by complex trade-offs and feedback loops. We suggest that the resulting uncertainties necessitate a precautionary approach. On the one hand, precautionary reasons support CT technology as a means to contribute to the prevention of harms caused by alternative interventions, or COVID-19 itself. On the other hand, however, both the extent to which such technology itself present risks of serious harm, as well as its effectiveness, remain unclear. We therefore argue that a precautionary approach should put reversibility of CT technology at the forefront. We outline several practical implications.

Epistemic architecture: steering the public perception of the messy problem of antibiotic resistance.

In this perspective, we discuss non-experts' beliefs about the complex and 'messy' problem of antibiotic resistance (ABR). First, we explain what we mean by complex and messy problems and why ABR fits that description. We then suggest that the attitudes of non-experts are particularly relevant to these problems. This gives rise to social epistemic risks; risks that involve the collective and social aspects of the formation of epistemic attitudes. Steering these epistemic attitudes as a way of handling these risks can take the form of creating what we call 'epistemic architecture'. That is, a planned design of the structure within which the formation of epistemic attitudes takes place. This entails risks of its own, which leads us to conclude that there is an important responsibility for experts to take these social epistemic risks into account when communicating on messy problems, such as ABR.