Abstract
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.
Highlights
The COVID-19 pandemic presents unprecedented challenges to public health decision-making
contact tracing (CT) technology is presented as one tool to move beyond blanket lockdowns, contributing to the prevention of both the damage associated with COVID-19 directly and the consequences of responses to it (Parker 2020)
In determining the desirability of CT technology we are confronted by difficult trade-offs and feedback loops, the assessment of which is hindered by the overall epistemic uncertainty
Summary
There are no easy answers to the question of the proportionality of CT technology or any of the other possible surveillance interventions. The infrastructure that is created in battling the pandemic enables governments, or private companies, to exercise an inordinate amount of control over individual citizens For these reasons, a centralized approach needs a stronger justification in terms of a substantial increase of effectiveness, the evidence of which will be very difficult to establish. Any attempt to encourage or mandate CT apps is likely to worsen the situation, by creating backlash effects that cause CT technology to lose support of large parts of the population (Munthe and Nijsingh 2019) It is precisely because of the potential benefit of being able to trace the spread of the virus more and pervasively than with the labour intensive method of contacting people personally that we may expect the chances of these kinds of effects to rise. The problem is, we do not know the relative weight and probability of the different factors in play
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