Abstract
Since 2016, social media companies and news providers have come under pressure to tackle the spread of political mis- and disinformation (MDI) online. However, despite evidence that online health MDI (on the web, on social media, and within mobile apps) also has negative real-world effects, there has been a lack of comparable action by either online service providers or state-sponsored public health bodies. We argue that this is problematic and seek to answer three questions: why has so little been done to control the flow of, and exposure to, health MDI online; how might more robust action be justified; and what specific, newly justified actions are needed to curb the flow of, and exposure to, online health MDI? In answering these questions, we show that four ethical concerns—related to paternalism, autonomy, freedom of speech, and pluralism—are partly responsible for the lack of intervention. We then suggest that these concerns can be overcome by relying on four arguments: (1) education is necessary but insufficient to curb the circulation of health MDI, (2) there is precedent for state control of internet content in other domains, (3) network dynamics adversely affect the spread of accurate health information, and (4) justice is best served by protecting those susceptible to inaccurate health information. These arguments provide a strong case for classifying the quality of the infosphere as a social determinant of health, thus making its protection a public health responsibility. In addition, they offer a strong justification for working to overcome the ethical concerns associated with state-led intervention in the infosphere to protect public health.
Highlights
The internet’s capacity to generate and spread misinformation had already been identified and described 24 years ago [1]
Autonomous agents can accept moral constraints out of respect for others’ freedom, autonomy and dignity, and fairness and equal opportunity for all members of society [37]. These four arguments—(1) that education is necessary but insufficient, (2) that there is precedent for acceptable state-led control of the internet content in other domains, (3) that network dynamics adversely affect the spread of accurate health information, and (4) that justice is best served by protecting those susceptible to online health-related misinformation and disinformation (OHMDI)—justify working to overcome the ethical concerns associated with state-led intervention in the infosphere in the name of public health
The current COVID-19 pandemic has sparked some specific action: Apple is rejecting all coronavirus-related apps that are not from governments or official health organizations; Google Play is blocking all searches for coronavirus; the UK government has set up a Rapid Response Unit to directly respond to false coronavirus narratives by, for example, issuing a rebuttal on social media or asking platforms to remove harmful content [84,85]; and, still in the United Kingdom, the Culture Secretary, Oliver Dowden, asked platforms to be more aggressive in contrasting conspiracy theories linking the coronavirus pandemic to 5G networks
Summary
The internet’s capacity to generate and spread misinformation had already been identified and described 24 years ago [1]. Autonomous agents can accept moral constraints (provided they are transparent [29]) out of respect for others’ freedom, autonomy and dignity, and fairness and equal opportunity for all members of society [37] Taken together, these four arguments—(1) that education is necessary but insufficient, (2) that there is precedent for acceptable state-led control of the internet content in other domains, (3) that network dynamics adversely affect the spread of accurate health information, and (4) that justice is best served by protecting those susceptible to OHMDI—justify working to overcome the ethical concerns associated with state-led intervention in the infosphere in the name of public health. We can conclude that is it possible to overcome the ethical concerns regarding individual autonomy vs group-level protection to justify government-led control of online health information, and doing so definitely is within the remit of public health bodies. Evaluating the reach and influence of high-risk health MDI (protective monitoring)
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