Applying a Precautionary Approach to Mobile Contact Tracing for COVID-19: The Value of Reversibility
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SYMPOSIUM: COVID-19
Applying a Precautionary Approach to Mobile Contact Tracing for COVID-19: The Value of Reversibility Niels Nijsingh
&
Anne van Bergen & Verina Wild
Received: 10 May 2020 / Accepted: 27 July 2020 # The Author(s) 2020
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 tradeoffs 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 COVID19 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. Keywords Public health ethics . Risk, Precautionary principle, Pandemic . mHealth . Uncertainty . Infectious disease N. Nijsingh (*) : A. van Bergen : V. Wild Institute for Ethics, History and Theory of Medicine, Ludwig Maximilians Universität, Lessingstrasse 2, 80336 München, Germany e-mail: [email protected]
It has been suggested that it could be morally justified, or even morally obligatory, to implement contact tracing technology (CT technology) in the response to the current COVID-19 pandemic (Parker et al. 2020). There are different ways of implementing CT technology, but they all aim to retrospectively trace and alert contacts of confirmed infected persons (Rimpiläinen, Thomas, and Morrison 2020). Like any other form of surveillance, CT technology raises privacy issues. However, given the enormous risks and burdens associated with either ongoing population lockdowns, or letting the virus spread freely, some infringement of privacy may be considered proportional (Schaefer and Ballantyne 2020). This raises the question of what an acceptable trade-off would be. What is a reasonable price to pay to help mitigate some of the worst effects of the global crisis? Epistemic Uncertainties There are no easy answers to the question of the proportionality of CT technology or any of the other possible surveillance interventions. Attempts to deal with the various threats posed by the pandemic are hindered by epistemic uncertainties on different levels (Aven and Bouder 2020). The social, economic, and health risks associated with the pandemic are largely unknown and are systemically interrelated: in many cases addressing on
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