Ethics, public health and technology responses to COVID-19.

The COVID-19 pandemic has infected millions around the world. Governments initially responded by requiring businesses to close and citizens to self-isolate, as well as funding vaccine research and implementing a range of technologies to monitor and limit the spread of the disease. This article considers the use of smartphone metadata and Bluetooth applications for public health surveillance purposes in relation to COVID-19. It undertakes ethical analysis of these measures, particularly in relation to collective moral responsibility, considering whether citizens ought, or should be compelled, to comply with government measures.

Digital Professionalism in Patient Care: A Case-Based Survey of Surgery Faculty and Trainees.

BACKGROUND: Use of digital devices have become ubiquitous in healthcare and can create professionalism issues. This study presents opinions of faculty, residents, and medical students to inform policy on the appropriate use of digital devices in the patient care setting. MATERIALS AND METHODS: A survey was administered from September 2018 to October 2018 to faculty and residents within the general surgery department at a large academic medical center and all fourth-year medical students at an affiliated university. The survey included direct statements and case-based scenarios on similar themes to triangulate responses. RESULTS: There were 114 participants in the survey-50 faculty, 26 residents, and 38 medical students. Digital device utilization was equivalent among all groups, and all participants use a smartphone. Digital devices were most frequently used during rounds and clinical conferences. Overall, digital device use was found more appropriate when seen in the case-based format rather than as a direct statement. Furthermore, use of these devices was seen as most appropriate when the provider explained its use or left the room to use the device. CONCLUSIONS: Digital devices are used by faculty and trainees at similar rates for parallel purposes, and the benefits for patient-related care are evident. However, the use of digital devices in the presence of patients should be minimized and always preceded by an explanation. These findings can inform institutional policy when creating guidelines on the professional use of these devices in the patient care setting.

A survey on the attitudes of parents with young children on in-home monitoring technologies and study designs for infant research.

Remote in-home infant monitoring technologies hold great promise for increasing the scalability and safety of infant research (including in regard to the current Covid-19 pandemic), but remain rarely employed. These technologies hold a number of fundamental challenges and ethical concerns that need addressing to aid the success of this fast-growing field. In particular, the responsible development of such technologies requires caregiver input. We conducted a survey of the opinions of 410 caregivers on the viability, privacy and data access of remote in-home monitoring technologies and study designs. Infant-friendly wearable devices (such as sensing body suits) were viewed favourably. Caregivers were marginally more likely to accept video and audio recording in the home if data was anonymised (through automated processing) at point of collection, particularly when observations were lengthy. Caregivers were more open to international data sharing for anonymous data. Caregivers were interested in viewing all types of data, but were particularly keen to access video and audio recordings for censoring purposes (i.e., to delete data segments). Taken together, our results indicate generally positive attitudes to remote in-home monitoring technologies and studies for infant research but highlight specific considerations such as safety, privacy and family practicalities (e.g. multiple caregivers, visitors and varying schedules) that must be taken into account when developing future studies.

Use of Photography in Dermatology: Ethical and Legal Implications. / Implicaciones bioéticas y médico-legales del uso de la fotografía en dermatología.

Photographs are necessary in the clinical practice of dermatology, but there are ethical implications to consider. Moreover, dermatologists must be aware of and comply with certain legal requirements affecting the use of photographs. The main ethical principles are respect for patient autonomy and the physician's obligation to do no harm. The law differentiates between 2 bases for protection: one concerns the photographed person's rights over the image and the other protects personal data. Recent legislation places restrictions on taking photographs and exhibiting them. Photographs taken to be stored with a medical history have not been called into question, but the physician is recommended to inform the patient that they exist. When a photograph is exhibited for the purpose of teaching or illustrating concepts, it is necessary to determine whether or not the patient can be identified. If the answer is yes, the patient must give explicit permission. Caution should be exercised when publishing medical photographs on social media.

Digital Contact Tracing, Privacy, and Public Health.

Digital contact tracing, in combination with widespread testing, has been a focal point for many plans to "reopen" economies while containing the spread of Covid-19. Most digital contact tracing projects in the United States and Europe have prioritized privacy protections in the form of local storage of data on smartphones and the deidentification of information. However, in the prioritization of privacy in this narrow form, there is not sufficient attention given to weighing ethical trade-offs within the context of a public health pandemic or to the need to evaluate safety and effectiveness of software-based technology applied to public health.

Using Smartphones to Collect Behavioral Data in Psychological Science: Opportunities, Practical Considerations, and Challenges.

Smartphones now offer the promise of collecting behavioral data unobtrusively, in situ, as it unfolds in the course of daily life. Data can be collected from the onboard sensors and other phone logs embedded in today's off-the-shelf smartphone devices. These data permit fine-grained, continuous collection of people's social interactions (e.g., speaking rates in conversation, size of social groups, calls, and text messages), daily activities (e.g., physical activity and sleep), and mobility patterns (e.g., frequency and duration of time spent at various locations). In this article, we have drawn on the lessons from the first wave of smartphone-sensing research to highlight areas of opportunity for psychological research, present practical considerations for designing smartphone studies, and discuss the ongoing methodological and ethical challenges associated with research in this domain. It is our hope that these practical guidelines will facilitate the use of smartphones as a behavioral observation tool in psychological science.

Realising the technological promise of smartphones in addiction research and treatment: An ethical review.

BACKGROUND: Smartphone technologies and mHealth applications (or apps) promise unprecedented scope for data collection, treatment intervention, and relapse prevention when used in the field of substance abuse and addiction. This potential also raises new ethical challenges that researchers, clinicians, and software developers must address. AIMS: This paper aims to identify ethical issues in the current uses of smartphones in addiction research and treatment. METHODS: A search of three databases (PubMed, Web of Science and PsycInfo) identified 33 studies involving smartphones or mHealth applications for use in the research and treatment of substance abuse and addiction. A content analysis was conducted to identify how smartphones are being used in these fields and to highlight the ethical issues raised by these studies. RESULTS: Smartphones are being used to collect large amounts of sensitive information, including personal information, geo-location, physiological activity, self-reports of mood and cravings, and the consumption of illicit drugs, alcohol and nicotine. Given that detailed information is being collected about potentially illegal behaviour, we identified the following ethical considerations: protecting user privacy, maximising equity in access, ensuring informed consent, providing participants with adequate clinical resources, communicating clinically relevant results to individuals, and the urgent need to demonstrate evidence of safety and efficacy of the technologies. CONCLUSIONS: mHealth technology offers the possibility to collect large amounts of valuable personal information that may enhance research and treatment of substance abuse and addiction. To realise this potential researchers, clinicians and app-developers must address these ethical concerns to maximise the benefits and minimise risks of harm to users.