The ethics and value of contact tracing apps: International insights and implications for Scotland's COVID-19 response.

The COVID-19 pandemic has put health systems, economies and societies under unprecedented strain, calling for innovative approaches. Scotland's government, like those elsewhere, is facing difficult decisions about how to deploy digital technologies and data to help contain, control and manage the disease, while also respecting citizens' rights. This paper explores the ethical challenges presented by these methods, with particular emphasis on mobile apps associated with contact tracing. Drawing on UK and international experiences, it examines issues such as public trust, data privacy and technology design; how changing disease threats and contextual factors can affect the balance between public benefits and risks; and the importance of transparency, accountability and stakeholder participation for the trustworthiness and good-governance of digital systems and strategies. Analysis of recent technology debates, controversial programmes and emerging outcomes in comparable countries implementing contact tracing apps, reveals sociotechnical complexities and unexpected paradoxes that warrant further study and underlines the need for holistic, inclusive and adaptive strategies. The paper also considers the potential role of these apps as Scotland transitions to the 'new normal', outlines challenges and opportunities for public engagement, and poses a set of ethical questions to inform decision-making at multiple levels, from software design to institutional governance.

Notification of transfusion transmitted infection.

The National Blood Policy of India, 2002, advocates the disclosure of results of transfusion transmitted infections (TTI) to blood donors. However, in the absence of well-defined notification processes, and in order to avoid serious consequences resulting from unguided disclosure, blood bank personnel discard blood that is TTI-positive. We report on a survey of 105 voluntary blood donors in Kerala. Only two out of three participants had filled the donor form in the last year. Only half were aware that the blood bank was supposed to inform them if they tested positive for TTI. Fifty-seven per cent of donors wanted to be informed every time they donated blood, irrespective of a positive or negative result.

HIV-infected individuals as partners in prevention: a redefinition of the partner notification process.

Over the past ten years, the advances that have turned HIV into a chronic illness have also highlighted the importance of integrating prevention and care in the fight against the epidemic. This integration involves not only the creation of new programs, but also a reexamination of the process through which services and supports are provided. In this article, HIV partner notification is used as a case example; the discussion includes: the shifting time frame within which partner notification occurs; the expanding role of HIV-positive individuals in effecting both disease management and prevention goals; the connection between partner-notification and behaviorally-based risk reduction; and the ethical implications of advances on the partner notification process. The authors argue that partner notification services must be located in the context of overall treatment for infected individuals, and demonstrate how a redefinition of the partner notification process can serve as a spring-board for ongoing prevention counseling and support.