Ethical Concerns in

COVID-19-related Applications

Report By,
Zesrab Tanjeel Khan (0112230941)
Md Fazley Rabbi (0112230944)
Mehrab Sadekin Borno (0112230763)
Wasiur Rahman Sakib (0112230747)
Sadia Sharin Jannat (0112230892)
Md. Rakibul Islam Rafat (011173023)
 1. Objective:

The aim of writing this article is to talk about and assess several ethical problems and
considerations that are associated with creating or using apps in relation to COVID-19 like
tracking applications for contacts, health monitoring systems as well as platforms for data
collection. Obviously, what we try to achieve in this report is to weigh up public health benefits
against potential risks of these applications which include but not limited to invasion into
personal privacy; security breaches on data; discrimination among different groups within
society. The study thus stipulates some principles wherefore it suggests should be followed
during the process of designing and implementing such programs from an ethical perspective.

2. Problems:

The effectiveness of all technological solutions, including COVID-19 apps, also depends on
implementation’ settings. COVID-19 apps can be useful if viral tests are widely available to
corroborate the alerts, 17 if quarantine is achievable, and patient care is available. Indeed, there
are several reasons to be wary of COVID-19 apps: there is a risk that they will circulate false
information that would pose risks to individuals. Healthcare providers are unlikely to be able to
endorse any particular app for COVID-19 education and self-monitoring. This would mean that
COVID-19 apps would be unaffected in camps for refugees, crowded workers’ dormitories or
impoverished villages.

2.1. Primary Obstacles for COVID-19 Applications:

• Effectiveness: In order for COVID-19 apps to be effective, majority of the general public
should be using it appropriately (60 percent)."
• Technical Issues: The problem of false-positive results is a major concern.
• Privacy: There’s a risk that population surveillance on an unprecedented scale could be
used for purposes beyond pandemic control.
• Inequities: The economic consequences of using COVID-19 apps are likely to be
unevenly distributed across the population.
2.1.1. Effectiveness: If technology is unsuccessful, it might be a major problem to invest time
and money in it. The utilization of COVID-19 apps determines their success. For these
applications to be effective, it is expected that at least 60% of the population must utilize them. It
is extremely unlikely to achieve such high consumption rates, though. The efficacy of the system
depends on how soon people respond, even with adequate uptake. Effective containment of the
outbreak will be hampered by COVID-19 apps if users fail to respond to alarms in a timely
manner.
2.1.2. Technical issues: Some COVID-19 applications do not work on devices that are more
than two years old. It cannot be overemphasized that the problem with false alarms is way broad.
A good number of false positive outcomes emerge during Bluetooth proximity testing because
the latter may exaggerate the number of encounters. With regard to such fake positives, in case
the users doubt them, they might fail in responding to warnings issued or alternatively start
isolating themselves unknowingly.
2.1.3. Privacy: Since apps might be hacked due to a combination of privacy and technical issues,
security vulnerabilities appear. There is a tendency for big data storage systems that tend to be
hacked leading to grave inconsistencies, for instance the kind of public surveillance that has
never been witnessed before, therefore it is not advisable for scientists to develop them.
Consequently, there has always been a possibility of utilization of this facility by governments in
order to keep traces of their citizens’ lives that could help them when they require evidence from
them. On the other hand this data can be used for purposes of keeping track on the citizens.
2.1.4. Inequities: Access to COVID-19 apps leads to prejudice, as one might predict. For
example, this technology is not available to the elderly, who might not even have access to cell
phones. Consequently, applications may make the digital gap worse. Furthermore, there's a good
chance that the advantages and disadvantages of utilizing applications will not be fairly split
across users. A marginally larger risk applies to disadvantaged workers, who are less likely to
work from home. Their contacts are frequently in similar circumstances. Many of these people
will be segregated if app warnings force the imposition of a restricted quarantine. As a result,
these workers are not only economically disadvantaged but also more prone to suffer from the
social, economical, and psychological repercussions of isolation.

3. Case Studies:
3.1. Employer Surveillance and Remote Work
To cope with the new normal of remote work; since the onset of COVID-19 pandemic, most
employers depend more on surveillance technologies while assessing staff effectiveness and
compliance to firm regulations. This poses concerns regarding intrusion into personal life among
other things like probable misapplication by bosses of confidential information they might have
gathered from such channels. Consequently, under such circumstances, workers may opt to
surrender their private lives as they strive for protection of their positions, hence, leading to
questions of ethical standards.
 3.1.1.Concerns:

Harm should be avoided (ACM 1.3, IEEE 1,4)

It notes that the obligation to avert risk also involves observing privacy rights of people. “One’s
decisions are to be guided by the greater good of humanity concerning its safety, health as well
as general well-being; besides this, anything which is likely to place either the society or the
ecosystem at risk has to be disclosed immediately”. When privacy is breached it may lead to
harm on one’s own life; hence this undermines this principle.

Potential misuse of data(ACM 1.1, 1.3, IEEE 3,4,5)

One of the primary principles, is being honest and trustworthy. It is not trustworthy to use
surveillance technologies that collect data for anything other than productivity monitoring
purposes due to losing trust on the side of employees in the organization. Another principle is to
avoid injury to others or property damage , defamation , or ruining someone’s career through lies
or deliberate harm.

Employee Pressure(ACM 1.1, 1.7, IEEE 1,4)

“Promoting human welfare and society.” The health and well-being of the employees are
damaged by the atmosphere of fear and mistrust generated by the constant surveillance. “To
make decisions consistent with public safety and the other interests of the people that affect
them.” This principle contradicts the pressure on employees’ mental health and job satisfaction.

3.1.2.Solutions:

Transparency and Consent(ACM 1.1, 1.3, 3.7, IEEE 2)

Regard this as we have to respect your privacy and uphold it. “Respect privacy.” This means that
Employers should be clear about the use of surveillance technologies to their employees, respect
their right to privacy and give them a chance to agree. “To accept responsibility in making
decisions consistent with the safety, health, and welfare of the public”, it can be said that
attaining transparency and getting permission from the staff is in line with safeguarding their
well-being and freedoms.

Reduced Data Collection(ACM 1.1, 1.3, IEEE 6)

"Be Honest and Trustworthy". To enhance genuity and credibility in the management of
employee information, organizations must collect only what is imperative for legitimate reasons.
To search for, accept and provide honest reviews about technical works, this concept is
consistent with the approach to privacy protection for employees through minimizing the data
collected thus reducing possible data abuse harm in-line with safe practices.

Empowerment of Workers(ACM 1.4, IEEE 8)

The empowerment of workers equally is ensured through giving them systems for the support
with which they may make complaints or resolve cases of invasion of privacy or other
grievances. This is a situation that is in agreement with ACM’s Principle 1.4 which states that
everybody should be fair and free from discrimination. As per Principle 8 of the IEEE Code of
Ethics, it says that “All persons shall be treated fairly without any discrimination of race,
religion, sex, disabilities, age or national origin, sexual orientation, gender identity and gender
expression”. The facilitation of employee empowerment mechanisms such as grievance
procedures and whistle-blower protection will promote objectivity and in return reduce cases of
discriminatory surveillance technology usage.

3.2. Telemonitoring:
One of the applications that became a subject of great use during the pandemic was
telemonitoring. This technology was implemented in the care of patients with COVID-19 as well
as other conditions such as diabetes, lung cancer, kidney transplants, and pregnancy1. While
telemonitoring has been considered an important way to alleviate pressures on hospitals, its
increased application has brought about ethical issues1.

3.2.1. Concerns:

Ethical Concerns with Ethical Codes

Shift in Responsibilities(IEEE Code: I.1, ACM Code: 1.3):

The responsibilities of patients, healthcare providers, and other parties have shifted due
to telemonitoring.

o Be honest and trustworthy.

o To hold paramount the safety, health, and welfare of the public.

Empowerment and Self-Management(IEEE Code: I.2, ACM Code: 1.1):

The degree in which telemonitoring promote empowerment and self-management of
patients is a concern.

o Contribute to society and to human well-being.

o To improve the understanding by individuals and society of the capabilities and
societal implications of conventional and emerging technologies.

Value of Face to Face Consultations(IEEE Code: II.7, ACM Code: 1.4):

The value of face to face consultations in the telemonitoring era is being questioned.

o Be fair and take action not to discriminate.

o To treat all persons fairly and with respect.

Inclusivity and Equal Access(ACM Code: 1.2, IEEE Code: I.1):

A fundamental concern is that we may be increasing health inequalities and making it

harder for people to obtain the healthcare they need..

o Avoid harm.
o To hold paramount the safety, health, and welfare of the public.

Privacy and Big Data(ACM Code: 1.6, IEEE Code: I.1):

A major ethical issue is the impact that telemonitoring could have on privacy and big
data ownership.
 o Respect privacy.
o To protect the privacy of others.

3.2.2. Solutions:

Proposed Solutions
Explicit Allocation of Responsibilities: Ensure explicit and realistic allocation of
responsibilities and avoid expectations that monitoring is more direct and continuous than
it actually is.
Be honest and trustworthy.
To hold paramount the safety, health, and welfare of the public.
Promote Optimal Self-Management: Create opportunities for an optimal form of self-
management, particularly for patients with chronic conditions, and for meaningful
conversations.
Contribute to society and to human well-being.
To improve the understanding by individuals and society of the capabilities and societal
implications of conventional and emerging technologies.
Integrate Telemonitoring within Trusting Relationships: Integrate telemonitoring within
an established healthcare provider-patient trust relation and stimulate research on the
conditions for face-to-face consultations.
Be fair and take action not to discriminate.
To treat all persons fairly and with respect.
Consider Vulnerability in Inclusion & Exclusion Criteria:Consider the advantage of
including vulnerability as part of the selection conditions and engaging patients in the
planning and execution phases.
Avoid harm.
To hold paramount the safety, health, and welfare of the public.
Address Data Collection Concerns: Address the concerns of data collection that are
beyond the privacy domain and identify risks of dependency on commercial companies.
Respect privacy.
To protect the privacy of others.
 3.3. Individuals’ Right to Privacy in a Contact Tracing App:

In reaction to the Covid pandemic, an agency of the government, set up an app which worked in
tracking and notifying people who might have possibly been exposed to the virus. The app was
being stressed as being a vital resource facilitating the preventing contagion of the COVID-19 and
protecting public health. However, seemingly, right after its creation privacy-related questions
concerned the public opinion about the app's data collection and monitoring operations.

3.3.1. Concerns:

Avoiding Harm (ACM 1.2, IEEE 1.2): Data collection and data warehousing the contact tracing
application without proper privacy barriers may go against private information of individuals of
app in case; if their sensitive information is compromised or misused. This goes against the rule
outlined in both ACM and IEEE codes of ethics termed as “do no harm”.
Respect for Privacy (ACM 1.6, IEEE 1.6): The opacity in the methods of data collection and
surveillance shows a lack of transparency and consent. That is against the Law of the land which
e-governance principle recognizes individuals' right to privacy. Beyond continuous, both codes
acknowledge the value for the private rights and empower individuals to determine the usage of
their personal information.
High Standards of Professional Conduct (ACM 2.2, IEEE 2.2): On the part of the app’s
designers and those in charge of deploying the contact tracing app, it is imperative that professional
standards be upheld, ethical considerations be accepted, and conduct be acceptably
demeanoriferous. This involves bringing in acting accordingly, holding them accountable and
incorporating users in the decisions process.

3.3.2. Solutions:
Privacy-Enhancing Measures: For data protection, introduce optimum privacy-giving
techniques for example, data anonymization, encryption and data collection less often to minimize
the risk of data breaches. Through adopting the data protection policy from the beginning, the
application can give the end user a sense of privacy and save such an individual right to privacy.
Transparency and Informed Consent: Make sure that communication with users about the aim
of data collection, the type of data collected, and its aftermath is clear and without doubts. Get
permission from the people before you start collecting the personal data. Let them make the choice
between opting in and opting out.
Ethical Professional Conduct (ACM 2.2, IEEE 2.2): Comply strictly with the high professional
standards, code of practice, and ethics in the making of the contact tracing app for design,
development, and deployment. The developers and policymakers must attach the highest privacy,
security and autonomy of users while producing and implementing the apps stages.

Addressing these issues while also following the principles of both the ACM and IEEE codes of
ethics, the contact app will be put in place in such a manner that it will help to improve the welfare
of society while at the same time it will protect the rights of individuals and uphold ethical conduct
between professions.

3.4. CovaCare Technology Company:

During the COVID-19 pandemic, CovaCare, which is a healthcare technology company, came up
with an AI-powered triage system whose main objective was to ease patient intake in all nation
hospitals and make it easy to tell those whose cases were most at risk of developing life-threatening
complications. However, despite its potential for improving the distribution of health services, this
approach faced criticism from some quarters owing to fears about inequity resulting from the use
of possible biased algorithms especially in marginalized communities. The AI system of CovaCare
was used to assess a patient’s risk of developing severe COVID-19 complications by the use of
machine learning algorithms trained on historical medical data. Factors such as age, pre-existing
conditions and initial symptom severity were inputted into the algorithm which produced a risk
score for every patient, which decided how urgently they needed assistance and where they would
be in the health care system.
Concerns:
1. Algorithmic Bias (ACM 1.4, IEEE 7): Machine learning algorithms developed from past
clinical data could result to biasness because they are not an exact reflection of all people.
Consequently, this might lead to unjust behaviour directed at some particular races or
classes of people which runs against ACM’s principle of equal opportunity without
discriminating against anybody as well as IEEE’s principle of fair treatment of all
individuals irrespective of their status in life.
2. Impact on Vulnerable Populations (ACM 1.1, IEEE 1): In case the system discriminates
against disadvantaged groups unfavorably because of algorithmic partiality, it will go
against the doctrine of ACM on contributing to the welfare of humanity and recognizing
that everybody is involved in computer science and IEEE which prioritizes public safety,
health, and welfare.
 3. Privacy Concerns (ACM 1.6, IEEE 1): The software can generate risk scores using
personal health information that are based on it. However, not handling it correctly could
mean a violation of privacy, going against the ACM and IEEE’s guiding principles on the
matter of privacy.
4. Transparency and Trust (ACM 1.3, IEEE 5): In order to maintain trust, the users require
knowledge of how the AI system operates and what it takes into account while developing
risk scores otherwise the ACM’s principle of honesty and trustworthiness, as well as
IEEE’s principle of acceptance and offer of good critics to technical works, will be
infringed upon.
5. Professional Competence (ACM 2.6, IEEE 6): Only those with the necessary training
and experience are fit to develop and implement such systems. If they do not, they might
be contravening ACM’s principle of working within their areas of competence and IEEE’s
principle of enhancing and upholding technical competence.

Solutions:
1. Algorithmic Bias: CovaCare should avoid ongoing fairness disparities by training its AI
systems on diverse datasets and using bias correction methods. It is consistent with fairness and
anti discrimination principles.
2. Vulnerable Populations: It is important to make regular impact assessments in order to know
the way the system affects various categories including vulnerable populations. Systems should be
adjusted appropriately so that all users have equitable benefit.
3. Privacy Protection: In order to protect user privacy and honor the principle of respecting
privacy, strong safety measures for data must come first, together with clear communication on
how data are used.
4. Transparency and Trust: For someone to trust, it requires knowing how AI system operates.
To make sure users comprehend and adhere to honesty and trustworthiness the explanation of how
risk scores are made and what aspects are looked at is necessary.
5. Professional Competence: CovaCare needs professionals who are trained and continue training
to maintain their technical competence, so they should be the one doing it.
4. Discussion:

COVID-19 gives way to ethical issues:

COVID-19 has placed a difficult ethical ground on the shoulders of healthcare workers.
Several factors, such as sociodemographic characteristics, level of knowledge about the
virus, and workplace problems, are determinants of their ethically sensitive disposition to
individual conflicts and holistic care.

Governments, health workers, and health systems must all join hands to facilitate healthful
ethical decision-making in this crisis.

Moral distress and what it means:

moral distress is a helpful area for further research. It is a concept in bioethics that describes
the psychological anxiety experienced by healthcare workers who feel they can't act
according to their ethical convictions. Understanding moral distress helps us differentiate
between the most pressing ethical concerns faced by medical practitioners.

The origins of moral distress are:

Institutional policies with unforeseen consequences.

Decision-making frameworks that compromise professional integrity.
Concerns about patient well-being and resource limitations.
However, moral distress can be hard to disentangle from other psychological effects of
stress and disaster management, such as fear and grief. The distinction is important because
it is different from all those other effects.

Building up resilience:

We need to equip the health workers by providing enough mental health resources to cope
with moral distress. There can also be research into resilience, based on individual and
organizational coping mechanisms, which can play a crucial role.

Ethics in the pandemic response

This section concludes by showing the range of ethical issues in the medical response to
COVID-19. These include:

Balancing public health measures such as gathering restriction, screens, and isolation
against individual freedoms.
 The ethics of researching treatments and vaccines.
The importance of core ethical principles such as preventing harm, beneficence, protecting
vulnerable groups, and ensuring confidentiality and privacy is also stressed.

5. Conclusion:

The COVID-19 pandemic brought the development and use of technology in the fight against the
virus into an ever-increasing complex ethical landscape. According to some reports, some of the
ethical dilemmas of COVID-19 apps and the potential tension with public health benefits and
individual rights are:

We have described the challenges on how these apps raise ethical concerns: their effectiveness,
technical glitches, potential for privacy breaches, and potential discrimination. Case studies on
employer surveillance and telemonitoring in healthcare give practical insights on the issues
raised.

In this line of thought, we have suggested some solutions that point to transparency, user
consent, data minimalism, and adherence to established ethical codes. By doing so, stakeholders
involved in developing and deploying COVID-19 applications may ensure that they effectively
address this pandemic while meeting ethical standards and individual rights.

Another part of this paper is that call to further research into moral distress among healthcare
workers. It is imperative to understand this psychological strain and its origins for support for
healthcare professionals on the frontlines of this global crisis.

The rest of an efficient response to the COVID-19 pandemic requires a multi-faceted approach
and one that balances public health imperatives with ethical considerations. Understanding the
potential pitfalls of technological solutions and adhering to ethical principles would be able to
harness the power of technology to effectively fight the crisis and responsibly.