INTRODUCTION

NEVER BEFORE HAS A PANDEMIC SPREAD ACROSS A WORLD SO ABUNDANT IN TECHNOLOGIES AND DATA. WHILE NOT ENABLING ALL COUNTRIES TO SUFFICIENTLY ANTICIPATE THE IMPACT OF COVID 19 FROM ITS ONSET, THE POWER OF DIGITAL TECHNOLOGY HAS BEEN LEVERAGED UNIVERSALLY TO ACCELERATE SCIENTIFIC RESEARCH, LIMIT THE SPREAD OF THE EPIDEMIC AND NOW FACILITATE THE REOPENING OF BUSINESSES.

However, use of this significant power can also present its own risks and raise concerns that may even slow the adoption of proposed solutions. Often caught up in a tangle of constraints or contra dictory orders, public and private decision-makers are faced with choosing between the lesser of two evils. In particular, the effectiveness of health measures, safeguards for individual liberties, digital sovereignty, social inclusion and widespread adoption of the proposed measures are the issues at stake.

Citizens are questioning politicians on the social impacts of the health and IT-based systems they are considering. Businesses are turning to the authorities for concrete recommendations to follow and guide lines defining their responsibilities. Employees are challenging their employers about how real their commitments are to social responsibility and work place safety. Governments are calling on various intermediary bodies that can facilitate adoption of the measures they recommend, without actually imposing them. And businesses are also trying to assess the ways and means available to promote the buy-in for protective solutions among their employees. Customers are challenging the right of a store owner to oblige them to take a particular action to enter the store, or even to benefit from special conditions. So many different situations! So many ethical beliefs and values tossed around by all and sundry, on either side of the fence. In the end, they are all dilemmas and constraints for those who have to decide on or manage the implementation of IT based health protection measures

This report and its proposed methodology are primarily addressed to such decision-makers. This approach aims to provide them with the means for analyzing and deciding on the use of technologies to safely exit the crisis and accelerate a healthy return to normalcy. This report can be read on two levels: the first addresses decision-makers across all types of organizations and governance bodies, and the second is more specifically geared to businesses.

Developed during the COVID¬19 crisis, the proposed method in fact heralds a more general approach (which will be the subject of future work) for implementing algorithmic and personal data processing, whose adoption and proper use involve fundamental ethical considerations.

This approach can be naturally extended to other areas of healthcare, where the crisis has catalyzed underlying existing trends, paving the way for in creasingly digital and data-intensive health services. Even more broadly, this method could be adapted to make ethics an enabler and not a constraint for developing digital services whose sensitive nature requires a contextualized approach in our democratic societies.

Our proposed methodological approach consists of several stages:

  • Setting up an appropriate governance body, which brings together all stakeholders and steers the project from design stage through completion (return to "normal" health conditions), and has technical, ethical and legal expertise.
  • Building a single frame of reference. Often-used analogies to familiar situations (plague, war, terrorism, mass surveillance, etc.), conjure up images and mould our perceptions of the situation. Some biases cause decision-makers to prefer certain solutions while others trigger rejection or opposition from those the solutions are intended for. Clearly, the choice of mindset is key. Among other things, it helps build a shared vision of the issues at stake.
  • Clear identification of needs (tracing individuals carrying the virus, studying community behaviour, monitoring compliance with health measures, controlling access to private spaces, etc.), taking into account the overall health system in which an IT-based solution is to be used.
  • In-depth analysis of available technologies and the technical, safety, ethical and legal issues related to deploying them.
  • Based on the foregoing, a decision-making process should be rolled out using a multifactor matrix that involves all project stakeholders. The considerations incorporated in this process will make it possible to identify risks and understand how to mitigate them, pave the way for broad adoption of the chosen measures, and determine the governance conditions and how they should evolve over time.

This report is made up of three main parts

  • The first part focuses on the anthropological, social and ethical aspects related to the IT-based responses for exiting the health crisis. In particular, it discusses the different mindsets, principles and values conducive to achieving the crucial shared frame of reference mentioned above.
  • The second part provides an overview of the main technologies available with regard to health, technical and societal issues. Particular attention is paid to the most impactful issues, such as the nature of the data collected, how the data are processed and stored (centralized/decentralized/ hybrid), the security aspects related to the technology used, etc. This part also aims to make the IT-based aspect understandable for decision-makers from outside the industry
  • The third part sets out in detail the methodology and accompanying tools. It presents the multi factor impact matrix we developed and how it is used. The matrix is presented in its entirety in the appendix. The method has been fully applied to a selection of responses illustrating the diversity of anti-COVID¬19 IT-based solutions developed around the world. Eleven solutions were analyzed in depth by an international team of experts in technology, health, ethics and law. The results and lessons learned from this work are highlighted in the different sections of the report and inform our recommendations. Appendices include a comparative table of these 11 responses, as well as summaries of the analyses carried out on each.

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