Ethics and informatics in the age of COVID-19: challenges and recommendations for public health organization and public policy

Vignesh Subbian; Anthony Solomonides; Melissa Clarkson; Vasiliki Nataly Rahimzadeh; Carolyn Petersen; Richard Schreiber; Paul R DeMuro; Prerna Dua; Kenneth W Goodman; Bonnie Kaplan; Ross Koppel; Christoph U Lehmann; Eric Pan; Yalini Senathirajah

doi:10.1093/jamia/ocaa188

Ethics and informatics in the age of COVID-19: challenges and recommendations for public health organization and public policy

J Am Med Inform Assoc. 2021 Jan 15;28(1):184-189. doi: 10.1093/jamia/ocaa188.

Authors

Vignesh Subbian^{1

2}, Anthony Solomonides³, Melissa Clarkson⁴, Vasiliki Nataly Rahimzadeh⁵, Carolyn Petersen⁶, Richard Schreiber⁷, Paul R DeMuro⁸, Prerna Dua⁹, Kenneth W Goodman¹⁰, Bonnie Kaplan¹¹, Ross Koppel^{12

13}, Christoph U Lehmann¹⁴, Eric Pan¹⁵, Yalini Senathirajah¹⁶

Affiliations

¹ Department of Biomedical Engineering, The University of Arizona, Tucson, Arizona, USA.
² Department of Systems and Industrial Engineering, The University of Arizona, Tucson, Arizona, USA.
³ NorthShore University HealthSystem, Evanston, Illinois, USA.
⁴ University of Kentucky, Lexington, Kentucky, USA.
⁵ Stanford University, Stanford, California, USA.
⁶ Mayo Clinic, Rochester, Minnesota, USA.
⁷ Geisinger Health System, Camp Hill, Pennsylvania, USA.
⁸ Royal Palm Companies, Miami, Florida, USA.
⁹ Louisiana Tech University, Ruston, Louisiana, USA.
¹⁰ University of Miami, Miami, Florida, USA.
¹¹ Yale University, New Haven, Connecticut, USA.
¹² University of Pennsylvania, Pennsylvania, USA.
¹³ University at Buffalo, The State University of New York, Buffalo, New York, USA.
¹⁴ UT Southwestern Medical Center, Dallas, Texas, USA.
¹⁵ Westat Inc, Rockville, Maryland, USA.
¹⁶ University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Abstract

The COVID-19 pandemic response in the United States has exposed significant gaps in information systems and processes that prevent timely clinical and public health decision-making. Specifically, the use of informatics to mitigate the spread of SARS-CoV-2, support COVID-19 care delivery, and accelerate knowledge discovery bring to the forefront issues of privacy, surveillance, limits of state powers, and interoperability between public health and clinical information systems. Using a consensus-building process, we critically analyze informatics-related ethical issues in light of the pandemic across 3 themes: (1) public health reporting and data sharing, (2) contact tracing and tracking, and (3) clinical scoring tools for critical care. We provide context and rationale for ethical considerations and recommendations that are actionable during the pandemic and conclude with recommendations calling for longer-term, broader change (beyond the pandemic) for public health organization and policy reform.

Keywords: COVID-19; contact tracing; ethics; privacy; public health surveillance.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bioethical Issues*
COVID-19*
Contact Tracing / ethics*
Healthcare Disparities
Humans
Information Dissemination / ethics
Medical Informatics / ethics*
Privacy
Public Health / ethics*
Public Health Surveillance*
Public Policy
United States