Censorship in the area of public health has become increasingly important in many parts of the world for a number of reasons.  Groups with vested interest in public health policy are motivated to censor material.   This may include governments, corporations, professions, and organizations.   The censorship may be direct (legal sanctions) or indirect (corporate and individual self-censorship).   As experts in the field, NGOs and other citizen movements champion competing visions of public health issues, the more incentive there may be to censor.   This is true in a number of circumstances:   curtailing access to information regarding the health and welfare of soldiers in the Kuwait and Iraq wars, poor health conditions in Aboriginal communities, downplaying epidemics to bolster economies, and so forth.   This paper will look at the use of a computer worm (the benevolent health worm) to disseminate vital information in situations where public health is threatened by government censorship and where there is great risk for those who ‘speak out’.

   While there are many examples along the spectrum of public health censorship, this paper’s discussion of the benevolent health worm will be limited that of the Peoples’ Republic of China (China) drawing on three public health crises:   AIDS, SARS and Avian Influenza.   In each of these situations Chinese citizens faced a public health epidemic (which then spread to the international community).   In each of these situations the Chinese government heavily censored information allowing for the disease to unnecessarily spread faster in an uncontained manner.   And in each of these situations individuals who vocalized or published unauthorized news articles on the epidemic (many prominent experts, doctors and activists) were detained without reason serving time in prison.   Some were threatened or charged with divulging a state secret.   The author uses China by way of example due to the extremity of the example as well as due to her experience and familiarity with politics, censorship strategy and legal developments in the region.

   The use of a controversial technology such as a computer worm to disseminate uncensored, sanctioned public health information in China presents contentious ethical issues worth examining.    For the purpose of the final paper, a brief account will be given of the censorship environment in China both in general and in the specific context of public health censorship.   This will be followed by an account of technical aspects of the benevolent healthworm inasmuch as it will inform and frame the debate on ethical issues.   A further account will be given examining the use of an illegal technology such as a computer worm to disseminate non-authorized public health information.  

   The benevolent health worm provides a stratum of ethical issues.   When is the use of an illegal technology ethical?   Does the dual use of a computer worm for malicious or benevolent reasons play a part in the analysis?   If so, at what point? Is motivation the determining factor?    Intended use?   Actual consequences?   Is there a moral duty to write and disseminate public health information which differs from authorized accounts?   Is the duty a general duty or is it specific to certain members of society?   Does the mode information delivery play a part in an ethical analysis?   Are anonymous modes of dissemination less ethical than methods which provide accountability?   To what extent does the source of the information factor into the equation?   What role does risk of criminal sanction play in ethics?   Does the risk of criminal sanction depend on the actual use or potential consequences of the technology? Does the violation of human rights justify the illegal activity?   If so, is the Chinese context justifiable?   Is the use of a benevolent worm compatible with Western ethical traditions?   Chinese ethical traditions?

   Ethical issues will be examined drawing on the moral philosophy of Confucianism in comparison with western based notions of civil liberties / human rights rhetoric.   Confucianism is often thought to be incompatible with western rights-based theories (democracy, civil liberties, human rights and other autonomous rights based theories).   The point is not merely to justify the benevolent health worm through either a ‘western’ or ‘eastern’ lens.   The point, rather, will be to examine many of the ethical issues with Chinese moral philosophy – Confucianism – which is rooted within the framework of values and duties, and comparing them to a Western human rights-based analysis.  

   Western-based rights treatises, in particular human rights frameworks, may provide for some justification of a benevolent health worm.   Human rights or civil liberties frameworks operate on two theoretical models.   The first is one related to public international law where States bind themselves to legal obligations contained in treaties.   Specific rights and obligations, therefore, are only provided to the extent of treaty provisions.   Such rights are then entrenched in domestic law.   The State then has the obligations of providing and securing these rights.   The question arises, to what extent is a public international law framework tantamount to an ethical norm? The second level relates to the universality of human rights.   Universality is not a legal proposition but a moral one; that human rights are naturally acquired at birth regardless of the area of the world where you reside.   Human rights subsist regardless of international and domestic legal obligations.  Regardless of the interpretation of human rights, the benevolent health worm represents undisputed rights which may be stated in a simple form: everyone has the right of freedom of expression, and the right to the enjoyment of the highest attainable standard of physical and mental health.   These rights are legally protected in a number of international, regional, and United Nations Treaties to which China is party to, and, according to the model of human rights one adheres to, are inherently entrenched regardless of the law.

   Confucius moral philosophy is often referred to as a duty-based philosophy.   Confucian ethical teachings are grounded in five moral values: Li (ritual), Hsia (filial piety, duty to family), Yi (righteousness), Xin (honesty and trustworthiness), Ren/Jen (benevolence, social virtue, humaneness towards others), and Chung (loyalty to the state).   The Confucius view of duty was not traditionally extended to all people but was limited to five relationships: ruler to subject, father to son, eldest brother to younger siblings, husband to wife, and elders to juniors.   There has never been a duty from human to human in traditional Confucius thought.   Two contentious issues are brought to our attention in applying Confucius teachings to the benevolent health worm.   First, the values of ren, benevolence towards others, may compete with that of chung, loyalty to the state.   Second, there is no general duty between humans outside of the five relationships.

   The value of Chung requires a person to be loyal to the state but not at any cost. Confucius writes, “If a ruler’s words be good, is it not also good that no one oppose them?   But if they are not good, and no one opposes them, may there not be expected from this one sentence the ruin of his country?” [The Analects].    The most important value as espoused by Confucius was ren.  A major component of ren involved individual self-cultivation in virtuous action.   Good governance and social order were derived from a hierarchical chain of individual virtuous action thus it is written that, “their hearts being rectified, their persons were cultivated.   Their persons being cultivated, their families were regulated.   Their families being regulated, their States were rightly governed.   Their States being rightly governed, the whole kingdom was made tranquil and happily” [Great Learning].   What of the case where ren is not personally cultivated leading to poor governance?   Loyalty to the State is loyalty to a righteous government who has fulfilled its duties to its citizens in the spirit of ren; loyalty to the State has never been an absolute.  

   The formation of a person’s character through virtuous action is strongly tied to a sense of community and to one’s role in a community.   For this reason, Confucius defined ren in different manners depending on the person asking the questions [Edward Slingerland].   Modern Confucius scholars have given new interpretations to many of Confucius works.   For example, Tu extends his interpretation to include ecological issues, O’Dwyer to include democracy, and Tsai to include bioethics.   Similarly, extension of duties beyond the classic five relationships has also been newly interpreted.   It could be said that certain members of society may have the duty to disclose information on epidemics which could save lives, reduce the spread of the infectious disease, and perhaps altogether avoid a disease reaching the level of epidemic.   Certain members may include scholars, doctors, journalist, experts, NGOs, and other international organizations.   The dissemination of vital information is potentially a virtuous act whether it is through direct means of an Internet website, news publications, or whether it is less indirect through a benevolent health worm.  

   The use of Western rights-based theories (human rights) alongside the Eastern duty-based theory of Confucius moral philosophy provides an interesting platform for an ethical analysis of the benevolent health worm. The author will suggest how human rights and Confucius moral philosophy may be used to better understand and, to a certain extent, justify the use of the benevolent health worm.  The application of the analysis could extend to a broader one which looks at the ethical use of illegal technologies.

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The author notes that many human rights based theories were derived from Liberalism.   Many western philosophers, such as Kant, emphasized duties.