Quiz Entry - updated: 2026.10.22
How can a Digital Public Health intervention be evaluated ethically in a systematic way, and which criteria are used?
In two methodical steps: first define and justify the normative criteria (what counts as good or bad), then assess the intervention step by step against them with a clear method. The criteria (functionality, alternatives, benefit, harm, self-determination, privacy, data security, justice, efficiency, responsibility, legitimacy) each trace back to the four principles or to means-end rationality.
* Each evaluation criterion is justified by one of the medical-ethics principles *
The two building blocks:
- Normative framework: determine and justify the standards, i.e. what counts as "good" and "not good".
- Method: a clearly defined procedure to assess the specific intervention step by step on that basis (e.g. user surveys, interviews).
Together they ensure the quality of the ethical evaluation. Marckmann's criteria, with their ethical justification:
| Criterion | What is checked | Justified by |
|---|---|---|
| Functionality | goal of the technology, effectiveness, data quality, technical efficiency | means-end rationality; non-maleficence; beneficence |
| Alternatives | other ways to reach the goal | means-end rationality |
| Benefit for target population | better mortality, morbidity, quality of life; strength of evidence | beneficence |
| Harm for participants | safety, low error rate, burdens and risks | non-maleficence |
| Self-determination | health literacy, informed decisions, freedom of choice | respect for autonomy |
| Privacy and health data | informational self-determination, data-protection measures | respect for autonomy |
| Data security | integrity of health data against system failures | non-maleficence |
| Justice | non-discriminatory access, fair distribution of benefit and harm, reducing inequalities | justice |
| Efficiency | cost-benefit ratio | distributive justice under scarcity; means-end rationality |
| Responsibility | who is accountable when the application is used | non-maleficence |
| Legitimacy | legitimate decision-maker, fair procedure | justice; respect for autonomy |
Go deeper:
Marckmann (2020) — Table 1 of the open-access article (German).