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Introduction Passive data refers to data generated without the active participation of the subject. This includes data from global positioning systems and accelerometers or metadata on phone call and text activity. Although the potential healthcare applications are far-reaching, passive data raises numerous ethical challenges. Materials and Methods We performed a systematic review to identify all ethical concerns, normative standpoints, and underlying arguments related to the use of passive data in healthcare. Results Among the various challenges discussed in the ethical literature, informational privacy, informed consent, and data security were the primary focus of the current debate. Other topics of discussion were the evaluation and regulation of products, equity in access, vulnerable patient groups, ownership, and secondary use. Conclusion No clear ethical framework has been established that stimulates passive data-driven innovation while protecting patient integrity. The consensus in the ethical literature, as well as the parallels with similar concerns and solutions in other fields, can lay a foundation for the construction of an ethical framework. The future debate should focus on conflicts between two or more ethical, technical, or clinical values to ensure a safe and effective implementation of passive data in healthcare.

Passive data (PD) refers to data generated without any active participation of the subject, such as data from global positioning systems and accelerometers, but also includes metadata on phone call and text activity. As PD can provide unique insight into a patient’s behavior and functioning, it can have numerous applications in neurosurgery, varying from early symptom recognition to postoperative monitoring. The deployment of this technique is, however, associated with substantial ethical challenges. This chapter aims to address these ethical challenges by reviewing the normative ethical literature on this topic. The ethical discussion focusses predominantly on informational privacy, informed consent, and data security; however, significant concerns are also expressed related to regulation of PD products, equity in access, vulnerable patient groups, ownership of the data, and secondary use. The significant degree of consensus in the current ethical literature, the broader empirical evidence supporting the discussed concerns, and the parallels with ethical topics, solutions, and regulations in other medical and nonmedical fields can guide the construction of an ethical framework that ensures a safe and sound implementation of PD in neurosurgery.

Image analysis of historical aerial photographs was used to examine the effects of the Amoco Cadiz oil spill and resulting clean-up on marsh ecology. Two heavily oiled marsh systems were compared. The marsh which received no clean-up recovered to its prior condition. The marshes in the system cleaned by sediment removal were extensively altered as a result of changes in intertidal height of the sediment surface.