Infection control, subjective estimates, and the ethics of testing during the COVID-19 pandemic

Abstract

On March 16, 2020, the Director-General of the World Health Organization said: "We have a simple message to all countries-test, test, test." This seems like sound advice, but what if limiting the number of tests has a positive effect on infection control? Although this may rarely be the case, the possibility raises an important ethical question that is closely related to a central tension between deontological and consequentialist approaches to ethics. In this paper, we first argue that early during the COVID-19 pandemic, Japan offers an interesting case because it experienced few deaths due to COVID while the number of tests was limited, suggesting that there may be cases in which low testing contributes to infection control indeed. After that, we examine deontological constraints on such a "low-testing" policy, focusing on issues related to a supposed "right to know," which is a central issue in medical ethics in general.

Keywords: COVID-19 testing; consequentialism; deontology; infection control; right to know.