Ghent University Hospital, Gent, Belgium.
Department of Public Health and Primary Care, Ghent University, Gent, Belgium.
Bioethics. 2021 Jul;35(6):581-588. doi: 10.1111/bioe.12877. Epub 2021 May 5.
The COVID-19 pandemic has had an immense and worldwide impact. In light of future pandemics or subsequent waves of COVID-19 it is crucial to focus on the ethical issues that were and still are raised in this COVID-19 crisis. In this paper, we look at issues that are raised in the testing and tracing of patients with COVID-19. We do this by highlighting and expanding on an approach suggested by Fineberg that could serve as a public health approach. In this way, we highlight several ethical issues. As regards testing, questions are raised such as whether it is ethical to use less reliable tests in order to increase testing capacity or minimize harm for patients. Another issue is how wide testing should be and whether selective testing is in accordance with principles of social justice. Patients who have recovered from COVID-19 might have some degree of immunity but attributing certain 'immunopriviliges' raises ethical questions. The use of various tracing methodologies (mobile apps or databases and trained tracers) raised evident questions of social justice and privacy. We argue why it is key to always uphold a test of proportionality where a fair balance must be sought.
COVID-19 大流行产生了广泛而深远的全球性影响。鉴于未来可能发生的大流行或 COVID-19 的后续浪潮，关注在此次 COVID-19 危机中提出的伦理问题至关重要。在本文中，我们着眼于在 COVID-19 患者的检测和追踪中提出的问题。我们通过强调并扩展 Fineberg 提出的一种方法来做到这一点，该方法可以作为一种公共卫生方法。通过这种方式，我们强调了几个伦理问题。在检测方面，人们提出了这样的问题，即是否可以使用不太可靠的测试来提高检测能力或最大限度地减少对患者的伤害。另一个问题是应该进行多广泛的检测，以及选择性检测是否符合社会正义原则。从 COVID-19 中康复的患者可能具有一定程度的免疫力，但赋予某些“免疫特权”会引发伦理问题。各种追踪方法（移动应用程序或数据库和受过训练的追踪者）的使用引发了明显的社会正义和隐私问题。我们认为，始终坚持进行相称性检验至关重要，必须在其中寻求公平的平衡。
