Developing an ethical framework for asymptomatic COVID-19 testing programmes in higher education institutions

Cox, Caitríona; Ansari, Akbar; McLaughlin, Meredith; Scheer, Jan W van der; Liddell, Kathy; Burt, Jenni; McGowan, James; Bousfield, Jennifer; George, Jenny S.; Leach, Brandi; Parkinson, Sarah; Dixon‐Woods, Mary

doi:10.12688/wellcomeopenres.16807.1

Cited by 2 publications

(4 citation statements)

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“…It offered multiple perspectives on an important problem and informed the generation of a comprehensive framework, demonstrating the strength of using participatory approaches with involvement from different stakeholders to engage with a complex (ethical) issue [ 54 – 57 ]. It was also a valuable approach in a parallel project focusing on asymptomatic COVID-19 testing for students in higher education institutions [ 23 ], which similarly combined stakeholder consultation with a process of reasoned and deliberative justification [ 72 ].…”

Section: Discussionmentioning

confidence: 99%

“…We used a multi-stage iterative process to develop an ethical framework for asymptomatic COVID-19 testing in workplaces, using methods very similar to those we have previously reported in relation to an ethical framework for COVID-19 testing in higher education institutions [ 23 ], including:…”

Section: Methodsmentioning

confidence: 99%

“…COVID-19 asymptomatic testing programmes have, however, attracted considerable controversy, for example regarding their efficacy, possible unintended negative consequences, and issues around equity and privacy [ 6 , 10 , 13 – 22 ]. Many debates so far have concerned large-scale mass testing programmes, such as in public health districts or higher education settings [ 23 – 28 ]. Distinctive issues are raised by organisations choosing to operate workplace asymptomatic testing programmes for their staff [ 1 , 29 – 32 ].…”

Section: Introductionmentioning

confidence: 99%

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Guiding organisational decision-making about COVID-19 asymptomatic testing in workplaces: mixed-method study to inform an ethical framework

et al. 2022

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Background Workplace programmes to test staff for asymptomatic COVID-19 infection have become common, but raise a number of ethical challenges. In this article, we report the findings of a consultation that informed the development of an ethical framework for organisational decision-making about such programmes. Methods We conducted a mixed-method consultation – a survey and semi-structured interviews during November–December 2020 in a UK case study organisation that had introduced asymptomatic testing for all staff working on-site in its buildings. Analysis of closed-ended survey data was conducted descriptively. An analysis approach based on the Framework Method was used for the open-ended survey responses and interview data. The analyses were then integrated to facilitate systematic analysis across themes. Inferences were based on the integrated findings and combined with other inputs (literature review, ethical analysis, legal and public health guidance, expert discussions) to develop an ethical framework. Results The consultation involved 61 staff members from the case study organisation (50 survey respondents and 11 interview participants). There was strong support for the asymptomatic testing programme: 90% of the survey respondents viewed it as helpful or very helpful. Open-ended survey responses and interviews gave insight into participants’ concerns, including those relating to goal drift, risk of false negatives, and potential negative impacts for household members and people whose roles lacked contractual and financial stability. Integration of the consultation findings and the other inputs identified the importance of a whole-system approach with appropriate support for the key control measure of isolation following positive tests. The need to build trust in the testing programme, for example through effective communication from leaders, was also emphasised. Conclusions The consultation, together with other inputs, informed an ethical framework intended to support employers. The framework may support organisational decision-making in areas ranging from design and operation of the programme through to choices about participation. The framework is likely to benefit from further consultation and refinement in new settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13993-1.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Guiding organisational decision-making about COVID-19 asymptomatic testing in workplaces: mixed-method study to inform an ethical framework

et al. 2022

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“…The evidence suggests it is possible to sustain high levels of adherence to regular, voluntary, asymptomatic screening using nose and throat swabs 89. University led testing programmes have been strongly supported by students,81011 providing reassurance at a time when student mental health and wellbeing have been severely affected by the pandemic 812…”

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confidence: 99%