Table 2 Thematic summary of findings
Theme | Sub-theme | Social and ethical considerations |
|---|---|---|
Perceived benefits of testing | Creates knowledge of personal COVID-19 status | • Responsibility for one’s own health and wellbeing • Responsibility to keep people you know safe • Responsibility to the wider community to reduce transmission/contribute to a collective response. insert bullet point Social contract with the state • Fear of moral judgment by others |
Keeps friends, family, and colleagues safe | ||
Avoids social stigma | ||
Reduces levels of transmission in population | ||
Contributes to disease surveillance and policy/planning | ||
Expectations of, and trust in, testing provision and providers | Expectations about the availability of testing | • Obligation of government to make testing available and accessible • Obligation of citizens to access testing when symptomatic • Responsibility of citizens not to waste public resources • Making profit from a public good considered unethical |
Concerns about wasting tests | ||
Concerns about testing, or testing data, as a commodity rather than a public good | ||
Experiences of symptoms and testing decisions | COVID-19 testing criteria (continuous cough, temperature) are experienced as ambiguous | • Responsibility for the risk one poses to others, and moral duty to test when symptomatic or at increased risk of infection • Ethical tensions between moral responsibility to test versus uncertainty about symptoms and/or personal/social/economic costs of testing |
Concerns about exposure and risk | ||
Accessing tests | Booking systems can be arduous to navigate | • Frustration with government over challenges of accessing tests • Individual responsibility for not spreading infection through travel (e.g., public transport) • Obligations to employer |
Challenges getting to a testing centre | ||
Taking time off work | ||
Sample collection | Experiences of physical discomfort | • Duty to get oneself or one’s child tested • Parental responsibility for children’s physical and emotional wellbeing • Frustration with government over hidden challenges of testing |
Difficulties interpreting instructions and guidance | ||
Doubts about accuracy of self-swabbing method | ||
Waiting for, receiving, interpreting, and acting on results | Ambivalence about self-isolating while awaiting a test result | • Lack of recognition by government of personal costs of testing and isolation • Ethical obligation to isolate balanced with personal circumstances and/or social obligations to others • Responsibility for self-diagnosis |
Negative test result enables a return to work, and social obligations to be fulfilled | ||
People question accuracy of testing when test results do not align with their diagnostic suspicions | ||
Willingness to self-isolate following a positive test result, despite anticipated challenges |