Understanding the Ethics of Natural Experiments in a Pandemic

Abstract

Pandemics invite natural experiments: testing hypotheses through observing the effects of interventions without manipulating exposure to the intervention. With novel infections like COVID-19 that spread rapidly and widely, knowledge gaps may be extensive. Quick action may be necessary and randomized trials impracticable if not downright impossible. But what can justify such interventions ethically, given that they are in some sense widescale experiments upon unaware members of the public who have no opportunity to choose not to participate? And what ethical limits to them should there be?

Keywords: pandemics, COVID-19, medical experimentation