Lab-on-a-Chip: An Ethical Assessment of Self-Testing Devices of HIV

AUTHOR
Cajetan Okechukwu Ndukwe

ABSTRACT

Introduction

It can be argued that ethical values are embedded in health care practice and tradition following from the Hippocratic Oath. This has resulted among other things in a synthesis between ethics and health care practice and the application of philosophical ethics in health care. It is this applied philosophical ethics in health care that paves my way into an ethical assessment of self-testing devices of HIV. As someone coming from a philosophy background, I am interested in how critical thinking and evaluative reflection can help those engaged in health care service especially when dealing with issues that pose ethical quandaries.

From studying applied ethics, it has come to my attention that at the core of contemporary ethical concerns in health care is issues related to HIV and AIDS. While this essay might not be focusing on all the ethical issues concerning HIV and AIDS, my focal point will be ethical issues in the use of lab-on-a-chip self-testing devices of HIV. But what is lab-on-a-chip?

Lab-on-a-chip

Lab-on-a-chip is used to refer to devices that integrate multiple laboratory functions on a single chip of only millimetres to a few square centimetres in size. They are capable of handling extremely small fluid volumes down to less than pico liters.Lab-on-a-chip technology is being used today to develop HIV self-testing devices.

Self-Testing Devices

These are devices that are used in point of care application and self-test home. These devices can diagnose a health condition like the case of the home pregnancy test kit. They can monitor health conditions and offer information on the possibility of adjusting treatment. An example of this is glucose testing to monitor blood sugar levels in diabetes patients. Individuals might also use self-testing devices to screen for an illness or health condition as in the measurement of cholesterol or triglyceride levels. From the reading that individuals get, they might make decisions to help curtail their risk of heart disease. The self-testing devices take various forms but I am interested on lab-on-a-chip self-testing devices of HIV.

Statement of the problem

Self-testing devices of HIV generates both excitement and uneasiness. On the one hand, self-testing devices of HIV allows earlier detection of HIV which makes people to seek treatment on time if available. In this way they lead to earlier and more effective treatment for HIV. But the use of self-testing devices of HIV generates ethical questions. The self-testing devices of HIV are inexpensive and could easily be adapted and made available for point of care testing and for home use. What is the justification of putting such devices in the hands of the public when there is no cure for HIV? How competent are persons who will use these devices? How reliable will the test be given that persons might not read or interpret the readings of the devices accurately? Even when they can do this, have they access to pre and post counselling in case they are HIV positive? Furthermore, can they access the antiretroviral drugs if they are available?

Arguments are put forward that the provision of such self-testing devices of HIV will promote individuals’ autonomy. This assumes that individuals will use and interpret the HIV self-testing devices properly. The information they gain would hopefully lead to decisions that promote their health. However, health care professionals have traditionally been essential participants in HIV testing to insure accurate results and support for HIV sero-positive individuals. Might persons actually be harmed by HIV self-testing devices if they use or interpreted inaccurately? How will the ethical principles of beneficence and non-maleficence be weighed with the HIV self-testing devices?

In addition, the act of self-testing produces information which will impact users’ of self-testing devices, perceptions of themselves and their reality. Hence self-testing can be viewed as an ontological event. Such information carries implications for the person and how they should act (such as whether they should seek treatment, if available).Therefore, the act of self-testing for HIV carries great significance for the person. How people interpret this experience and its meaning is a great ethical concern for me in this essay. Would it be ethical to leave persons on their own during this process, as would be most likely with self-testing devices of HIV? I explore these ethical concerns in this essay.

Purpose of the study

This essay is aimed at establishing ways of resolving the ethical concerns that arise in the use of self-testing devices of HIV. By investigating the problems and risks inherent in the use of self-testing devices of HIV, I intend to educate health care workers and individuals generally of their responsibilities in the use of self-testing devices of HIV.

In addition, this essay is an invitation for more research regarding ethical issues on the use of self-testing devices of HIV in health care. I will offer some suggestions regarding what research in applied ethics can do in resolving problematic ethical issues bothering on the use of self-testing devices of HIV in health care. I intend to do this via some analytical questions as my research guide.

Research questions

I am to examine three inter-related general questions in this essay. They are;

  • What are the ethical issues implicated in the introduction and use of self-testing devices of HIV in health care?
  • How do we analyse these ethical issues in relation to the demands of the ideals of health care practice?
  • What implications do the use of self-testing devices of HIV hold for the ethical principles of autonomy, beneficence and non-maleficence?

I am to do an extensive analysis of the ethical principles of autonomy, beneficence and non-maleficence which will enable me to answer the core moral questions of this research.

Methodology

The research methodology is that of careful and critical analysis of available and relevant scholarly literature towards proffering solutions to the ethical concerns in the use of HIV self-testing devices.

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