Dr Carolyn Johnston1
1University of Tasmania, Hobart, Australia
Parents of children with type 1 diabetes are increasingly using the Internet of Things to build home-based closed loop systems that monitor glucose levels and automate insulin delivery. In this context standard treatment is modified by technology, parents are not making an outright rejection of treatment for their child. In 2018, Diabetes Australia issued a position statement that diabetes healthcare professionals should continue to provide support of, and care for, a person (or their parent) who chooses to build a DIY system. Nevertheless, as these systems are untested and unregulated this creates legal and ethical challenges for healthcare professionals who give implicit support by providing prescriptions for insulin and monitoring the child.
I consider the legal and ethical duties of care owed by paediatric endocrinologists and diabetes educators and the reasonable precautions it would be appropriate to take, commensurate with the probability and seriousness of harm of looping technologies (s49(2) Wrongs Act 1958 (Vic)). Through analysis and application of common law and civil liability legislation I address the potential for a claim in negligence against a healthcare professional for 1. failing to adequately inform parents about the risks of using a DIY system to manage their child’s T1D and 2. supporting the use of a DIY system by provision of prescriptions for insulin and using data from the system to monitor the child. Although indemnity providers may take a conservative approach, I conclude that a claim is unlikely to be successful if the parents are properly counselled about the risks.
Research Fellow at University of Tasmania and honorary Senior Fellow, Law at Melbourne University. Carolyn is Clinical Ethicist at Monash Children’s Hospital and provides academic input for the Australian Network for Art & Technology art residency.