Integrated Human Practices
Our human practices reflection is based on the interactions between the conception of our device and the society. How could our work be integrated in the prevention of STIs? The goal was to conduct a rigorous reflexion on the project. First we used the knowledge acquired during meetings and surveys we carried to build an ethical matrix.
The help provided by our human sciences instructors was very valuable as they guided us through interesting ways of thinking.
Ethical matrix - Click to enlarge
Once the matrix was established, on the one hand, we confronted it with the results of the survey in the matrix synthesis.
On the other hand, it was used as an instrument to have a human overview of the project to take a needed step back as everyone was focused on its parts. An ethical matrix was a useful framework to assist us in our deliberation about technical choices but also social choices.
The matrix synthesis was realized to have a humanist point of view integrated into our project. In this perspective, we used the approach of the ethic of care (Joan Tronto, Moral boundaries: a political argument for ethic of care, 1993) to interpret our results.
We identified 4 statements: innovation, perception, risk, responsibility to improve our project according to two phases of the ethic of care.
CARING ABOUT
The innovation deals with human consequences of our technology.
Early detection, short delivery time of results, low cost impact the use of the diagnosis. The early detection allows to improve patient's care, thus the treatment can begin very early. The short delivery time of results is compatible with mobile prevention campaign and emergency situations. Low cost is for better test accessibility and increase the user population. All those decisions were made to develop an attractive test that would answer the technical expectations of healthcare professional.
The perception of the test by the user was also analyzed to establish the preliminary basis of acceptability issues. The human relationship of the user during the test realization and the management of intimacy were our main reflection axis.
TAKING CARE OF
Integration of the risks was also necessary. We identified 3 major risks. The contamination risk implies to use safe biological materials. The reliability deals with false positive and false negative. It is a technical issue that is related to our technology. The goal is to reduce them as much as possible. The use decay risk introduced by the user.
The risk principle results in the concept of responsibility. Support is good way to reduce those risks, being supervised by the medical staff can be very reassuring during the test execution. The announcement of the results also questions the presence of medical staff according to the serious consequences of some STIs. The easy access and the simplicity of use are necessary to guarantee an equal right to get diagnosed.
Nowadays, the responsibility is not restricted to the user, it must also respect the environment. That’s what motivated our technical choices for the device.
The matrix was also intended to be a decision helper tool. It was very useful when taking important decision (e.g. changing the revelation system).
Matching technical solutions to ethical values (accessibility, respect of the user, biosafety) can be really complex but stimulating!
Decisions taken thanks to the matrix
Sample choices: blood for a non invasive test and easily standardized sample.
Materials choices: paper, biosourced plastic…for an eco friendly cycle of life.
Early-detection: RT instead of the p24 to detect the early stage infection of HIV.
Reliability: a system that minimizes the false negative risk by using two epitopes instead of one.
Usability: redaction of a usernote to improve the user experience.
Biosafety: latex beads instead of RT proteins or HbSAg as bio-safe migration controls.
This work can serve as an inspiring example to other 2016 iGEM teams: Stanford-Brown and Michigan. We could organize an ethical debate about our technology. Our work on an ethical matrix is documented but there are still a lot of questions (writen in red in the matrix). With others, we can build upon to answer to doubt.
We were able to come up with a device that combines the expertise of physicians specializing in STIs, potential patients’ expectations, curiosity and foresight of young engineering students. So this device can be usable and useful.
