QUT Law Review ISSN: Online–2201-7275 Volume 18, Issue 2, pp. 93–110 DOI: 10.5204/qutlr.v18i2.748 This work is licensed under a Creative Commons Attribution 4.0 Licence. As an open access journal, articles are free to use with proper attribution in educational and other non-commercial settings. LEGAL AND ETHICAL ISSUES ARISING FROM THE USE OF EMERGING TECHNOLOGIES IN PAEDIATRIC TYPE 1 DIABETES CAROLYN JOHNSTON * AND LYNN GILLAM *∗ Mobile health apps and wearable devices are widely available. They provide an opportunity to monitor and track health metrics continuously, and in real time, thus enabling diagnosis and chronic condition management to take place outside a hospital setting. The digital data produced can be shared with healthcare providers, researchers, and on social media. In this paper, we explore some of the legal and ethical challenges for doctors of these emerging technologies, by focusing on the example of management of childhood diabetes using continuous glucose monitors and insulin pumps. We identify and explicate these challenges through an analysis of three different case scenarios, all hypothetical but all realistic and reflective of current experiences of doctors caring for children with Type I diabetes. We argue that current legal and ethical approaches can effectively be applied in determining duties of healthcare professionals using emerging technologies, whilst recognising the significant change in the nature of the doctor-patient relationship and the perception of therapeutic benefit of some technologies. I INTRODUCTION This paper identifies the ethical and legal issues that arise in the management of children with Type 1 diabetes (T1D) when parents fit, and use, medical devices for their children without the support of their treating doctor. These situations arise because of recent advances in technologies for monitoring blood glucose levels and delivering insulin, coupled with the capacity for parents to buy devices direct from the supplier, rather than going through their child’s doctor. They present significant challenges for clinicians involved in the care of the child, especially where parents seek assistance with using the device, despite the child’s doctor having advised that it is not suitable for their child. We begin by providing some background about childhood diabetes and its usual management, and then describe some of the devices in question. Next, we set out three clinical scenarios and identify the legal and ethical questions which arise for the doctors involved. We draw on existing concepts in law and ethics to address these questions, but indicate where existing concepts might need to be extended to cover novel situations. ∗ Carolyn Johnston, PhD; MA; LLM; LLB (Hons); Senior Research Fellow, Melbourne Law School, University of Melbourne; ** Lynn Gillam, PhD; MA; BA; Professor in Health Ethics, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne and Clinical Ethicist and Academic Director, Children’s Bioethics Centre, Royal Children’s Hospital Melbourne. The authors are members of a project team evaluating regulation of, and attitudes to, personalised closed loop systems for childhood diabetes: <https://networkedsociety.unimelb.edu.au/research/projects/active/closed-loop-diabetes>.