People are using innovative internet of things technologies to gain individualised management of their type 1 diabetes. The #WeAreNotWaiting movement supports them to build their own hybrid closed loop systems and access their real time blood sugar data via any web connected device. A small number of parents in Australia use such DIY looping systems to manage their child’s type 1 diabetes, but these systems have not been approved by the Therapeutic Goods Administration in Australia, creating ethical dilemmas for clinicians (...) about how to respond to the use of medical devices that are not registered on the Australian Register of Therapeutic Goods. This article considers whether the use of DIY looping is in the best interests of the child and, if not, whether intervention in parental decision making is justified to prevent harm to the child. It addresses the ongoing duty of healthcare professionals to provide care to children who are ‘looping.’ Reference is made to findings from a study, Personalised Closed Loop Systems for Childhood Diabetes, to illustrate stakeholders’ perceptions of benefits and harms of DIY looping systems. I conclude that the decision of parents to use DIY looping technology could be considered to be in a child’s best interests, broadly defined, and falls within the Zone of Parental Discretion, however healthcare practitioners who support parents may have professional concerns in doing so. (shrink)

The study of complexity in chronic care is an emergent discipline that has not yet developed a consistent theoretical framework. Thinking in the field of complexity encompasses complexity science and complexity theories, which represent a convergence of different types of ideas and theories that focus on the interactions of individual parts that make up a complex system. In this context, an important distinction is to be made between "complex" and "complicated." If a system—despite the fact that it may consist of (...) a huge number of components— can be given a complete description in terms of its individual constituents, such a system is merely complicated. An example could be computers. In a complex system, on the .. (shrink)