Matthew J Randell
Thesis Title: The social and ethical implications of type 1 diabetes screening in childhood
Health screening carries unique ethical considerations because, unlike the majority of healthcare, it entails offering medical testing to seemingly healthy populations. Type 1 diabetes (T1D) is an autoimmune condition preventing the body from producing its own insulin, requiring lifelong management, and is an example of a particularly ethically complex potential screening programme. T1D is often preceded by the presence of multiple islet autoantibodies, which can be detected in blood. Although there is no medical intervention able to prevent the eventual onset of symptomatic T1D, forewarning may facilitate earlier diagnosis and avoid potentially fatal complications. However, screening for T1D leaves people living with knowledge of their risk of future disease – a liminal state between health and disease that has under-researched psychosocial harms.
This project uses qualitative research methods with several participant groups, including those who have received equivocal screening results and ‘patients-in-waiting’ eligible for emerging drugs to delay symptomatic onset, as part of an empirical bioethics approach to explore the way different stakeholder groups construct and prioritise ethical principles in this context. By mapping these onto the UK National Screening Committee (UK NSC)’s ethical framework, this research contributes to ethical and social theory as well as the evaluation of T1D screening by the UK NSC.
Biography
While now focused on medical ethics in the context of screening programmes, Matthew originally graduated with a BSc in Virology and Immunology from the University of Bristol, where his final year research project developed a novel large-scale luminesce method for detecting islet autoantibodies (predictive of type 1 diabetes) in serum. Upon graduating, he worked as a Research Technician in that same laboratory and continued this work, and developing similar tests for antibodies to SARS-CoV-2, writing up both projects as a part-time Masters by Research.
Matthew’s long-standing interest in ethics, evidenced by his position as a lay member on a Health Research Authority Research Ethics Committee, meant he became increasingly interested in the ethics of this disease prediction he had been working to facilitate. After completing an MA Social Science Research, Matthew began his ESRC-funded PhD in the social and ethical implications of screening for type 1 diabetes in childhood, which he is due to complete in Autumn 2026.
Since 2022, Matthew has also worked part-time with Warwick Screening, where he lectures on the ethical implications of screening programmes and reviews evidence from screening trials for the UK National Screening Committee as part of the Warwick-Birmingham Screening Evidence Synthesis Group (WeBS-ESG).
Publications
Quinn, Lauren M., Narendran, Parth, Bhavra, Kirandeep, Boardman, Felicity, Greenfield, Sheila M., Randell, Matthew J., Litchfield, Ian, Developing a General Population Screening Programme for Paediatric Type 1 Diabetes: Evidence from a Qualitative Study of the Perspectives and Attitudes of Parents, Pediatric Diabetes, 2024, 9927027, 10 pages, 2024. https://doi.org/10.1155/2024/9927027
Quinn LM, Narendran P, Randell MJ, et al. General population screening for paediatric type 1 diabetes—A qualitative study of UK professional stakeholders. Diabet Med. 2023; 40:e15131. doi:10.1111/dme.15131
Halliday A, Long AE, Baum HE, Thomas AC, Shelley KL, Oliver E, Gupta K, Francis O, Williamson MK, Di Bartolo N, Randell MJ, Ben-Khoud Y, Kelland I, Mortimer G, Ball O, Plumptre C, Chandler K, Obst U, Secchi M, Piemonti L, Lampasona V, Smith J, Gregorova M, Knezevic L, Metz J, Barr R, Morales-Aza B, Oliver J, Collingwood L, Hitchings B, Ring S, Wooldridge L, Rivino L, Timpson N, McKernon J, Muir P, Hamilton F, Arnold D, Woolfson DN, Goenka A, Davidson AD, Toye AM, Berger I, Bailey M, Gillespie KM, Williams AJK, Finn A. Development and evaluation of low-volume tests to detect and characterize antibodies to SARS-CoV-2. Front Immunol. 2022 Nov 9;13:968317. doi:10.3389/fimmu.2022.968317. PMID: 36439154; PMCID: PMC9682908.
Abstracts and Posters
M.J. Randell. “Nowhere left to turn? Genetic information, confidentiality, and an indecisive duty of care”. (Poster presentation). Socio-Legal Studies Association Annual Conference. March 26th-28th 2024, Portsmouth, UK, and Postgraduate Bioethics Conference. September 2nd-3rd 2024, Cambridge, UK.
M.J. Randell. “Is it worth it? Patient, relative, and at-risk perspectives on the ethics of screening for type 1 diabetes in childhood”. (Flash poster presentation). UK Type 1 Diabetes Research Consortium Scientific Meeting, November 23rd 2023, Bristol, UK.
M.J. Randell, L.M. Quinn., P. Narendran, S.M. Greenfield, F. Boardman, I. Litchfield. “Parents and providers’ views towards paediatric screening for type 1 diabetes in the UK”. (Oral presentation and poster). The 59th European Association for the Study of Diabetes Annual Meeting, October 2nd-6th 2023, Hamburg, Germany. Diabetologia 66 (Suppl 1), 1–536 (2023). https://doi.org/10.1007/s00125-023-05969-6
M.J. Randell; K. T. Elvers; V. Lampasona; A. J. K. Williams; K. M. Gillespie; A. E. Long (2022). P72 Development of a novel, low volume, non-radioactive luminescence method of detecting islet autoantibodies in serum for large-scale screening Poster abstracts. Diabet. Med., 39: e14810. https://doi.org/10.1111/dme.14810
Health & Wellbeing
University of Warwick
2022 Cohort, 1+3
matthew.j.randell@warwick.ac.uk
Supervisory Team
Prof Felicity Boardman
Prof Parth Narendran
Prof Sheila Greenfield