Four thousand years ago, the ancient Egyptians developed a home test for pregnancy. The woman’s urine was sprinkled onto bags of wheat and barley seeds. If the barley grew, the woman would have a boy, if the wheat grew it would be a girl. If neither sprouted, then the woman wasn’t pregnant.
Amazingly, when scientists came to test the test in the 20th century, it proved to be correct 70 per cent of the time – in other words, better than any lucky coincidence. But when it came to the development of 20th century pregnancy testing, it took a long time before women were given the right, or opportunity, to test at home for themselves.
From the 1920s to the 1960s, pregnancy testing was controlled by the medical profession, and the only way a woman could find out for certain if she was pregnant was by becoming a patient. Laboratories would only give the results of pregnancy tests to doctors and not to women.
Even when commercial laboratories began offering a direct service to women, many doctors (and the BMA) were opposed, arguing that pregnancy was a serious medical condition and women could not be trusted to deal with the results of a test which could be wrong. Women could be ‘risking their lives’.
Obviously all this changed as campaigners argued successfully in the late ‘60s and ‘70s that it was a woman’s right to know, and they were perfectly capable of understanding the implications of the test and its result.
Today, quite apart from pregnancy testing, there are self test kits that can be used in privacy by individuals for many conditions. These include bowel cancer, cholesterol levels, irritable bowel syndrome, blood glucose levels for diabetics and gluten intolerance. And of course they can be accessed online as well as on the high street. In France it’s now actually compulsory for drivers to carry a self-test kit for alcohol levels in their car.
There are important issues surrounding this growing phenomenon. Among the most important are: is the test safe? Is it easy to use? Might it cause distress or pain? What are the risks of using it against the benefit it offers? How accurate is it? Can the results be easily interpreted and are they accurate? The answers to these questions are not always straightforward, and even among the experts there may be differing views as to what is safe, and how the user can best interpret and act on the results.
In addition, we’ve seen a huge rise in commercial organisations offering health screening and testing for specific conditions, many through the internet. These too raise ethical issues about how such testing is controlled, the risk versus the benefit, and who should have access to the results.
It’s been recently reported that researchers in Finland have identified what could be the ultimate self-test – one which will reliably predict the chance of a healthy person dying within five years of taking the test. It measures four particular bio-markers in the blood that are linked to liver and kidney function, infection and the condition of veins and arteries.
Such a test obviously has far-reaching implications and it may be a long time before it’s widely used. But it’s clear that self-testing is here to stay, and it’s an issue we’ll all need to know more about. In many areas, what is not available now is likely to be developed and approved for use in the future.