Ethical Challenges in Point-of-Care Testing for Cardiac Biomarkers: Balancing Rapid Diagnosis with Clinical Responsibility

The rapid expansion of point of care testing (POCT) has significantly transformed clinical decision-making, particularly in acute care settings. Cardiac biomarkers such as troponins (conventional and high sensitivity) and natriuretic peptides are increasingly being deployed at the bedside to expedite diagnosis and guide timely management [1]. While the clinical advantages of POCT are well recognized, its widespread implementation raises important ethical considerations that remain insufficiently addressed [2]. We aim to project that the rapid expansion of cardiac biomarker POCT has outpaced the development of practical ethical guidance for its implementation. In particular, challenges related to analytical reliability, accountability, quality oversight, equitable access, patient autonomy, and environmental sustainability require a structured ethical framework to support safe and clinically responsible use of POCT in cardiac care. One of the primary ethical concerns relates to the trade-off between speed and analytical accuracy. Although POCT offers faster turnaround times, variability in analytical performance compared to central laboratory assays may compromise diagnostic certainty [3]. This is particularly critical in the context of cardiac biomarkers, where even minor inaccuracies can lead to misclassification of myocardial infarction. In cardiac care, such errors carry particularly significant ethical implications because troponin results may directly influence urgent decisions regarding admission, invasive procedures, discharge, or withholding of treatment. This underscores the necessity of an ethical framework to ensure rapid testing does not compromise diagnostic integrity and patient safety.