The use of genetic test information in insurance: The argument from indistinguishability reconsidered

Abstract

In the bioethical literature, discrimination in insurance on the basis of genetic risk factors detected by genetic testing has been defended and opposed on various ethical grounds. One important argument in favour of the practice is offered by those who believe that it is not possible to distinguish between genetic and non-genetic information, at least not for practical policy purposes such as insurance decision-making. According to the argument from indistinguishability, the use of genetic test information for insurance purposes should be permitted, because genetic test information is no different from non-genetic medical information in any relevant respect, therefore it would be inconsistent to prohibit the former whilst permitting the latter. This paper discusses and defends this argument and suggests a new, more tenable foundation.

Judicial Stereotyping Associated with Genetic Essentialist Biases toward Mental Disorders and Potential Negative Effects on Sentencing

“…There is evidence of genetic essentialist approaches to decisionmaking in other legal contexts besides sentencing, such as privacy (Kaye 1999), employment discrimination (Pagnatarro 2001), health insurance (Launis 2000), and reproductive law cases (Bender 2003). Thus, as genetic essentialist thinking is already present in other areas of legal decisionmaking and biases associated with such thinking are known to lead to negative outcomes for individuals being stereotyped, it is reasonable to think that genetic essentialist biases may negatively affect sentencing if an offender's essential characteristics are known to be genetically influenced.…”

Practical Importance of Genetic Research Results when Developing an Insurance Product for Personal Insurance: International Experience

“…The practice of medical underwriting in health insurance reflects what is often called "actuarial justice", based on the need to group entities with similar risks for the insurer to predict his costs and determine fair and sufficient insurance premium rates. Although the actuarial justice can be intuitively attractive, it is generally believed that it does not comply with the principle of justice from a moral and social point of view [9]. The main argument in favor of eliminating genetic discrimination in the health insurance system is the need to exercise the right to health care that cannot be made dependent on any merit, public contribution, or ability to pay.…”

“…At the same time, it is impossible not to note a different point of view. According to it, the use of genetic information for insurance purposes should be allowed because in some sense it does not differ from nongenetic medical information in any appropriate respect, therefore, it would be inconsistent to prohibit the first one, while allowing the latter [9]. In addition, the attention is drawn to the fact that the use of genetic information for life insurance is not something fundamentally new because insurers have been able to request information on the applicant's family history of diseases for decades.…”

Is genetic Information Family Property? Expanding on the Argument of Confidentiality Breach and Duty to Inform Persons at Risk

“…On an ethical basis, Juth (18) 4 and others (19)(20)(21)(22) also put genetic information on a par with other biological data normally used in clinical settings on the grounds that commonly advanced criteria for distinguishing between the two (intimate and personal information, predictive of future health conditions, transmittable to offspring, revealing about other relatives) are indeed shared by both genetic and other kinds of biomedical information. One of the two authors of this paper elaborates extensively on this topic; 5 Causalities in the Biomedical and Social Sciences.…”