Genetic information and life insurance: a proposal for an ethical European policy.

Abstract

Developments in molecular biology will enable development of tests for genetic predisposition to multifactorial diseases. People identified with increased risk might be able to prevent or delay the onset of illness by medical treatment and/or changing their environmental exposure. But tests might also help organizations, such as employers, insurers, and government bodies, to minimize their future economic risks. This article searches for an ethical and feasible European policy for the use of genetic information in life insurance. It first argues that genetic information is not so relevantly different from at least one other kind of medical information, that of HIV infection, that it justifies unlike policy treatment. European life insurance is then claimed to be a non-primary social good which should be handled by the private market. The problem of adverse selection is argued to be a reasonably serious threat. Insurers should therefore be allowed to demand some genetic risk information in order to secure the sustainability of insurance schemes. However, the moral principles and values of autonomy, privacy, non-discrimination, non-deterrence, solidarity and confidentiality, put limits on insurers justified information demands. The article ends up advocating a regime of limited community-rated private life insurance, first proposed by a Dutch committee. It stipulates that insurers should be forbidden to demand genetic tests as a condition for an insurance contract, but be allowed to ask for existing genetic information when the sought insurance cover is above a certain limit.