Genetic Testing, Conscientious Refusal of Medical Treatment to Children, and Organ Donation: An Introduction

Abstract

This second issue of the 35th volume of The Journal of Medicine and Philosophy (JMP) is a collection of articles on a variety of bioethical topics. Though not connected thematically, these papers share the high quality this journal strives to present in every issue, whether it is a thematic issue or a nonthematic, year after year. The first article in this issue of JMP is “Genetic nondiscrimination and healthcare as an entitlement” by Kious (2010). The author begins by noting that the US government outlawed most forms of genetic discrimination in health insurance in June, 2008, when then-President George W. Bush signed the Genetic Information Nondiscrimination Act of 2008 into law. This law prohibits insurers from requesting genetic tests from prospective costumers or using the results of previous genetic tests to determine customers’ eligibility for coverage or to determine their premiums. It, also, prohibits insurers from adjusting the premiums or policies or denying the claims of currently policyholders based on any genetic information obtained from any of a variety of these tests. According to Kious, most of the justifications for this law, and genetic nondiscrimination in general, “assume some form of genetic exceptionalism: they claim, or at least seem to claim, that there is something special about genetic information, or discrimination on the basis thereof, that makes such discrimination specially wrong, in contrast with discrimination on the basis of other sorts of information” (p. 87). Kious argues, however, that such reasoning is often mistaken, confused, and misleading. He argues further that the only plausible arguments against genetic discrimination, which ought to be accepted, are those which depend on the view that health care is an entitlement because it is this view that lays at the foundation, or at the very least as an unargued for presupposition, by all arguments against genetic discrimination in health care.