Abstract
Basic research will spur development of genetic tests that are capable of presymptomatic prediction of disease, disability, and premature death in presently asymptomatic individuals. Concerns have been expressed about potential harms related to the use of genetic test results, especially loss of confidentiality, eugenics, and discrimination. Existing laws and administrative policies may not be sufficient to assure that genetic information is used fairly. To provide factual information and conceptual principles upon which sound social policy can be based, the Human Genome Initiative established an Ethical, Legal, and Social Issues Program. Among the first areas to be identified as a priority for study was insurance. This paper provides a review of life, health, and disability insurance systems, including basic principles, risk classification, and market and regulatory issues, and examines the potential impact of genetic information on the insurance industry.
Full text
PDF












Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Billings P. R., Kohn M. A., de Cuevas M., Beckwith J., Alper J. S., Natowicz M. R. Discrimination as a consequence of genetic testing. Am J Hum Genet. 1992 Mar;50(3):476–482. [PMC free article] [PubMed] [Google Scholar]
- Caskey C. T., Kaback M. M., Beaudet A. L. The American Society of Human Genetics statement on cystic fibrosis screening. Am J Hum Genet. 1990 Feb;46(2):393–393. [PMC free article] [PubMed] [Google Scholar]
- Crandall L., Moseley R. Public policy implications of scientific research: the human genome initiative and the future of insurance. New Biol. 1991 Dec;3(12):1135–1136. [PubMed] [Google Scholar]
- Dewar M. A., Moseley R., Ostrer H., Crandall L., Nye D., Allen B. Genetic screening by insurance carriers. JAMA. 1992 Mar 4;267(9):1207–1208. doi: 10.1001/jama.1992.03480090055021. [DOI] [PubMed] [Google Scholar]
- Friedman E. The uninsured. From dilemma to crisis. JAMA. 1991 May 15;265(19):2491–2495. doi: 10.1001/jama.265.19.2491. [DOI] [PubMed] [Google Scholar]
- Gilbert S. K. The health insurance plight of patients with sickle cell disease. J Natl Med Assoc. 1986 Jul;78(7):663–665. [PMC free article] [PubMed] [Google Scholar]
- Gostin L. Genetic discrimination: the use of genetically based diagnostic and prognostic tests by employers and insurers. Am J Law Med. 1991;17(1-2):109–144. [PubMed] [Google Scholar]
- Holtzman N. A., Rothstein M. A. Eugenics and genetic discrimination. Am J Hum Genet. 1992 Mar;50(3):457–459. [PMC free article] [PubMed] [Google Scholar]
- Juengst E. T. Priorities in professional ethics and social policy for human genetics. JAMA. 1991 Oct 2;266(13):1835–1836. [PubMed] [Google Scholar]
- McKusick V. A. Genomic mapping and how it has progressed. Hosp Pract (Off Ed) 1991 Oct 15;26(10):74-84, 89-90. doi: 10.1080/21548331.1991.11705306. [DOI] [PubMed] [Google Scholar]
- Moseley Ray, Crandall Lee, Dewar Marvin, Nye David, Ostrer Harry. Ethical implications of a complete human gene map for insurance. Bus Prof Ethics J. 1991 Winter;10(4):69–82. [PubMed] [Google Scholar]
- Natowicz M. R., Alper J. K., Alper J. S. Genetic discrimination and the law. Am J Hum Genet. 1992 Mar;50(3):465–475. [PMC free article] [PubMed] [Google Scholar]
- Sullivan C. B., Rice T. The health insurance picture in 1990. Health Aff (Millwood) 1991 Summer;10(2):104–115. doi: 10.1377/hlthaff.10.2.104. [DOI] [PubMed] [Google Scholar]
