Genetic Testing in Insurance Underwriting: A Blessing or a Curse - An Examination of the Tension between Economics and Equity in Using Genetic Testing in Risk Classification
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GENETIC TESTING IN INSURANCE UNDERWRITING:
A BLESSING OR A CURSE? AN EXAMINATION OF
THE TENSION BETWEEN ECONOMICS AND
EQUITY IN USING GENETIC
TESTING IN RISK
CLASSIFICATION
INTRODUCTION
The Human Genome Project (HGP) is a federally funded pro-
gram established for the purpose of mapping and sequencing all
human genes.' The dramatic genetic advances resulting from the
HGP have given rise to hope of finding additional approaches to the
prevention and cure of diseases.2 However, these same advances also
lead to ethical problems relating to right to privacy and discrimina-
tion.3 Some of the deepest fears of society relate to the confidentiality
of genetic test results and to the discriminatory effect of genetic test-
ing on the issuance of insurance.4 Moreover, physicians also fear that
stigmatization, which would undoubtedly accompany denial of insur-
ance coverage, would prevent individuals from seeking early diagno-
sis and treatment, thereby aggravating the existing problem of
escalating health care costs and uninsurability in the United States.5
1. H.R. 2045, 102d Cong., 1st Sess. § 2(6-7)(1991) [hereinafter H.R. 2045]; Rossiter
& Caskey, Molecular Studies of Human Genetic Disease, 5 FED'N. AM. SOCIETIES FOR
EXPERMENTAL BIOLOGY J. 21, 24-25 (1991). The authors state that the ultimate goal of
the Human Genome Project is to enable clinical geneticists to study the mechanism of
genetic diseases and to provide molecular diagnoses of genetic disorders. This goal
could be achieved by locating an individual's entire complement of genes and deci-
phering the message encoded in each gene. Id.
2. AMERIcAN COUNCIL OF LIFE INS. & HEALTH INS. ASS'N OF AM., REPORT OF
THE ACLI-HIAA TASK FORCE ON GENETIC TESTING 1 (1991) [hereinafter ACLI-HIAA].
3. OFFICE OF TECHNOLOGY AssESsMENT, GENETIC MONITORING AND SCREENING
IN THE WORKPLACE 15 (1990). The report states that if the method used in genetic test-
ing as well as the use of information resulting from such testing are in accord with
ethical principles, then genetic testing is ethically justifiable. The report also notes
that job applicants and employees believe in the confidentiality of all genetic informa-
tion to prevent the use of such information to deprive them of opportunities and bene-
fits such as job and health insurance. Id.
4. ACLI-HIAA, supra note 2, at 2.
5. Meyer, Battle Brews Over Genetic Screening, Am. Med. News, Nov. 25, 1991,
at 3, col. 3, at 24, col 2. See Friedman, The Uninsured, From Dilemma to Crisis, 265 J.
AM. MED. ASS'N 2191, 2494 (1991). Friedman notes that because of delays in diagnosis
and treatment, the savings obtained from cost-effective prevention and treatment of
the disease conditions are lost when the diseases progress to severe illnesses. These ill-
nesses are associated with higher morbidity and they require high-cost emergency and
specialty treatments. Id. For example, the simple careful review of foot care for a dia-
betic may avoid life threatening gangrene and potential amputations. Id.](ViewImageLocal?handle=hein.journals/creigh25&div=72&collection=&method=preview&ext=.png&size=3)
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