Genetic Discrimination

Abstract

Knowledge about the relationship between genes and health, as well as genes and behaviour, is expanding rapidly. Genetic and other predictive tests are becoming less expensive and so knowledge about individuals’ genetic backgrounds is likely to become commonplace. Although such information holds the promise of eventually being very useful in the context of improving health outcomes for individuals, it has long been recognised that this promise may be accompanied by the threat of increased genetic discrimination, most notably in insurance markets. Genetic discrimination may also arise in personal and social spheres of life. Each aspect creates different types of problems. Thus, different types of remedies or responses are in order. This article reviews the ethical and economic aspects of this new information from a variety of normative perspectives and considers the appropriateness of the sorts of regulations recently put in place to limit its adverse social implications.

Key Concepts:

  • Genetic information can lead to improved decision‐making and treatments for people's health but may also lead to discrimination in insurance markets and beyond.

  • Many academics and members of the public believe that charging different prices to different people based on genetic test results is unfairly discriminatory.

  • However, many insurance market analysts believe individuals at higher risk of death or higher need of healthcare should pay more for insurance regardless of what causes their higher risk status.

  • Economic arguments can be made that not charging risk‐relevant prices for insurance will discourage ‘better’ risks from participating in the market for insurance and this will lead to higher overall prices for insurance.

  • The conflicting views noted above have led to unresolved issues regarding the appropriate regulation of genetic information in the area of insurance pricing.

  • Genetic discrimination may also increase in areas of personal or social relations where market regulations are not effective remedies.

  • Education about genetic differences may be an appropriate alternative mechanism for dealing with genetic discrimination in the personal and social spheres.

Keywords: genetic tests; discrimination; social environment; insurance and employment; regulation

References

Alper JS and Natowicz MR (1993) Genetic testing and insurance. British Medical Journal 307: 1506–1507.

Bernheim BD, Forni L, Gokhale J and Kotlifkoff LJ (2003) The mismatch between life insurance holdings and financial vulnerabilities: evidence from the health and retirement study. American Economic Review 93(1): 354–365.

Davies K (2010) The $1000 Genome: The Revolution in DNA Sequencing and the New Era of Personalized Medicine. New York, NY: Free Press, Simon & Schuster.

Dionnes G, Doherty N and Fombaron N (2000) Adverse selection in insurance markets. In: Dionne G (ed.) Handbook of Insurance, pp. 185–243. Boston/Dordrecht/London: Kluwer Academic.

Dworkin R (2000) Sovereign Virtue: The Theory and Practice of Equality. Cambridge, MA: Harvard University Press.

Filipova L and Hoy M (2009) Genetic advances and health insurance. In: Costa‐Font J, Courbage C and McGuire A (eds) The Economics of New Health Technologies: Incentives, Organisation, and Technology, pp. 125–146. Oxford, NY: Oxford University Press.

Flew A (1990) Three concepts of racism. Encounter 75: 63–66.

Hamer DH (2005) The God Gene: How Faith Is Hard‐wired into Our Genes. New York, NY: Anchor Press.

Hoy M, Orsi F, Eisinger F and Moatti JP (2003) The impact of genetic testing on health care insurance. The Geneva Papers on Risk and Insurance: Issues and Practice 28(2): 203–221.

Hoy M and Polborn M (2000) The value of genetic information in the life insurance market. Journal of Public Economics 78: 235–252.

Hoy M and Ruse M (2005) Regulating genetic information in insurance markets. Risk Management and Insurance Review 8(2): 211–237.

Hoy M and Ruse M (2008) No solution to this Dilemma Exists: Discrimination, Insurance, and the Human Genome Project. Discussion Paper Number 2008‐8. Guelph, ON: Department of Economics University of Guelph, p. 35.

Kitcher P (1996) The Lives to Come: The Genetic Revolution and Human Possibilities. New York, NY: Simon and Schuster.

Knoppers B, Godard B and Joly Y (2004) Life insurance and genetics: a comparative, international overview. In: Rothstein M (ed.) Genetics and Life Insurance: Medical Underwriting and Social Policy, pp. 173–194. Cambridge, MA; London: MIT Press.

Pargetter R and Prior EW (1987) Discrimination and AIDS. Social Theory and Practice 13: 129–153.

Rosenberg A (2000) Privacy as a matter of taste and right. In: Paul EK, MillerFD Jr and Paul J (eds) The Right to Privacy, pp. 1–24. Cambridge, MA: Cambridge University Press.

Rothschild M and Stiglitz J (1976) Equilibrium in competitive insurance markets: an essay on the economics of imperfect information. Quarterly Journal of Economics 90(4): 630–649.

Thomas RG (2008) Loss coverage as a public policy objective for risk classification schemes. Journal of Risk and Insurance 75(4): 997–1018.

Williams ACJ (1969) Price discrimination in property and liability insurance. In: Denenberg HS and Kimball SL (eds) Insurance, Government and Social Policy, pp. 209–242. Homewood, IL: Richard D. Irwin Inc, University of Pennsylvania.

Wilson C (1977) A model of insurance with incomplete information. Journal of Economic Theory 16: 167–207.

Further Reading

Bonilla‐Silva E (1997) Rethinking racism: toward a structural interpretation. American Sociological Review 62: 465–480.

Daniels N (2004) The functions of insurance and the fairness of genetic underwriting. In: Rothstein M (ed.) Genetics and Life Insurance: Medical Underwriting and Social Policy. Cambridge, MA; London: MIT Press.

Durnin M, Hoy M and Ruse R (2012) Genetic testing and insurance: the complexity of adverse selection. Ethical Perspectives 19: 123–154.

Finkelstein A and Poterba J (2002) Selection effects in the United Kingdom individual annuities market. Economic Journal 112: 28–50.

Hoy M (2006) Risk classification and social welfare. The Geneva Papers on Risk and Insurance: Issues and Practice 31: 245–269.

Hoy M and Lambert PJ (2000) Genetic screening and price discrimination in insurance markets. The Geneva Papers on Risk and Insurance Theory 25: 103–130.

Hoy M and Witt J (2007) Welfare effects of banning genetic information in the life insurance market: the case of BRCA1/2 genes. Journal of Risk and Insurance 74(3): 523–546.

Pauly MV, Withers KH, Subramanian‐Viswana K, Lemaire J and Hershey JC (2003) Price Elasticity of Demand for Term Life Insurance and Adverse Selection. NBER working paper #9925. Cambridge, MA: National Bureau of Economics Research.

Polborn M, Hoy M and Sadanand A (2006) Advantageous effects of regulatory adverse selection in the life insurance market. Economic Journal 116: 327–354.

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Hoy, Michael(Nov 2014) Genetic Discrimination. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0005186.pub2]