Genetics and Life Insurance : Medical Underwriting and Social Policy

by Mark A. Rothstein (Ed.)

• ISBN13: 9780262182362
• ISBN10: 026218236X
• Edition: 1st
• Format: Hardcover
• Copyright: 2004-05-01
• Publisher: MIT PRESS

Summary

Insurance companies routinely use an individual's medical history and family medical history in determining eligibility for life insurance; this is part of the process of medical underwriting. Insurers have also long used genetic information, often derived from family history, in underwriting. But rapid advances in gene identification and genetic testing are changing the way we look at genetic information. Should the results of genetic testing (which might identify a predisposition toward disease not related to medical history) be available to life insurance medical underwriters? Few if any life insurers currently require genetic testing, but there are no laws or regulations prohibiting its use. Genetics and Life Insuranceexamines the complex economic, legal, and social issues surrounding the use of genetic information in life insurance underwriting. The contributors are legal scholars, representatives of the life insurance industry (including an actuary and an insurance physician), a geneticist, a genetic counselor, a philosopher, and a consumer advocate. They explore all aspects of an issue that has only recently drawn the attention of policymakers and the public. The book opens with a report on the results of a public opinion poll on genetics and life insurance. Succeeding chapters present the insurer perspective, a discussion of the economics of risk selection in life insurance, background information on the process of underwriting, a scientific analysis of genetic risks and mortality rates, a philosophical discussion of fairness and genetic underwriting, the viewpoints of consumers and genetics counselors, a comparison of different international policy approaches to the issue, and a legal analysis of antitrust implications when insurers collaborate in setting standards for medical underwriting. In the final chapter the editor addresses various policy options, examining the pros and cons of each one and assessing their political feasibility. Basic Bioethics series

Author Biography

Mark A. Rothstein is Herbert F. Boehl Chair of Law and Medicine and Director of the Institute for Bioethics, Health Policy, and Law in the School of Medicine at the University of Louisville

Table of Contents

Series Foreword	vii
Preface	ix
Introduction	xi
Contributors	xv
1. Public Attitudes	1	(26)
Mark A. Rothstein and Carlton A. Hornung
2. The Insurer Perspective	27	(22)
Roberta B. Meyer
3. The Economics of Risk Selection	49	(24)
Arnold A. Dicke
4. Medical Underwriting	73	(22)
Robert K. Gleeson
5. Genetic Risks and Mortality Rates	95	(24)
J. Alexander Lowden
6. The Functions of Insurance and the Fairness of Genetic Underwriting	119	(28)
Norman Daniels
7. Perspectives of Consumers and Genetics Professionals	147	(26)
Wendy R. Uhlmann and Sharon F. Terry
8. A Comparative International Overview	173	(22)
Bartha Maria Knoppers, Beatrice Godard, and Yann Joly
9. Antitrust Implications of Insurers' Collaborative Standard Setting	195	(22)
Robert H. Jerry II
10. A Consumer Agenda	217	(16)
J. Robert Hunter
11. Policy Recommendations	233	(34)
Mark A. Rothstein
Appendix: Life Insurance and Genetic Testing General Population Survey Questionnaire	267	(18)
Index	285