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The Use of Genetic Testing Information in the Insurance Industry: An Ethical and Societal Analysis of Public Policy Options

Author

Listed:
  • Alexander Nill

    (University of Nevada Las Vegas)

  • Gene Laczniak

    (Marquette University)

  • Paul Thistle

    (University of Nevada Las Vegas)

Abstract

Informed by a search of the literature about the usage of genetic testing information (GTI) by insurance companies, this paper presents a practical ethical analysis of several distinct public policy options that might be used to govern or constrain GTI usage by insurance providers. As medical research advances and the extension to the Human Genome Project (2016, https://en.wikipedia.org/wiki/Human_Genome_Project_-_Write ) moves to its fullness over the next decade, such research efforts will allow the full synthesis of human DNA to be connected to predictive health dispositions. As testing costs fall, there will be ever more pressure for citizens to disclose GTI. Genetic testing information is integral to future medical care because it can be used to better assess individually tailored medical therapies as well as to allow a more informed risk analysis by the insurance industry, which in some countries such as the USA underwrites a majority of citizen medical expenses. As discussed in this examination, the revelation of people’s uniquely personal GTI to insurers has enormous societal implications. The major contribution of the paper is to offer policy makers and concerned citizens a nuanced articulation of the basic options to regulate GTI, with a special consideration for ethical fairness and equity. As genetic-based medicine blossoms and pressures to reduce healthcare costs increase, there will be an ever greater impetus for countries to revisit their genetic testing policies. Organizations and policy makers striving to create GTI oversights perceived to be both “fair and effective” need to be aware of the ethical perspectives discussed in this paper.

Suggested Citation

  • Alexander Nill & Gene Laczniak & Paul Thistle, 2019. "The Use of Genetic Testing Information in the Insurance Industry: An Ethical and Societal Analysis of Public Policy Options," Journal of Business Ethics, Springer, vol. 156(1), pages 105-121, April.
    • Handle: RePEc:kap:jbuset:v:156:y:2019:i:1:d:10.1007_s10551-017-3554-y
    DOI: 10.1007/s10551-017-3554-y
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    References listed on IDEAS

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    1. Maureen Durnin & Michael Hoy & Michael Ruse, 2012. "Genetic Testing and Insurance: The Complexity of Adverse Selection," Working Papers 1208, University of Guelph, Department of Economics and Finance.
    2. Cardon, James H & Hendel, Igal, 2001. "Asymmetric Information in Health Insurance: Evidence from the National Medical Expenditure Survey," RAND Journal of Economics, The RAND Corporation, vol. 32(3), pages 408-427, Autumn.
    3. Oster, Emily & Shoulson, Ira & Quaid, Kimberly & Dorsey, E. Ray, 2010. "Genetic adverse selection: Evidence from long-term care insurance and Huntington disease," Journal of Public Economics, Elsevier, vol. 94(11-12), pages 1041-1050, December.
    4. Xavier Landes, 2015. "How Fair Is Actuarial Fairness?," Journal of Business Ethics, Springer, vol. 128(3), pages 519-533, May.
    5. Georges Dionne & Casey Rothschild, 2014. "Economic Effects of Risk Classification Bans," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 39(2), pages 184-221, September.
    6. Michael Rothschild & Joseph Stiglitz, 1976. "Equilibrium in Competitive Insurance Markets: An Essay on the Economics of Imperfect Information," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 90(4), pages 629-649.
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    Cited by:

    1. Martin Eling & Irina Gemmo & Danjela Guxha & Hato Schmeiser, 2024. "Big data, risk classification, and privacy in insurance markets," The Geneva Risk and Insurance Review, Palgrave Macmillan;International Association for the Study of Insurance Economics (The Geneva Association), vol. 49(1), pages 75-126, March.
    2. Cameron Graham & Martin E. Persson & Vaughan S. Radcliffe & Mitchell J. Stein, 2023. "The State of Ohio’s Auditors, the Enumeration of Population, and the Project of Eugenics," Journal of Business Ethics, Springer, vol. 187(3), pages 565-587, October.
    3. Michele Loi & Christian Hauser & Markus Christen, 2022. "Highway to (Digital) Surveillance: When Are Clients Coerced to Share Their Data with Insurers?," Journal of Business Ethics, Springer, vol. 175(1), pages 7-19, January.

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