The gene dilemma: Testing question for insurance firms
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Your support makes all the difference.INSURANCE companies are considering whether to ask applicants if they have undergone a genetic test, just as they now ask about tests for HIV, write Susan Watts and Tom Wilkie.
The question could be routinely included on application forms. If the answer were 'yes', the companies would expect to be given the results. These might indicate whether someone will die of, for instance, the degenerative brain disease Huntington's Chorea, or what their chances are of developing heart disease.
This echoes the position on HIV and Aids. An HIV test is not a prerequisite to getting insurance, but if a potential client has had a test he or she is expected to disclose the result.
A spokesman for the Association of British Insurers said that while companies had 'no plans' to introduce genetic screening as a prerequisite to insurance, the industry had to weigh up two conflicting issues. 'We must make sure our stance is not one that stops people having the tests, and make sure we have the best information available to underwrite our risks - for the sake of our shareholders and other clients.'
The ABI has yet to establish how it might respond once it had the results of a genetic test. The result of a genetic test would be less clear-cut than one for HIV, where a positive result indicates with near certainty that the applicant will die of an Aids-related condition, but not when. In contrast, two people with identical defects in their DNA can suffer vastly different effects.
The Nuffield Council on Bioethics has warned that many health professionals are concerned that there could be 'undue pressure to be screened, inappropriate demands for disclosure of test results, the misinterpretation of results, and the breaking of confidentiality' - all of which run counter to ethical practice. Programmes of genetic screening that could benefit individuals and families 'may be hampered by fears relating to insurance', said the council's report, published last month.
The council recommended a moratorium on the use of genetic data by the insurance industry. But its recommendation was weakened by a qualification that if anyone applied for a policy of more than 'moderate size' then the insurers could seek genetic data. It quoted a precedent from the Netherlands where the upper limit for moderate policies was set at just pounds 65,000.
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