.. the fundamental principle of the insurance business is “pooling uncertainty.” The concept of adverse selection also causes insurers much dismay. Adverse selection refers to the probability that people privately aware of a medical problem are more likely to seek medical insurance. This negates the insurers policy of setting premiums with accordance to statistical information on the rates of illnesses and sicknesses in society. “The whole foundation of insurance is based on the fact that we and the insurance applicant are operating with equal levels of knowledge and ignorance.” Without this level of ignorance, insurance companies will lose their social value as a means of spreading risk across groups of people.
Genetic engineering with respect to insurance does not stop here. Further development could lead to a complete knowledge of who will develop a disease and when. This will drastically effect the practicality of life insurance policies. “I can see 20 or 30 years from now that life insurance policies will be essentially accident policies, because everything else will be foreseeable. The essence of insurance is you assess a risk against the unknown; if there’s no medical unknown, the only unknown is whether you’re going to get hit by a bus.” Another striking danger of insurance companies discriminating with respect to a person’s DNA profile is with infants.
The companies may become extremely hesitant in insuring babies who have a high susceptibility to certain diseases. In fact there have been some cases where the insurers actually demanded the parents to abort the fetus or risk losing insurance. This obviously constitutes a blatant violation of people’s rights. Plus, it dangerously causes the insurance companies to begin to play the role of God, that is, in deciding who should live and who should not. “By agreeing to pay for some infants and not for others, insurance companies could inadvertently practice a form of economic eugenics, based not on grand designs for a superrace but on who requires the least expensive medical care.” Perhaps, some form of national health insurance is the only remedy for these problems.
“Genetic testing may provide the best reason yet for a nationalized health-care policy.” But insurance companies are not the only private entities with the potential to discriminate against people with unfavorable genetic profiles. Employers, too, have a substantial financial risk in hiring an employee with an above average propensity for illness or early death. Ellen spent four years completing her PhD in industrial and chemical engineering. Now, wincing as a company doctor drew a few drops of blood for her preemployment physical, she could hardly contain her excitement about the job she’d been offered at one of the country’s fore- most metallurgical research institutes. Two days later the phone call came. You are perfectly healthy, the young doctor said.
But tests have revealed you harbor a gene that can result in decreased levels of a blood enzyme, glucose-6-phosphate dehydrogenase. With- out the enzyme’s protection, you have a slightly increased risk of developing a red blood cell disease if you come into contact with certain chemicals in our laboratory. I’m sorry, he said. The job has been offered to someone else. As Ellen’s case shows, the danger of discrimination certainly does not end with health insurance. There is also a grave danger of discriminatory hiring practices in the workplace. In 1989, Jonathan Beckwith, a geneticist at Harvard, and Dr.
Paul Billings, director of the division of genetic medicine at Pacific Presbyterian Hospital in San Francisco, completed a small-scale study of genetic discrimination. Of 55 responses, Billings and Beckwith could document 29 people who reported multiple instances of discrimination by adoption agencies, employers and insurers. And the percentages will only get worse as more and more companies implement genetic screening policies. In a survey of 400 U.S. firms conducted in 1990, 15 percent of companies responded that by the year 2000, they planned to check the health status of not only their prospective employees, but their dependents as well before making a job offer. These statistics show all too well the impending problem with genetic discrimination in the workplace.
Employers will have a number of potential justifications for genetic testing in the workplace. In some cases, there may be an argument in favor of testing for public health reasons. Fortunately, judges and juries have predicted these justifications and have began to make the necessary rulings to ensure true justification for discrimination. The relevant judicial opinions indicate that there will have to be a significant or reasonable likelihood of harm to others from having the individual employed. Hopefully, rulings such as these will serve their purpose in protecting the right of all citizens. With the balance of interests laid out (individuals concerned about confidentiality and discrimination, and insurers and employers concerned about adverse selection and fiscal liability), it will fall upon legislators and the courts to define the proper use of genetic information. Policy makers will have to confront an apparent discrepancy between the reality of genetic variability and the democratic ideal that all citizens are “created equal.” The information itself is not the problem.
What matters is how the knowledge is used. Scientific advancements are not to blame. “What science does is give society opportunities. What we have to do is look at these opportunities and then set up the constraints and the rules that will allow society to benefit in appropriate ways.” Without the proper constraints, the price of glimpsing one’s medical future is high indeed. DNA profiling can be an extremely beneficial tool in the war against crime.
However, when used for discriminatory purposes, this tool becomes a crime in itself. The ability to compare and contrast a person’s genetic code with another should not be taken lightly, for with this great knowledge comes great responsibility. If not used wisely, this ability of the few.. will develop into a disability for the many. Bibliography “One Worked; The Other Didn’t,” Science 5 Jan.
199018. William C. Thompson, “DNA Evidence in Criminal Law: New Developments,” Trial August 199437. Thomas J. Mack, “Scientific Testimony After Daubert: Some Early Returns from Lower Courts,” Trial August 199425. Thompson42. Roger Lewin, “Limits to DNA Fingerprinting,” Research News 24 Mar.
19891550. Mack39. Thompson47. Thompson45. Thomas Hobbes, “The Case Against Anarchy,” 1651158. Council on Ethical and Judicial Affairs, AMA, “Use of Genetic Testing by Employers,” JAMA 2 Oct.
19911827. Rick Weiss, “Predisposition and Prejudice,” Science News 21 Jan. 198940. Shannon Browniee, “The Assurances of Genes,” U.S. News & World Report 23 Jul.
199059. Browniee57. Renee Twombly, “The Wider Implications,” Patient Care 15 Sep. 199420. Browniee57.
Browniee57. Weiss42. Browniee58. Browniee59. Weiss40. Browniee57. Browniee58.
JAMA 2 Oct. 19911827. David Orentlicher, MD, “Genetic Screening by Employers,” JAMA 16 Feb. 19901008. Weiss40.
Weiss42. WORKS CITED AMA. “Use of Genetic Testing by Employers,” JAMA. Oct 2, 19911827-1830. Beardsley, Tim.
“Fatal Flaw,” Scientific American. Dec. 199128-29. Browniee, Shannon. “The Assurances of Genes,” U.S. News & World Report. Jul.
23, 199057-59. Hobbes, Thomas. “The Case Against Anarchy,” Leviathan. 1651. L.R. “One Worked; The Other Didn’t,” Science.
Jan 5, 1990: 18. Lewin, Roger. “Limits to DNA Fingerprinting,” Research News. Mar 24, 19891549-1551. Mack, Thomas J.
“Scientific Testimony After DaubertSome Early Returns from Lower Courts,” Trial. Aug. 199423-31. Orentlicher, David, MD. “Genetic Screening by Employers,” JAMA. Feb 16, 19901005-1008.
Robertson, John A. “Liberty and Assisted Reproduction,” Trial. Aug, 1994: 49-53. Thompson, William C. “DNA Evidence in Criminal LawNew Developments,” Trial.
Aug, 199435-46. Twombley, Renee. “The Wider Implications,” Patient Care. Sep 15, 199420. Weiss, Rick. “Predispostion and Prejudice,” Science News.
Jan 21, 198940-42.