UK insurance companies should have access to genetic test results so they can set fair insurance premiums, according to an article published in the Lancet medical journal last week. Nick Raithatha and Richard Smith, both health economists at the University of East Anglia in Norwich, UK, argue that information from genetic tests is no different from the other types of medical information used by insurers. They conclude that genetic tests do not present any new ethical dilemmas, but that doctors need to reassure patients that they will be dealt with in a similar way to other medical test results.
The potential use of genetic test results by insurance companies has triggered concerns that families affected by genetic disorders will face unfair discrimination when applying for policies. Partly in response to these fears, the UK's Association of British Insurers (ABI) agreed to impose a five-year moratorium on the use of genetic test results, which is due to expire in November 2006. The self-imposed industry ban followed a previous decision by the UK Department of Health's Genetics and Insurance Committee (GAIC) to allow insurers to use test results for the rare genetic condition Huntington's disease, for life insurance. GAIC was re-formed with an extended remit in 2002, and has recently published its second annual report, in which it says that insurance companies have all complied with the moratorium. However, GAIC is currently considering 17 other applications by insurers to use genetic test results, including those for inherited breast cancer and early onset Alzheimer's disease.
The authors of the Lancet article say that the lack of information on the links between a person's genes, lifestyle and future health may mean that the use of genetic tests by insurers might be inappropriate, rather than unethical. But they also say that compared to other medical tests - for example, blood cholesterol tests - genetic testing poses 'no new ethical issues compared with already accepted (non-genetic) practices adopted by insurance companies'. In fact, they say, 'the present inconsistency concerning the disclosure of results of genetic and non-genetic based tests seems unethical', because people withholding genetic tests results have an unfair advantage over those who reveal the results of other medical tests.
However, Dr Helen Wallace, of the pressure group Genewatch, said that people with a family history of a disease already face a difficult decision about getting information from genetic tests, without the need for extra anxiety. 'The insurance industry claims that if it doesn't press for this information, it could be cheated by customers who use it to take out extra cover', she said, adding that 'there has never been any evidence for this'. She called for the current moratorium on the use of genetic test results by insurers to be turned into a law.