Jecker Nancy S
J Law Med Ethics. 1993 Spring;21(1):109-16. doi: 10.1111/j.1748-720x.1993.tb01236.x.
In this paper, I have pressed the general question, "Are private health insurers responsible for preventing the problems of equity and access that genetic discrimination would pose?" I have argued that socially responsible insurance companies will avoid genetic discrimination, even if they conceive of their social responsibility in narrow terms. The significance of this point extends beyond the specific question of genetic testing, and bears relevance to broader debates about reforming the nation's health care system. Ultimately, society's attraction to retaining a private health insurance market depends upon private health insurers affirming and meeting responsibilities to the wider society. How society and the insurance industry respond in the face of new genetic testing capabilities will be a moral guidepost indicating how we as a society should devise and implement health care reform.
在本文中，我探讨了一个一般性问题：“私人健康保险公司是否有责任防止基因歧视可能带来的公平性和可及性问题？” 我认为，具有社会责任感的保险公司会避免基因歧视，即便它们对社会责任的理解较为狭隘。这一点的意义不仅限于基因检测这一具体问题，还与关于国家医疗保健系统改革的更广泛辩论相关。最终，社会对保留私人健康保险市场的青睐取决于私人健康保险公司对更广泛社会履行并承担责任。社会和保险业面对新的基因检测能力时的反应，将成为一个道德标杆，指示我们作为一个社会应如何设计和实施医疗保健改革。
