Lemmens T
Faculty of Law and Department of Medical Genetics and Microbiology, University of Toronto, Canada.
McGill Law J. 2000 May;45(2):347-412.
This article discusses the desirability of legislation focusing on genetic discrimination, in particular in the context of insurance. Many American states and some European countries as well as the Council of Europe have introduced protective measures against discrimination on the basis of genetic susceptibility. The author questions their effectiveness and queries whether they may be inequitable, because they fail to address more fundamental underlying issues related to the nature of insurance, access to health care, and unequal distribution of wealth. There is also a problem of definition in these statutes. They fail to capture what constitutes genetic information. Nonetheless, the author argues it is important to consider the social consequences of genetic testing. Michael Walzer's theory of justice is used to examine the role of insurance and health care. Using this approach, the author finds the American system of distribution for health care to be problematic. This is then used to inform the author's discussion of the future of health care in Canada. Anti-discrimination provisions could be used in a way that is consistent with Walzer's theory of justice. They would encompass both genetic and non-genetic health factors. These can be modelled on current anti-discrimination statutes in Canada. The author then proposes administrative committee structures to regulate the use of genetic data in Canada.
本文讨论了制定聚焦基因歧视的立法的可取性，尤其是在保险领域的背景下。许多美国州、一些欧洲国家以及欧洲委员会都已出台针对基于基因易感性的歧视的保护措施。作者质疑这些措施的有效性，并质疑它们是否可能不公平，因为它们未能解决与保险性质、医疗保健获取以及财富分配不均相关的更根本的潜在问题。这些法规还存在定义问题。它们未能明确什么构成基因信息。尽管如此，作者认为考虑基因检测的社会后果很重要。迈克尔·沃尔泽的正义理论被用于审视保险和医疗保健的作用。通过这种方法，作者发现美国的医疗保健分配体系存在问题。这进而为作者对加拿大医疗保健未来的讨论提供了参考。反歧视条款可以以与沃尔泽的正义理论相一致的方式使用。它们将涵盖基因和非基因健康因素。这些可以以加拿大现行的反歧视法规为蓝本。作者随后提议设立行政委员会结构来监管加拿大基因数据的使用。
