Newson Ainsley J, Ayres Sam, Boyle Jackie, Gabbett Michael T, Nisselle Amy
The University of Sydney,Faculty of Medicine and Health,Sydney School of Public Health,Sydney Health Ethics,Sydney,New South Wales,Australia.
Victorian Clinical Genetics Services,Murdoch Children's Research Institute,Melbourne,Victoria,Australia.
Twin Res Hum Genet. 2018 Dec;21(6):533-537. doi: 10.1017/thg.2018.60. Epub 2018 Nov 21.
The expansion of genetic and genomic testing in clinical practice and research and the growing market for at home personal genome testing has led to increased awareness about the impact of this form of testing on insurance. Genetic or genomic information can be requested by providers of mutually rated insurance products, who may then use it when setting premiums or determining eligibility for cover under a particular product. Australian insurers are subject to relevant legislation and an industry standard that was updated in late 2016. In 2018, the Human Genetics Society of Australasia updated its position statement on genetic testing and life insurance to account for these changes and to increase the scope of the statement to include a wider scope of insurance products that are not rated according to community risk, such as life, critical care, and income protection products. Recommendations include that providers of professional education involving genetics should include ethical, legal, and social aspects of insurance discrimination in their curricula; that the Australian government take a more active role in regulating use of genetic information in personal insurance, including enacting a moratorium on use of genetic test results; that information obtained in the course of a research project be excluded; and that there is improved engagement between the insurance industry, regulators, and the genetics profession.
临床实践与研究中基因检测和基因组检测的扩展,以及家庭个人基因组检测市场的不断增长,使得人们越来越意识到这种检测形式对保险的影响。相互评级保险产品的提供商可能会要求提供基因或基因组信息,然后在设定保费或确定特定产品的承保资格时使用这些信息。澳大利亚的保险公司受相关立法和一项于2016年末更新的行业标准约束。2018年,澳大利亚人类遗传学会更新了其关于基因检测和人寿保险的立场声明,以考虑这些变化,并扩大声明范围,将更多不按群体风险评级的保险产品纳入其中,如人寿、重症护理和收入保障产品。建议包括:涉及遗传学的专业教育提供者应在课程中纳入保险歧视的伦理、法律和社会方面内容;澳大利亚政府应在规范个人保险中基因信息的使用方面发挥更积极的作用,包括颁布暂停使用基因检测结果的禁令;排除在研究项目过程中获得的信息;以及改善保险业、监管机构和遗传学专业之间的互动。