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健康专业人士对澳大利亚基因检测和寿险禁令的看法和经验:一项定性研究。

Health professionals' views and experiences of the Australian moratorium on genetic testing and life insurance: A qualitative study.

机构信息

Public Health Genomics, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.

Murdoch Children's Research Institute, Parkville, Australia.

出版信息

Eur J Hum Genet. 2022 Nov;30(11):1262-1268. doi: 10.1038/s41431-022-01150-6. Epub 2022 Jul 28.

Abstract

Australian life insurance companies can legally use genetic test results in underwriting, which can lead to genetic discrimination. In 2019, the Financial Services Council (Australian life insurance industry governing body) introduced a partial moratorium restricting the use of genetic testing in underwriting policies ≤ $500,000 (active 2019-2024). Health professionals (HPs), especially clinical geneticists and genetic counsellors, often discuss the implications of genetic testing with patients, and provide critical insights into the effectiveness of the moratorium. Using a sequential explanatory mixed methods design, we interviewed 23 Australian HPs, who regularly discuss genetic testing with patients and had previously completed an online survey about genetic testing and life insurance. Interviews explored views and experiences about the moratorium, and regulation, in greater depth. Interview transcripts were analysed using thematic analysis. Two key themes emerged from views expressed by HPs during interviews (about matters reported to or observed by them): 1) benefits of the moratorium, and 2) concerns about the moratorium. While HPs reported that the moratorium reassures some consumers, concerns include industry self-regulation, uncertainty created by the temporary time period, and the inadequacy of the moratorium's financial limits for patients' financial needs. Although a minority of HPs felt the current industry self-regulated moratorium is an adequate solution to genetic discrimination, the vast majority (19/23) expressed concern with industry self-regulation and most felt government regulation is required to adequately protect consumers. HPs in Australia are concerned about the adequacy of the FSC moratorium with regards to consumer protections, and suggest government regulation is required.

摘要

澳大利亚的寿险公司可以合法地在核保过程中使用基因测试结果,这可能导致基因歧视。2019 年,澳大利亚寿险行业监管机构金融服务委员会(Financial Services Council)引入了一项部分暂停令,限制在不超过 50 万澳元的保险政策核保中使用基因测试(有效期为 2019 年至 2024 年)。医疗保健专业人员(HPs),尤其是临床遗传学家和遗传咨询师,经常与患者讨论基因检测的影响,并对暂停令的有效性提供关键见解。我们采用顺序解释性混合方法设计,采访了 23 名澳大利亚医疗保健专业人员,他们定期与患者讨论基因检测问题,并曾完成过一项关于基因检测和寿险的在线调查。采访深入探讨了他们对暂停令和监管的看法和经验。使用主题分析对访谈记录进行了分析。医疗保健专业人员在访谈中表达的观点(关于他们报告或观察到的事项)出现了两个关键主题:1)暂停令的好处,2)暂停令的担忧。虽然医疗保健专业人员报告说,暂停令使一些消费者感到放心,但他们也表示担心行业自我监管、临时期限造成的不确定性以及暂停令对患者财务需求的财务限制不足。尽管少数医疗保健专业人员认为目前行业自我监管的暂停令是解决基因歧视的一个适当解决方案,但绝大多数(23 人中的 19 人)对行业自我监管表示担忧,大多数人认为需要政府监管来充分保护消费者。澳大利亚的医疗保健专业人员对 FSC 暂停令在保护消费者方面的充分性表示担忧,并认为需要政府监管。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d22/9626480/449e47f6408b/41431_2022_1150_Fig1_HTML.jpg

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