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新西兰的保险公司对遗传信息的歧视:健康专业人员的经验和看法。

Genetic discrimination by insurance companies in Aotearoa New Zealand: experiences and views of health professionals.

机构信息

Genetic Health Service New Zealand - Northern Hub, Auckland City Hospital, Auckland, New Zealand.

Genetic Health Service New Zealand - Central Hub, Wellington Regional Hospital, Wellington, New Zealand.

出版信息

N Z Med J. 2023 Apr 28;136(1574):32-52. doi: 10.26635/6965.6116.

Abstract

AIMS

Genetic discrimination in insurance is a significant clinical, research and consumer issue. Recently, the Australian life insurance industry introduced a partial moratorium on the use of genetic test results. However, in Aotearoa New Zealand, both life and health insurers can still use genetic results legally to discriminate against applicants. We aimed to document experiences and concerns of New Zealand-based health professionals (HPs) around the potential misuse of genetic test results for insurance purposes.

METHODS

We administered an online survey to New Zealand HPs who discuss genetic testing with patients, their experiences regarding the use of genetic test results in insurance and views on regulation.

RESULTS

Twenty-three New Zealand HPs responded, 15 of whom worked in genetics clinics, representing >60% of the total New Zealand clinical genetics workforce. Eleven respondents reported having patients who experienced adverse outcomes related to insurance based on genetic results. Respondents reported patients sometimes/often delayed (n=11) or refused (n=4) genetic testing due to insurance concerns. Over 80% of those who answered (n=17/21) believe insurers' use of genetic results should be legally regulated.

CONCLUSION

New Zealand HPs have concerns about insurance companies using genetic test results in underwriting, including the effect on patients, and strongly believe government legislation is required.

摘要

目的

保险中的基因歧视是一个重大的临床、研究和消费者问题。最近,澳大利亚寿险业对基因检测结果的使用实行了部分暂停。然而,在新西兰,寿险和健康保险公司仍然可以合法地利用基因结果来歧视申请人。我们旨在记录新西兰卫生专业人员(HPs)在保险目的的基因检测结果潜在滥用方面的经历和担忧。

方法

我们向与患者讨论基因检测的新西兰 HPs 进行了在线调查,了解他们在保险方面使用基因检测结果的经验以及对监管的看法。

结果

23 名新西兰 HPs 做出了回应,其中 15 名在基因诊所工作,代表了新西兰全部临床遗传学工作人员的 60%以上。11 名受访者报告称,有患者因基因结果而在保险方面遭受不利后果。受访者报告称,由于担心保险问题,有些患者有时/经常推迟(n=11)或拒绝(n=4)进行基因检测。超过 80%的回答者(n=17/21)认为,保险公司使用基因结果应该受到法律监管。

结论

新西兰 HPs 对保险公司在承保中使用基因检测结果表示担忧,包括对患者的影响,并强烈认为需要政府立法。

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