Low L, King S, Wilkie T
Unit for Policy Research in Science and Medicine, Wellcome Trust, London NW1 2BE.
BMJ. 1998 Dec 12;317(7173):1632-5. doi: 10.1136/bmj.317.7173.1632.
To gather empirical evidence on any discrimination based on genetic information shown by the insurance industry in the United Kingdom and to assess how society is likely to handle future genetic information from tests for polygenic multifactorial conditions.
Postal questionnaire survey.
Sample (n=7000) of members from seven British support groups for families with genetic disorders and a representative sample (n=1033) of the general public who answered questions on applying for life insurance as part of an omnibus survey.
Subjects were asked about their experiences with insurers, the medical profession, employers, and social services. Experiences with insurers are reported here.
Altogether 33.4% of the study group had problems when applying for life insurance compared with 5% of applicants in the omnibus survey. Thirteen per cent of study respondents from subgroups who represented no adverse actuarial risk on genetic grounds reported that their treatment by insurers seemed to represent unjustified genetic discrimination.
Life insurers may not be operating a consistent policy for assessing genetic information or acting in accord with the actuarial risks brought to them. The inconsistency suggests error rather than a corporate policy of discrimination based on genetic characteristics. Any future proposals for genetic testing for common or multifactorial disorders should be examined carefully.
收集关于英国保险业基于基因信息存在任何歧视行为的实证证据,并评估社会未来可能如何处理来自多基因多因素疾病检测的基因信息。
邮政问卷调查。
来自七个英国遗传病患者家庭支持组织的成员样本(n = 7000),以及作为综合调查一部分回答人寿保险申请相关问题的公众代表性样本(n = 1033)。
询问受试者与保险公司、医疗行业、雇主和社会服务机构打交道的经历。此处报告与保险公司打交道的经历。
研究组中共有33.4%的人在申请人寿保险时遇到问题,而综合调查中的申请人这一比例为5%。代表在基因层面不存在不利精算风险的亚组中的13%的研究受访者表示,保险公司对他们的对待似乎构成了不合理的基因歧视。
人寿保险公司在评估基因信息时可能没有执行一致的政策,也没有根据带给他们的精算风险行事。这种不一致表明是失误而非基于基因特征的歧视性公司政策。未来任何针对常见或多因素疾病进行基因检测的提议都应仔细审查。