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人寿保险中的基因歧视:来自英国基因支持群体横断面调查的实证证据。

Genetic discrimination in life insurance: empirical evidence from a cross sectional survey of genetic support groups in the United Kingdom.

作者信息

Low L, King S, Wilkie T

机构信息

Unit for Policy Research in Science and Medicine, Wellcome Trust, London NW1 2BE.

出版信息

BMJ. 1998 Dec 12;317(7173):1632-5. doi: 10.1136/bmj.317.7173.1632.

DOI:10.1136/bmj.317.7173.1632
PMID:9848905
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC28743/
Abstract

OBJECTIVES

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.

DESIGN

Postal questionnaire survey.

SUBJECTS

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.

MAIN OUTCOME MEASURES

Subjects were asked about their experiences with insurers, the medical profession, employers, and social services. Experiences with insurers are reported here.

RESULTS

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.

CONCLUSIONS

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.

摘要

目标

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。

设计

邮政问卷调查。

对象

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)。

主要观察指标

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。

结果

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。

结论

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。

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本文引用的文献

1
Individual, family, and societal dimensions of genetic discrimination: a case study analysis.基因歧视的个人、家庭和社会层面:一项案例研究分析
Sci Eng Ethics. 1996 Jan;2(1):71-88. doi: 10.1007/BF02639319.
2
Genetics and insurance in Britain: why more than just the Atlantic divides the English-speaking nations.英国的遗传学与保险:为何不止大西洋将英语国家分隔开来。
Nat Genet. 1998 Oct;20(2):119-21. doi: 10.1038/2416.
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A survey of medical directors of life insurance companies concerning use of genetic information.一项针对人寿保险公司医学总监关于基因信息使用情况的调查。
Am J Hum Genet. 1993 Jul;53(1):33-45.
4
A survey of state insurance commissioners concerning genetic testing and life insurance.一项针对州保险专员开展的关于基因检测与人寿保险的调查。
Am J Hum Genet. 1992 Oct;51(4):785-92.