Controversy over use of genetic test results reignited

A leading medical ethicist has argued that the results of genetic tests should be made available to insurers. Professor Soren Holm, from Cardiff Law School, says that the availability of such genetic information is in principle no different to other types of medical data already made available to life insurance companies. Insurance companies currently make premium decisions by taking into account a person's cholesterol levels, body mass index (BMI), existing illnesses and lifestyle, to determine possible risk of disease and predict lifespan.

Opponents and health charities have long argued against genetic information being disclosed, for fear of creating a genetic underclass facing higher insurance premiums as a result of a perceived higher risk of disease. One of the main arguments against disclosure highlights the fact that a positive genetic test may only translate into a minimally higher overall risk of a person developing that disease.

Professor Holm argues that genetic information is 'not inherently more specific, predictive, sensitive or private than other kinds of information. It is true that many so-called genetic risk factors are not well validated, but the same is true of other risk factors measured by non-genetic means'. His arguments appear in an article published by the British Medical Journal (BMJ) last week.

In the same issue of the BMJ, Professor Richard Ashcroft, a biomedical ethicist from Queen Mary, University of London, argued that insurers may use the information in a discriminatory way and stated that 'it is important to note how genetic information can be misunderstood, or its importance overestimated, and therefore used in discriminatory ways that would not be justified on sound actuarial grounds'. He highlighted the BRCA1 gene in breast cancer, which makes little difference to a woman's life expectancy, but which could be interpreted as a grave risk of the disease and early death by an insurance company.

A voluntary moratorium on the use of genetic test results by UK insurance companies was introduced in 2001, and has been extended until 2011. Under the agreement insurers can only ask for the results of genetic tests approved by the Genetics and Insurance Committee, and then only on life policies worth more than £500k. This currently only applies to the test for Huntington's disease, a fatal brain degenerative disease.

John French, from the Association of British Insurers, said that there were currently no plans to submit applications for any other genetic tests to be approved for use by insurers. He acknowledged that 'genetic technology is developing rapidly, but there is no certainty about the accuracy of particular genetic tests for diseases apart from Huntington's disease'.