title: Genetic 'risk carriers' and lifestyle 'risk takers'. Which risks deserve our legal protection in insurance?
abstract: Over the past years, one of the most contentious topics in policy debates on genetics has been the use of genetic testing in insurance. In the rush to confront concerns about potential abuses of genetic information, most countries throughout Europe and the US have enacted genetics-specific legislation for insurance. Drawing on current debates on the pros and cons of a genetics-specific legislative approach, this article offers empirical insight into how such legislation works out in insurance practice. To this end, ethnographic fieldwork was done in the underwriting departments of Belgian insurance companies. Belgium was one of the first European countries introducing genetics-specific legislation in insurance. Although this approach does not allow us to speak in terms of ' the causal effects of the law', it enables us to point to some developments in insurance practice that are quite different than the law's original intentions. It will not only become clear that the Belgian genetics-specific legislation does not offer adequate solutions to the underlying issues it was intended for. We will also show that, while the legislation's focus has been on the inadmissibility of genetic discrimination, at the same time differences are made in the insurance appraisal within the group of the asymptomatic ill. In other words, by giving exclusive legal protection to the group of genetic risks, other non-genetic risk groups are unintendedly being under-protected. From a policy point of view, studying genetics-specific legislation is especially valuable because it forces us to return to first principles: Which risks deserve our legal protection in insurance? Who do we declare our solidarity with?
authors.affiliation: Health Care Ethics and Philosophy, Faculty of Health Care Sciences, University of Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands. i.vanhoyweghen@zw.unimaas.nl
authors.forename: Ine
authors.initials: I
authors.lastname: Van Hoyweghen
authors.forename: Klasien
authors.initials: K
authors.lastname: Horstman
authors.forename: Rita
authors.initials: R
authors.lastname: Schepers
mesh_terms: D000206:Actuarial Analysis; D003219:Confidentiality; D030661:Genetic Privacy / Q000331:legislation & jurisprudence*; D005820:Genetic Testing / Q000331:legislation & jurisprudence*; D033161:Government Regulation; D006801:Humans; D015273:Insurance Selection Bias; D007348:Insurance, Health / Q000331:legislation & jurisprudence*; D008019:Life Style; D011287:Prejudice; D018570:Risk Assessment / Q000331:legislation & jurisprudence / Q000379:methods