Genetic knowledge – is it morally permissible to use genetic information in the context of life insurance?

Abstract

Private life insurance is a social co-operative mechanism facilitated by an insurer through which policyholders seek to protect themselves from the adverse financial consequences of uncertain future events such as death, disability or illness in return for the payment of a premium. To provide such protection an insurer seeks to ascertain the probability of such events manifesting. To do this it relies on medical and genetic information procured from the applicant for insurance by which it sets a commensurate premium. The moral ideal of this mechanism, known as actuarial fairness, is to match the premiums as closely as possible to the likelihood (as calculated by the insurer) of a risk manifesting itself. The Human Genome Project (HGP) has enabled insurers to calculate risks more finely. It is this capability and the use of genetic information that has given rise to considerable debate. On the one hand there are those (characterised as exclusionists) who object to the use of genetic information in the insurance context, saying that a person should not be prejudiced for something that they do not have any control over. On the other, there are those (characterised as inclusivists) who say that it would be unfair to the other members of the risk pool if the use of genetic information were forbidden. The purpose of this thesis is to explore the moral foundations of the exclusionist and inclusivist arguments, evaluate their plausibility and finally advance an argument that the use of genetic information in the context of private life insurance can be morally justified if viewed through the lens of the social contract theory espoused by John Rawls.