Genetics and Life Insurance

From Basic Bioethics

Genetics and Life Insurance

Medical Underwriting and Social Policy

Edited by Mark A. Rothstein

Experts discuss the economic, legal, and social issues surrounding the use of genetic testing in determining eligibility for life insurance.





Experts discuss the economic, legal, and social issues surrounding the use of genetic testing in determining eligibility for life insurance.

Insurance companies routinely use an individual's medical history and family medical history in determining eligibility for life insurance; this is part of the process of medical underwriting. Insurers have also long used genetic information, often derived from family history, in underwriting. But rapid advances in gene identification and genetic testing are changing the way we look at genetic information. Should the results of genetic testing (which might identify a predisposition toward disease not related to medical history) be available to life insurance medical underwriters? Few if any life insurers currently require genetic testing, but there are no laws or regulations prohibiting its use. Genetics and Life Insurance examines the complex economic, legal, and social issues surrounding the use of genetic information in life insurance underwriting. The contributors are legal scholars, representatives of the life insurance industry (including an actuary and an insurance physician), a geneticist, a genetic counselor, a philosopher, and a consumer advocate. They explore all aspects of an issue that has only recently drawn the attention of policymakers and the public.

The book opens with a report on the results of a public opinion poll on genetics and life insurance. Succeeding chapters present the insurer perspective, a discussion of the economics of risk selection in life insurance, background information on the process of underwriting, a scientific analysis of genetic risks and mortality rates, a philosophical discussion of fairness and genetic underwriting, the viewpoints of consumers and genetics counselors, a comparison of different international policy approaches to the issue, and a legal analysis of antitrust implications when insurers collaborate in setting standards for medical underwriting. In the final chapter the editor addresses various policy options, examining the pros and cons of each one and assessing their political feasibility.


Out of Print ISBN: 9780262182362 312 pp. | 6 in x 9 in 14 illus.


$4.75 X ISBN: 9780262512596 312 pp. | 6 in x 9 in 14 illus.


Mark A. Rothstein

Mark A. Rothstein is Herbert F. Boehl Chair of Law and Medicine and Director of the Institute for Bioethics, Health Policy, and Law in the School of Medicine at the University of Louisville.


  • This book is a handy and informative reference for anyone who is considering the issues related to genetic discrimination in life insurance.

    The New England Journal of Medicine

  • This excellent collection of essays demonstrates why the relationship between genes and life insurance is an important one, both as a practical matter for many individuals and as a lesson in fashioning public policy.

    Journal of the American Medical Association


  • This book addresses a topic of great social relevance and succeeds in its intent of offering a balanced perspective on the current debate.

    Elettra Ronchi

    Coordinator of Biotechnology and Health Activities, Organisation for Economic Cooperation and Development

  • Genetics and Life Insurance addresses for the first time the relationship between genetics and an enormous industry. Professionals in the life insurance field will turn to this book as an authoritative discussion of the relevant viewpoints and issues. A strength of the book is the diversity of perspectives held by the authors of the various chapters.

    Peter P. Swire

    Moritz College of Law, Ohio State University

  • With the help of an exceptional collection of contributors, Mark Rothstein has illuminated one of the darkest corners of genetic discriminationin life insurance. With his usual combination of superb scholarship, wisdom, and common sense, Rothstein shows us where we are and what paths are open for sensible policies in the future.

    Thomas H. Murray

    President, The Hastings Center

  • This impressive volume, boasting contributions from a variety of perspectives, offers a detailed account of the current and potential uses of genetic information by life insurers. It should be the starting point for anyone who wants to learn more about this important and intriguing topic.

    Mark A. Hall

    Fred D. and Elizabeth L. Turnage Professor of Law and Public Health, Wake Forest University