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Dr. Robert Klitzman on Genetic Testing and Cheating the System

At a time when genetic testing is more and more accessible, what new challenges exist when patients opt for a clandestine test and buy life insurance based on the results? Dr. Robert Klitzman, director of the M.S. in Bioethics program, explores the possibilities in his op-ed “Get genetic testing and cheat the system?” for

Such actions can pass ethical dilemmas from the patient to the doctor: “Some patients who have done testing on their own and learned they have lethal mutations have told their physicians, ‘Here is information. But I don’t want you to put it in my chart’ – placing these doctors in a difficult spot.” He writes, “Patients who hide pertinent information could suffer later.”

In cases where life insurance companies discover a patient’s genetic test results, the corporation can legally choose to charge more for their services. “The Genetic Information Nondiscrimination Act (GINA) covers most forms of health insurance and employment,” Klitzman writes, “but it’s a different story with other types of insurance. Life, disability and long-term care insurance companies are legally allowed to discriminate based on people’s genes.”

“These companies are weighing what to do,” he says of insurers. “They could ask if applicants or relatives have undergone genetic testing and then raise insurance rates on certain individuals based on the results. They could also require genetic testing of all applicants and assess the results. Yet in both of these scenarios, they could end up unfairly discriminating – denying coverage or charging much more for it – for anyone with genes associated, even slightly, with serious disease.”

“These dilemmas pit patients’ rights to confidentiality against whatever social good insurance companies may provide,” he writes. For more on the nuances of these ethical dilemmas and possible solutions, read his article on