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Personalized health predictions challenge existing insurance frameworks: Time to revisit life and disability
Max Rensink1, Maartje Schermer2, Ineke Bolt1
1Department of Public Health - Medical Ethics, Philosophy, and History of Medicine Group, Erasmus Medical Centre, Rotterdam, The Netherlands.
Abstract:
Personalized health predictions are developing rapidly across a wide range of diseases, challenging the existing legal frameworks for life and disability insurance. These frameworks were originally developed with a focus on presymptomatic genetic testing for severe monogenic diseases such as Huntington's disease. The rapid expansion of personalized medicine raises questions about whether existing legal frameworks remain adequate. This paper examines the underlying ethical values of current legal frameworks that rely on financial thresholds to balance stakeholders' interests and explores how the growing availability of personalized predictions may give rise to ethical tensions. We argue that it is important to find a renewed balance between stakeholders' interests, to evaluate whether the concept of genetic exceptionalism is still meaningful in light of personalized predictions, and to consider how legislation can be reformulated to encompass personalized predictions and ensure solidarity. Furthermore, the potential for inaccuracies and misinterpretation of personalized predictions should be addressed. Our analysis highlights several ethical tensions that current legal frameworks may not be well equipped to address as personalized prediction technologies evolve. We therefore conclude that re-evaluating the legal frameworks underpinning life and disability insurance underwriting is both timely and necessary.
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