Predictive Genetic Testing for Alzheimer's Disease in Long-Term Care Insurance

The promise of new genetic research is the ability to prevent, treat, and cure a wide range of physical and mental disorders-both monogenic and complex disorders. While astonishing progress has been made in gene discovery and the development of genetic tests, progress has been much slower in developing medicalinterventions. Consequently, there is likely to be a gap of varying and indetermi- nate time-lasting years or decades-between the ability to identify and predict genetic risk and the ability to prevent, treat, or cure the condition. The gap between the ability to predict genetic risk and the ability to ameliorate the risk is the source of many of the ethical, legal, and social problems associated with predictive genetic testing.

If physicians could prevent or cure all genetic related disorders easily and cheaply, virtually all of the ethical and legal issues would disappear. Unfortunately, researchers are a long way from such medical interventions. Consequently, many individuals are concerned about learning information about health risks they cannot prevent from manifesting. Third parties, including insurers and employers, with a financial stake in the future health of individuals, may want to obtain access to the results of genetic tests or family health histories to learn individuals' risk statuses.

Part of the motivation for insurers is to avoid adverse selection, which may occur when individuals have more knowledge about future risks than do insurers. Additionally, employers may want to reduce health insurance costs or prevent cases of occupational illness.