So regulations today often protect consumers from the mandatory disclosure of predictive tests. But the rules are patchy. In Britain the industry has agreed to a blanket moratorium, renewable every three years, on using predictive genetic information. The sole exception is Huntington’s chorea, where a test of one gene is infallible and has to be disclosed to an insurer for life cover worth more than £500,000 ($662,000). In America the Genetic Information Nondiscrimination Act bans health insurers (and employers) from using such results, but is silent on other types of insurance. In several countries life insurers may already ask for disclosure of predictive genetic tests for policies over a certain value.
所以今天的規章制度經常保護消費者免於預測性檢測的信息遭到披露。但這些規則是零散的。英國的保險業同意全面暫停(實施這些規則)，基因預測信息每三年更新一次。亨廷頓舞蹈病是個例外，人們能確定其致病基因，而且必須向保險公司披露相關測試信息如果他們想投價值超過50萬英鎊(66.2萬美元)的生命保險。美國的《反基因歧視法》禁止健康保險公司(和僱主)使用測試結果，但未明確提及其它類型的保險公司。在有些國家，人壽保險公司可能已經就超過一定額度的保單要求公開預測基因測試的結果。
But testing is rarely cut-and-dried. Ronnie Klein from the Geneva Association, an insurance-industry think-tank, says that, unlike Huntington’s, most illnesses stem from a number of factors, including lifestyle and environment, and a combination of genes. For example, although the ApoE4 allele increases the risk of Alzheimer’s, many without it still get the disease.
但是測試很少能一錘定音。日內瓦協會的羅尼·克萊因是保險業的.一名智庫，他說與亨廷頓舞蹈病不同的是，大多數疾病源於一系列的事實，包括生活方式、環境和血多基因的混成。比如，儘管ApoE4的等位基因增加了患阿爾茨海默氏病的風險，但是許多沒有這個基因的人也會患該病。
Some regulators, such as Germany’s, have outlawed direct-to-consumer tests. But nothing stops Germans from ordering from abroad, and, just as it became normal for life insurers to ask for family history, so insurers will surely eventually have access to relevant genetic information. The question will be what they are allowed to do with it. When blood tests for AIDS first appeared, insurers also fretted about adverse selection. Many jurisdictions ruled they could not be used for calculating health premiums, as these were a basic good, but could be used for life policies. As genetic testing spreads, society and insurers may face many similar difficult assessments.
一些監管部門，比如德國的，已經宣佈直接面向消費者的測試是不合法的。但這不能阻止德國從國外採購。而且，正如保險公司詢問家族史成爲常態，他們最終一定會得到關於基因的信息。現在的問題是，在有了這樣的信息之後，他們可以做什麼。當檢測艾滋病的血液測試首次出現時，保險公司也曾擔心過不利的選擇。許多司法規定 在計算健康保險費時不可以使用它們，因爲它們是基本商品，但在計算人壽保險時可以。當越來越多的人使用基因檢測的時候，社會和保險商也許會遇到許多類似的困難評估。
【本文作者：徐州七中 彭向梅 。(公衆號：草根英語行思教)】
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