Genetic discrimination (GD) in life insurance underwriting presents a growing ethical and legal concern, particularly as genomic medicine advances. While several jurisdictions—including the UK, Singapore, Australia, Canada, South Korea, and Japan—have implemented moratoria or enacted laws to limit the use of genetic information, these measures remain fragmented and inconsistent regarding protections for predictive and diagnostic testing, and inclusion of family history in scope. We conducted a comparative analysis of GD protections for life insurance in the six countries listed above, finding two broad categories of GD protection justifications proferred by policymakers: pragmatic (to encourage uptake of genetic testing) and justice-based (to prevent the intrinsic wrongfulness of differential treatment based on genetic profile).
As countries like Singapore and Australia transition from moratoria to law, this paper proposes that justice-based frameworks for GD protections are more solidly founded than pragmatic ones. This is due to weak empirical evidence for pragmatic rationales, compared with more well-established ethical arguments for justice-based frameworks. Among countries surveyed, Japan’s approach aligned most closely with a justice-based framework, including the widest scope of protections barring use of both genetic test results and family history. Policymakers aiming at preventing unjust GD should look to adapting Japan’s approach, while being sensitive to local cultural, political and economic contexts.