This paper analyzes the ethical implications of genetic testing in employment and insurance decisions by applying two major ethical frameworks: deontological ethics, which emphasizes duties and categorical imperatives, and utilitarian ethics, which focuses on outcomes and overall welfare. Using the Burlington Northern Railway v. EEOC case as a foundational example, the paper argues that genetic discrimination conflicts with both American legal intent and utilitarian calculations of harm versus benefit. The deontological analysis reveals tension between capitalist profit-maximization and societal norms of equality and non-harm embedded in civil rights law and religious traditions. The utilitarian perspective demonstrates that corporate profits cannot ethically outweigh potential suffering and loss of life among workers and insurance holders. The paper concludes that while legal precedent remains limited, the ethical case against genetic discrimination is clear under both frameworks.
As with Darwin's theory of evolution, genetic testing has opened new frontiers in understanding medicine, as it allows us, among other things, to understand the degree to which we are predisposed to specific diseases and conditions (Miller, 2007). The case of Burlington Northern Railway v. the US Equal Employment Opportunity Commission (EEOC) marked the first time the law had addressed this issue. The railway had been conducting genetic testing on employees for the identification of a specific disorder that in theory predisposed workers to carpal tunnel syndrome (Schafer, 2001). This example illustrates one of the ways in which companies can use genetic information—in this instance to find ways to opt out of insurance and disability payments. Miller (2007) argues that such abuses of knowledge on the basis of bias have been common since the theory of evolution was put forth.
This paper will examine the issue of genetic testing from both a deontological perspective and a utilitarian perspective in order to determine the risks posed by such testing. That genetic testing could be used to deny basic health care or employment opportunities on the basis of genetic makeup is a frightening thought, but one that could occur.
The deontological perspective holds that the ethics of a situation can be determined by weighing the inputs of the decision against a categorical imperative. This provides the situation with an absolute judgment of right and wrong, regardless of outcome, but deontological ethics only functions if there is a specific categorical imperative. Under normal circumstances in the United States or any other secular democracy, the laws of the land reflect the prevailing ethical standards of society. Thus, they are a good guidepost for the categorical imperative.
Prior to the Burlington Northern case, the issue of genetic testing and its use in workplace situations had not been addressed in US law. As the case was settled out of court, there remains no clear precedent in the US legal system. Therefore, the deontological perspective lacks a categorical imperative in the form of legal guidance on which to draw.
American society as a whole does have some other potential sources of categorical imperative. It is not as though society is rudderless in the absence of clear laws governing an issue. The sense of right and wrong is vaguer, but there are guidelines in both the secular and religious spheres. At its core, deontological ethics is focused on the motivations behind the actions, rather than the actions themselves (Cline, 2011). In the case of genetic testing, this creates a conflict.
The conflict arises because firms that offer insurance and related protections are in business to earn profit, which means that they are focused on minimizing risk. A company may choose not to hire somebody if that person is likely to have an increased risk of a condition that will ultimately prove expensive to the company's health care plan. Likewise, insurance companies may deny coverage based on risks uncovered during genetic testing. These actions would be justified on the basis of a capitalist economic system where profit maximization is the primary social role of corporations. Yet, the Civil Rights Act and other anti-discrimination laws have been written specifically with the intent of eliminating discrimination in the workplace.
That genes have not been explicitly written into the law is irrelevant—the intent of Congress has been made clear over the past forty-seven years of legislation. Additionally, many religious texts hold equality as a central theme; others preach against doing harm to others. In either case, the categorical imperative in our society is generally to avoid harm to others. While the deontological case against genetic discrimination is complicated, there is reason to believe that such discrimination runs counter to the prevailing mores of both our secular and religious societies.
In contrast to the deontological perspective, the utilitarian perspective focuses on the outcomes of actions in order to determine their moral rightness. The utilitarian perspective focuses on the broad impacts of the actions, rather than just how the actions affect specific individuals (Andre & Velasquez, 2010). From the utilitarian perspective, genetic testing has the potential to do great harm to many, and to benefit many.
The utilitarian arithmetic points out that the benefits to companies in utilizing genetic testing is that profits increase. The argument can also be made that wealthier companies provide more jobs and wealthier insurance companies are better able to pay out to those who do receive payments. The counter to the former point is that this employment is theoretical—not only may it not occur, but it may not occur in the United States. The counter to the latter is that insurance is largely price inelastic, so there is no improvement in coverage likely from handing more profits to insurance companies.
On the harm side, many workers could have their disability coverage limited. If the concept is expanded to the insurance industry, many would find themselves either unable to obtain insurance coverage or unable to afford it because of their "deficient" genes. The implications of this are that many would suffer and some would die as the result of allowing genetic testing to determine disability and insurance coverage levels. When doing the utilitarian arithmetic, some judgment needs to be made with respect to the value of the different outcomes. In this case, those values are relatively easy to determine. Suffering and death are worse outcomes than a reduction in profit. Almost all human societies place health and life as among the most important criteria by which the ethics of an action can be measured. Even societies that place high value on economic gain at least nominally recognize that economic gain does not trump life and liberty.
The lack of a clear categorical imperative means that the deontological perspective may not be able to fully resolve the issue. In general, the trend among different interpretations of categorical imperative both secular and religious is that genetic testing for workplace decisions runs against our moral standards. Certainly, if the intent of Congress can be inferred through its treatment of other discrimination situations, the use of genetic testing to discriminate violates the morals of American society. The utilitarian response lacks any equivocation. There is very little ground on which to make a case that improving corporate profits at the expense of the health and lives of American citizens is a good moral choice.
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