1. Genetics, society and insurance Margo Trappenburg Universiteit Utrecht USBO

2. Professor John Harris (1945) University of Manchester

3. General ethical theories  Utilitarian philosophy, e.g. John Harris: maximize overall happiness.  Ambition sensitive and endowment insensitive.

4. This is not the way we do it  Moral norms are different in different political communities.  E.g.: abortion/PND in China, India versus abortion in Europa, US  E.g. euthanasia in US versus euthanasia in the Netherlands

5. Spheres of justice in liberal countries Political sphere Majority decides Divine grace Sphere of the market Free exchange Love and affection Medical care Education Welfare -- --

6. Sphere of medical care  Distribution according to need (not according to wealth, guilt, not ‘ambition sensitive’) Genetic technology was first developed in this sphere.

7. Genetics in the sphere of health care  IVF according to medical need  PND for medical reasons  PGD for medical reasons

8. Crossing borders I  Using medical technology (e.g. genetics) for non medical purposes: debate about eugenics Politicalsphere Health care Market Free exchange

9. Crossing borders II  Having a medical condition while being a consumer  Some analogies

10. Buying life insurance  The history of genetic exceptionalism  Ambition sensitive and endowment insensitive after all? Ine van Hoyweghen, Risks in the Making. Travels in Life Insurance and Genetics 2007

11. Abandoning genetic exceptionalism?  What would happen? Small group? Large group?  Is life insurance justly perceived as a market good? If not, what is it?

12. Conclusion  Abandoning genetic exceptionalism seems the right thing to do provided we manage to keep other societal spheres (education, medical care, welfare) free from market interference.