toward one of the two possible answer categories. For example, only 9.0% of the respondents believed that life insurance companies should have right to make genetic testing a precondition for coverage (coercion issue). On the question of whether life insurers should be allowed to know the results of genetic tests (control issue), 19.1% of respondents answered in the affirmative. Nearly a quarter of respondents (23.8%) believed that life insurance rates should be reduced for people testing negative for the BRCA1 gene mutation (consequence issue), but only 6.5% indicated rates should be increased when a person tests positive. Overall, these results suggest that members of the general public are rather cautious about the use of genetic testing in life insurance underwriting.

Answers to the four questions about genetic testing and life insurance are not highly intercorrelated and can therefore be analyzed separately. Answers to the two questions about whether insurance rates should be lowered or raised depending on test results for the BRCA1 gene mutation have the highest Pearson correlation coefficient of any two items (r= .40, p<.01). Yet, of those respondents who believe that insurance rates should be lowered when a person tests negative for the gene mutation, 76.4% percent believe they should not be raised for people testing positive. Thus, the four questions measure related but different aspects of the debate about the role of genetic test results in establishing life insurance premiums.

What factors account for variation in opinion among members of the public. Our study differs from typical public opinion samples inasmuch as it contains a subsample for whom genetic testing is more than an abstract concept. Eighty-five of the sample members have undergone genetic testing, thirty of whom tested positive for the BRCA1 gene. We therefore begin the analysis of public opinion by comparing the responses to the four dependent variables among: (1) members of the 2082 kindred who have tested positive for the BRCA1 gene, (2) members of the kindred who tested negative, and (3) members of the general public with varying degrees of family history of breast and ovarian cancer. Table 2 summarizes these results.

Table 2. Opinion on questions regarding life insurance practices by groups

Group N=329

Preferred life insurance industry practices (% Yes)

Require tests

Know results

Lower rates

Raise rates

Tested: Positive n= 30

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