Insurance companies could be tempted to link their services to very restrictive behavioural standards. Pregnant women could for instance be asked to take genetic pre-natal diagnostics or to participate in other early examinations or to take courses on prevention. Based on recent examples in the USA, where in individual cases insurance companies refused the expected back payment of costs because parents had decided to have their child although the prenatal findings had shown the foetus to be disabled (Fromme and Raabe, 1997), there is fear among the insured in Germany that exclusion from insurance services or other exclusions may be introduced. Not participating in such diagnostic or preventative programmes might therefore entail lower payments by the insurances companies in case treatment is needed. This is comparable to the system in dental care where a so called Bonus-System is in operation. This form of economising is continuously promised to the insured by the medical councils and by state institutions and it also forms part of the government's endeavours to cut costs in health.
The Rule Book V of the Social Welfare Legislation does with its § 1 indeed allow an adaptation of services according to appropriate criteria or the plan for financial sanctioning in the case of inappropriate behaviour and failure to co-operate.
Pessimistically this could mean that genetic risks involved say in a pregnancy, are in reality considerably less severe than the insurance companies let on. This would therefore result in the company refusing to take on potentially occurring costs if the child were to be diagnosed at an earlier stage with a genetic disorder. Not using any form of contraception or refusal to carry out an abortion turn into risk behaviour. Whether this can be agreed to in in a social context needs to be assessed, considering whether society would be burdened with avoidable costs incurred by individuals.
Using this as an example, disabled groups illustrate the apparent normative character of genetic diagnostics. They point out the danger of the general exclusion of genetically different humans and also the similarity of present cost-benefit analysis to those in the 20s and 40s. Genetic diagnostics could serve as a scientific justification for a new political movement in Eugenics.
Considering society as a whole, pre-natal tests could lead to euthanasia without governmental and legal guidelines, because a large number of parents, pressured by considerable social conformity might use negative test results as a reason to abort their unborn children who quite often are capable of life.
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