THE HINDU EDITORIAL : MARCH 3, 2018
THE HINDU EDITORIAL : MARCH 3, 2018
a) Staying ahead of the double helix
The Delhi High Court recently ruled against discrimination in health insurance by United India Insurance Company involving a person with a heart condition which was perceived to be a genetic disorder. The court held, “Discrimination in health insurance against individuals based on their genetic disposition or genetic heritage, in the absence of appropriate genetic testing and laying down of intelligible differentia, is unconstitutional.”
While the specific features of this case may depend on clauses in the original policy, this is a critical court decision around the broader question of discrimination on the basis of one’s genetic predisposition. As technology for genetic testing and tools to gather family history and compile them in databases become cheaper and more widespread, it becomes imperative that due social and ethical consideration be given to genetic discrimination as the implications are far-reaching and can affect everyone.
Questionable assumptions
Genetic discrimination (GD) is understood to be differential treatment of those not showing symptoms but who are nevertheless treated differently on the basis of any real or assumed genetic characteristics. We must recognise that GD is nothing new. There were robust policies of eugenics in the U.S. in the 1900s. These led to laws in many States that made sterilisation compulsory for those who expressed a range of conditions believed to be inherited. Such conditions covered those with disability, who were poor, had mental health problems, were promiscuous, were dwarfs, and so on. Eugenics was also practiced in many countries in Europe, not just in Nazi Germany. Nordic countries, for example, passed eugenics laws in the 1930s and some of those stayed in the books until the 1970s.
With newer and cheaper methods to sequence entire genomes, the era of expanded genetic testing is already upon us, although not everyone may associate it with eugenics. Whether specific genetic tests themselves are scientifically valid, whether they add value to those tested, and whether they should be generalised for populations or communities raise a separate but linked set of issues that I will not cover in this article. Rather, I will stay focussed on the issues of insurance and employment when there is family history of disease, the potential complications of genetic tests and their implications.
American precedent
In the U.S., researchers working with the Council for Responsible Genetics in Cambridge, Massachusetts recorded hundreds of cases of misuse of genetic information obtained through family history, genetic tests, or by employers and insurers accessing personal data.
There are many examples of employers and insurers using genetic information to engage in discriminatory policies. In 2001, the Burlington Northern Santa Fe Railroad Company settled a federal lawsuit in the U.S. The company had violated the Americans with Disabilities Act by threatening to fire a worker who did not give a blood sample to test whether he was predisposed to developing carpal tunnel syndrome. The company conducted genetic tests on its employees without their consent as a means of thwarting compensation claims for job-related stress injuries. A person diagnosed with a condition that causes excessive iron storage, but whose symptoms are otherwise manageable, lost her health insurance despite clear medical evidence that she was healthy.
In the U.S., the Genetic Information Nondiscrimination Act (GINA) was signed into law in 2008. GINA provides strong protection against access to genetic information and genetic discrimination in the context of health insurance and employment. It prohibits insurers from “requesting or requiring” genetic tests from an individual or members of the person’s family, or using genetic information to determine eligibility or establish premiums. It also prohibits employers from “requesting or requiring” genetic information for hiring or promotional decisions, or when determining eligibility for training programmes.
Geneticists are not in agreement on the usefulness of genetic tests or even on their veracity. Most importantly, very few single-gene health problems exist and the vast array of common diseases is related to the functioning of networks of genes in the milieu of other central cellular components and also depend on lifestyle and environment.
Too much miscommunication
Moreover, the popular notion of deoxyribonucleic acid (otherwise known as DNA) being the central and only player in cellular and genetic information and disease with a mere unfolding of characteristics is deeply flawed. While there is mounting evidence to oppose this perception of DNA as a master molecule, there is a lot of miscommunication among scientists and the media on this topic wherein a gene that codes for a protein associated with the outward expression of a condition is regarded as its cause. Correcting this perception, even when genetic reductionist paradigms have shifted, is an uphill battle when commercial interests such as testing have been unleashed.
The Council of Europe has adopted a set of recommendations on the use of genetic information for the purpose of insurance. Canada’s recent Genetic Non-Discrimination Act makes it illegal for insurers or employers to request DNA testing or results. It is reported that insurers in the U.K. are currently under a voluntary moratorium agreed upon between the Association of British Insurers and the government until 2019. Based on this agreement, results from genetic tests are not to be used for health or life insurance except for Huntington’s disease, which is dominantly inherited with a high penetrance. This simply means that there is a high likelihood that those who have this gene develop the disease, which is inherited as an autosomal-dominant trait. But it must be noted here that even with the rare single-gene conditions the genetic expression varies significantly because of other factors.
India too needs a law that prevents genetic discrimination. In this era of rampant genetic testing, we need to prevent discrimination and uphold “equal treatment under the law”. Would the court have ruled the same way if the insurance company had done a genetic test and included a clause that this particular heart condition would not be covered? Equality under the law cannot have exceptions.
A complex future
The situation is likely to get worse as people become more accepting of predictive genetic tests and insurance companies insist on them; at the moment, they generally use family medical history as the basis for determining premiums. In the medium term, there are also serious concerns related to the protection and privacy of medical and genetic data. Breaking into databanks, as we are all familiar by now, is not impossible as even America’s Federal Bureau of Investigations and other secure firewalls have been breached.
Looking beyond these immediate issues, everyone has genes for some predisposition or the other, this being the human condition. There should therefore be no discrimination based on genetic information. Insurance is developed from pooling risks. If companies begin to insist on tests for everyone, then potentially no one will be insurable. Only universal health care can therefore be a viable solution.
b) Fear of forfeiture: on the Fugitive Economic Offenders Bill
Given the apparent ease with which economic offenders flee India and cock a snook at the banking and judicial systems, the proposed law to seize their wealth is undoubtedly a welcome measure. In fact, given the public disquiet over the apparent impunity enjoyed by billionaire fraudsters living in the safety of foreign climes, any new law is likely to be viewed in a positive light. However, its success rides on the slim hope that the threat of confiscation of property will act as a serious deterrent to those seeking to flee or as a big incentive for fugitives to return. Legal provisions to confiscate the assets of offenders already exist, but these are regarded as somewhat inadequate. The Fugitive Economic Offenders Bill, which has been cleared by the Cabinet, aims to make up for the shortcomings and provide a fresh legal framework that would enable the confiscation of the property of those evading prosecution by fleeing the country or remaining abroad. From the provision in the Code of Criminal Procedure for attachment of the property of ‘proclaimed offenders’, to sections in Acts targeting smugglers, foreign exchange offenders and traffickers in narcotics, proceedings for forfeiture of property have been marked by shortcomings and procedural delays. But laws deemed draconian, such as the Smugglers and Foreign Exchange Manipulators (Forfeiture of Property) Act, 1976, have not exactly been a success. Experience has shown that disposal of confiscated assets is not easy, especially at a price sufficient to recoup losses or pay off all creditors.
Under the Fugitive Economic Offenders Bill, confiscation is not limited to the proceeds of crime, and extends to any asset owned by an offender, including benami property. Such clauses are liable for legal challenge, especially if there are third party interests and doubts about real ownership. Care must be taken to draft a law that is free from legal infirmities from the point of view of fundamental rights and due process. The government has justified not linking the forfeiture clause to criminal conviction by citing the principle enshrined in the UN Convention Against Corruption, which India ratified in 2011. The convention envisages domestic laws for confiscation of property without a criminal conviction in cases in which the offenders cannot be prosecuted for reasons of death, flight or absence. The Bill is reasonable in that a fugitive offender will cease to be one if he or she appears before court. There is a 180-day window during which the property will remain attached, with a provision for appeal against an order of confiscation. While the utility and effectiveness of laws are best assessed in the implementation, it is important to ensure they are fair and reasonable. The shortcomings in previous laws must be avoided, and the new legal regime impartially enforced.
WORDS/ VOCABULARY
1) Discrimination
Meaning: The ability to judge what is of high quality; good judgement or taste.
Example: “Those who could afford to buy showed little taste or discrimination”
Synonyms: Discernment, Judgement
2) Perceived
Meaning: Become aware or conscious of (something); come to realize or understand.
Example: “His mouth fell open as he perceived the truth”
Synonyms: Discern, Recognize
3) Heritage
Meaning: Property that is or may be inherited; an inheritance.
Example: “They had stolen his grandfather’s heritage”
Synonyms: Inheritance, Birthright
4) Imperative
Meaning: Of vital importance; crucial.
Example: “Immediate action was imperative”
Synonyms: Vitally important, Of vital importance
Antonyms: Unimportant, Optional
5) Eugenics
Meaning: The science of improving a population by controlled breeding to increase the occurrence of desirable heritable characteristics.
6) Sterilisation
Meaning: The process of making something free from bacteria or other living microorganisms.
Example: “Disinfection and sterilization of surgical equipment”
7) Promiscuous
Meaning: Demonstrating or implying an unselective approach; indiscriminate or casual.
Example: “The city fathers were promiscuous with their honours”
Synonyms: Indiscriminate, Undiscriminating
Antonyms: Careful, Selective
8) Dwarfs
Meaning: Cause to seem small or insignificant in comparison.
Example: “The buildings surround and dwarf All Saints church”
Synonyms: Dominate, Tower above
9) Insurers
Meaning: A person or company that underwrites an insurance risk; the party in an insurance contract undertaking to pay compensation.
10) Predisposed
Meaning: Make someone liable or inclined to a specified attitude, action, or condition.
Example: “Lack of exercise may predispose an individual to high blood pressure”
Synonyms: Make susceptible, Make liable
11) Carpal
Meaning: Relating to the bones forming the human carpus (wrist), or to their equivalent in an animal’s forelimb.
12) Thwarting
Meaning: Oppose (a plan, attempt, or ambition) successfully.
Example: “The government had been able to thwart all attempts by opposition leaders to form new parties”
Synonyms: Foil, Frustrate, Baulk
Antonyms: Assist, Facilitate
13) Premiums
Meaning: Relating to or denoting a commodity of superior quality and therefore a higher price.
Example: “Premium lagers”
Synonyms: Superior, Premier
Antonyms: Inferior
14) Veracity
Meaning: Conformity to facts; accuracy.
Example: “Officials expressed doubts concerning the veracity of the story”
Synonyms: Truthfulness, Truth
Antonyms: Falsity
15) Flawed
Meaning: Having or characterized by a fundamental weakness or imperfection.
Example: “A fatally flawed strategy”
Synonyms: Unsound, Defective
Antonyms: Sound
16) Paradigms
Meaning: A typical example or pattern of something; a pattern or model.
Example: “Society’s paradigm of the ‘ideal woman’”
17) Unleashed
Meaning: Cause (a strong or violent force) to be released or become unrestrained.
Example: “The failure of the talks could unleash more fighting”
18) Moratorium
Meaning: A temporary prohibition of an activity.
Example: “A moratorium on the use of drift nets”
Synonyms: Embargo, Ban
19) Rampant
Meaning: (Especially of something unwelcome) flourishing or spreading unchecked.
Example: “Political violence was rampant”
Synonyms: Uncontrolled, Unrestrained
20) Concerns
Meaning: Have a specific connection with or responsibility for.
Example: “Those concerned in industry, academia, and government”
Synonyms: Involve oneself in, interest oneself in
21) Breached
Meaning: (Especially of something unwelcome) flourishing or spreading unchecked.
Example: “Political violence was rampant”
Synonyms: Uncontrolled, Unrestrained,
22) Pooling
Meaning: Share (resources or information) for the benefit of all involved.
Example: “The skills of teachers can be pooled and shared”
Synonyms: Combine, Put together, Amalgamate
23) Viable
Meaning: Capable of working successfully; feasible.
Example: “The proposed investment was economically viable”
Synonyms: Workable, Feasible
24) Flee
Meaning: Run away from a place or situation of danger.
Example: “To escape the fighting, his family fled from their village”
Synonyms: Run, Run away
25) Snook
Meaning: Openly show contempt or a lack of respect for someone or something.
Example: “He spent a lifetime cocking a snook at the art world”
26) Impunity
Meaning: Exemption from punishment or freedom from the injurious consequences of an action.
Example: “The impunity enjoyed by military officers implicated in civilian killings”
Synonyms: Immunity, Indemnity
Antonyms: Liability, Responsibility
27) Confiscation
Meaning: The action of taking or seizing someone’s property with authority; seizure.
Example: “A court ordered the confiscation of her property”
Synonyms: Seizure, Impounding
Antonyms: Return
28) Deterrent
Meaning: A thing that discourages or is intended to discourage someone from doing something.
Example: “Cameras are a major deterrent to crime”
Synonyms: Disincentive, Discouragement
Antonyms: Incentive, Encouragement
29) Fugitives
Meaning: A person who has escaped from captivity or is in hiding.
Example: “Fugitives from justice”
Synonyms: Escapee, Escaper, Runaway
30) Confiscation
Meaning: The action of taking or seizing someone’s property with authority; seizure.
Example: “A court ordered the confiscation of her property”
Synonyms: Seizure, Impounding
Antonyms: Return
31) Evading
Meaning: Escape or avoid (someone or something), especially by guile or trickery.
Example: “Friends helped him to evade capture for a time”
Synonyms: Elude, Avoid
Antonyms: Confront, Run into
32) Traffickers
Meaning: A person who deals or trades in something illegal.
Example: “A convicted drug trafficker”
33) Narcotics
Meaning: An addictive drug affecting mood or behaviour, especially an illegal one.
Example: “Cultivation of a plant used to make a popular local narcotic”
34) Forfeiture
Meaning: The loss or giving up of something as a penalty for wrongdoing.
Example: “Magistrates ordered the forfeiture of his computer”
Synonyms: Confiscation, Sequestration
35) Deemed
Meaning: Regard or consider in a specified way.
Example: “The event was deemed a great success”
Synonyms: Regard as, Consider, Judge
36) Draconian
Meaning: (Of laws or their application) excessively harsh and severe.
Example: “The Nazis destroyed the independence of the press by a series of draconian laws”
Synonyms: Harsh, Severe
Antonyms: Mild
37) Recoup
Meaning: Regain (something lost or expended).
Example: “rains have helped recoup water levels”
Synonyms: Get back, Regain, Recover
38) Infirmities
Meaning: Physical or mental weakness.
Example: “Old age and infirmity come to men and women alike”
Synonyms: Frailty, Weakness
Antonyms: Strength, Good health, Certainty
39) Enshrined
Meaning: Preserve (a right, tradition, or idea) in a form that ensures it will be protected and respected.
Example: “The right of all workers to strike was enshrined in the new constitution”
Synonyms: Set down, Set out, Spell out, Express
40) Envisages
Meaning: Contemplate or conceive of as a possibility or a desirable future event.
Example: “The Rome Treaty envisaged free movement across frontiers”
Synonyms: Foresee, Predict
Wish to learn more , then you should definitely read the previous editions of THE HINDU EDITORIAL and extend your preparations.
THE HINDU EDITORIAL : MARCH 2, 2018
Aspirants can also check the previous month THE HINDU EDITORIAL and can improve the vocabulary list & can ace the exams. Learning the language is easy and this will make the process simple.
FEBRUARY – THE HINDU EDITORIAL
