Ethical issues in

Genetic counseling is a complex communication process that takes place between a genetic counselor and one or more counselees, also called clients. It may involve a single encounter lasting thirty to sixty minutes or multiple encounters over months or years. The type and duration of the encounter is determined by the nature of the condition that led to the encounter. This includes whether the condition under discussion is genetic or nongenetic, the mode of inheritance, and the severity of the disorder, including its prognosis. Therapeutic and reproductive implications play a significant role as well as the counselor's evaluation of the effectiveness of the counseling encounter.

Effective and helpful genetic counseling should be guided by several ethical principles and human values judged by most workers in the field to be of vital importance (Wertz et al.). These include autonomy; beneficence and nonmaleficence; confidentiality; veracity and truth-telling; and informed consent. It is also crucial that varied cultural and ethnic factors be taken into account. The professional code of ethics for genetic counselors should also be considered (Palmer).

Since genetic counseling usually occurs in medical settings such as clinics, medical centers, or private offices, the ethical values that prevail in medical and nursing practice should also play a role in genetic counseling. These principles or values influence different aspects of the counseling process to different degrees. Their influence may also vary according to the cultural background, ethnicity, or religious beliefs of the counselees and their families. The latter factors should receive serious attention, since cultural, religious, or ethnic differences can profoundly influence the relative weight given to one value or principle over another. This is especially true when counseling involves individuals from other countries (Wertz et al.). Counselees from the so-called Third World may cherish religious tenets and ethical values drastically different from those of the Jewish and Christian faiths that inform so much of Western medical ethics (Fisher).

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