Wolff G
Institut für Humangenetik und Anthropologie, Freiburg, Deutschland.
Schweiz Med Wochenschr. 1997 Jan 18;127(3):60-8.
Counseling plays a central role of the utmost importance in the doctor-patient/client relationship in medical genetics. Historically, its development may be described as a paradigm shift from eugenics via preventive medicine to a more psychosocial understanding as a communication process, which aims at individually bearable, autonomous decisions. The widely accepted conception of non-directiveness in genetic counseling has implications for the rights of patients and clients as well as for the duties of those offering and performing genetic diagnosis and counseling. In the context of prenatal diagnosis, genetic counseling has its special role as a framework to prevent ethically unacceptable automatism and to safeguard the interests of the individual patient/client. In view of the marked lack of adequate counseling capacities, increasing the potential of prenatal genetic diagnosis requires the development of different, possibly new concepts for counseling in this area.
咨询在医学遗传学的医患/客户关系中起着至关重要的核心作用。从历史角度看,其发展可被描述为一种范式转变,从优生学经预防医学转向将其作为一种交流过程的更具心理社会层面的理解,该交流过程旨在做出个体可承受的自主决策。遗传咨询中广泛接受的非指导性概念对患者和客户的权利以及提供和进行基因诊断与咨询者的职责都有影响。在产前诊断背景下,遗传咨询作为一个框架具有特殊作用,可防止出现伦理上不可接受的机械行为并维护个体患者/客户的利益。鉴于明显缺乏足够的咨询能力,提高产前基因诊断的潜力需要为该领域的咨询开发不同的、可能是新的概念。