The standard of neutrality during genetic counselling: an empirical investigation.

One of the standards for the genetic counsellor's profession is neutrality, which enables clients to decide 'in freedom' what is best for them. However, in a world with divergent and changing values, neutrality may be difficult to achieve. In order to highlight possible biases in counsellors' communications, verbal exchanges during 30 counselling sessions in a clinical genetics centre in the Netherlands were analyzed. The results show that the main background against which the attitudes of both clients and counsellors must be considered is their notion of the rapid development of medical science. Although most counsellors' attitudes clearly reflected a striving for neutrality, some did not always succeed in that: (a) they exceeded the original brief, (b) they implicitly expressed their own opinions and values, (c) they ignored client' objections and (d) they issued directives. Practical implications are discussed.