Theoretical Medicine

, Volume 10, Issue 2, pp 139–149 | Cite as

The role of beneficence in clinical genetics: Non-directive counseling reconsidered

  • Mark Yarborough
  • Joan A. Scott
  • Linda K. Dixon

Abstract

The popular view of non-directive genetic counseling limits the counselor's role to providing information to clients and assisting families in making decisions in a morally neutral fashion. This view of non-directive genetic counseling is shown to be incomplete. A fuller understanding of what it means to respect autonomy shows that merely respecting client choices does not exhaust the duty. Moreover, the genetic counselor/client relationship should also be governed by the counselor's commitment to the principle of beneficience. When non-directive counseling is reexamined in light of both these principles, it becomes clear that there are cases in which counselors should attempt to persuade clients to reconsider their decisions. Such attempts are consistent with non-directive counseling because, while respecting the clients' decision-making authority, they insure that clients act with full knowledge of the moral consequences of their decisions.

Key words

autonomy beneficence non-directive counseling pre-symptomatic genetic testing 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Fletcher JC, Berg K, Tranøy KE. Ethical aspects of medical genetics. Clin Genet 1983;27:199–205.Google Scholar
  2. 2.
    Hsia YE. The genetic counselor as information giver. In: Capron AM, Lappe M, Murray RF, Powledge TM, Twiss SB, Bergsma D, eds. Genetic Counseling: Facts, Values and Norms. New York: Alan R Liss Inc., 1979:169–86.Google Scholar
  3. 3.
    Elias S, Annas GJ. Reproductive Genetics and the Law. Chicago: Year Book Medical Publishers Inc., 1987.Google Scholar
  4. 4.
    Beauchamp TL, Childress JF. Principles of Biomedical Ethics. New York: Oxford University Press, 1983.Google Scholar
  5. 5.
    Pines M. In the shadow of Huntington's. Science 84 1984;5:32–9.Google Scholar
  6. 6.
    Gusella JF, Wexler NS, Conneally PM, et al. Polymorphic DNA marker genetically linked to Huntington's disease. Nature 1983;306:234–8.Google Scholar
  7. 7.
    Gilliam TC, Tanzi RE, Haines JL, et al. Localization of the Huntington's disease gene to a small segment of chromosome 4 flanked by D4S10 and the telomore. Cell 1987;50:565–71.Google Scholar
  8. 8.
    Purdy LM. Genetic diseases: can having children be immoral? In: Mappes TA, Zembaty JS, eds. Biomedical Ethics. 2nd ed. New York: McGraw Hill Book Company, 1981:468–75.Google Scholar
  9. 9.
    Ratzan R. Unsolicited medical opinion. J. Med Philos 1985;10:146–62.Google Scholar
  10. 10.
    Mosley R. Excuse me, but you have a melanoma on your neck! Unsolicited medical opinions. J. Med Philos 1985;10:163–70.Google Scholar
  11. 11.
    Mill JS. On Liberty. Indianapolis: Hackett Publishing Company, 1978.Google Scholar
  12. 12.
    Thomson JJ. A defense of abortion. In: Cohen M, Nagel T, Scanlon T, eds. The Rights and Wrongs of Abortion. Princeton: Princeton University Press, 1974:3–22.Google Scholar
  13. 13.
    McCullough LB, Wear S. Respect for autonomy and medical paternalism reconsidered. Theor Med 1985;6:295–308.Google Scholar
  14. 14.
    Ost D. The right not to know. J. Med Philos 1984;9:301–12.Google Scholar
  15. 15.
    Twiss SB. The genetic counselor as moral advisor. In: Capron AB, Lappe M, Murray RF, Powledge TM, Twiss SB, Bergsma D, eds. Genetic Counseling: Facts, Values and Norms. New York: Alan R Liss Inc., 1979;15:201–22.Google Scholar
  16. 16.
    Shaw MW. Testing for the Huntington gene: a right to know, a right not to know, or a duty to know. Am J Med Genet 1987;26:243–6.Google Scholar
  17. 17.
    Kessler S. The dilemma of suicide and Huntington disease. Am J Med Genet 1987;26:315–7.Google Scholar
  18. 18.
    Strasser M. Mill and the right to remain uninformed. J Med Philos 1986;11:265–78.Google Scholar
  19. 19.
    Smith DH, Pettegrew LS. Mutual persuasion as a model for doctor-patient communication. Theor Med 1986;7:127–46.Google Scholar

Copyright information

© Kluwer Academic Publishers 1989

Authors and Affiliations

  • Mark Yarborough
    • 1
  • Joan A. Scott
    • 2
  • Linda K. Dixon
    • 3
  1. 1.Department of PhilosophyUniversity of Colorado at DenverDenverUSA
  2. 2.Department of PediatricsUniversity of Colorado School of MedicineDenverUSA
  3. 3.Department of BiologyUniversity of Colorado at DenverDenverUSA

Personalised recommendations