FUTURE-DIRECTIONS IN GENETIC-COUNSELING - PRACTICAL AND ETHICAL CONSIDERATIONS

The accelerated discovery of gene mutations that lead to increased ris k of disease has led to the rapid development of predictive genetic te sts. These tests improve the accuracy of assigning risk, but at a time when intervention or prevention strategies are largely unproved. In c oming years, however, data will become increasingly available to guide treatment of genetic diseases. Eventually genetic testing will be per formed for common diseases as well as for rare genetic conditions. Thi s will challenge genetic counseling practice. The ethical principles t hat now guide this practice take into account the personal nature of t est decision making, the need to respect individual self-determination , and the importance of client confidentiality. Certain of these princ iples may have to be modified as genetic testing becomes more widespre ad in order to meet the changing needs of clients and society. This pa per offers recommendations to ensure that genetic counselors will take a leading role in the future delivery of ethical genetic services.