Genetic Counseling and the Spirit of Communication

Abstract

This dissertation elaborates and evaluates the proprieties of genetic counseling as they are accounted for in three models: 1) the teaching model 2) the psychotherapeutic model and 3) the responsibilist model. The elaboration of these involves an identification of the larger traditions, visions, and theories of communication that underwrite the models. In relation to these broader contexts, the models are explicated in the terms offered by key proponents. Each model’s theses are assessed and their adequacy is tested and compared in response to two important concerns in genetic counseling: the value of nondirectiveness and the assessment of spirituality. Nondirectiveness is a central and contested norm within genetic counseling that posits the appropriate ways to respect the understanding and decision making of patients. Spiritual assessment is an intervention being considered by some genetic counselors that would formalize inquiry into a patient’s spiritual life. These are discussed in reference to a case study about a pregnant woman who receives prenatal genetic counseling. All of these theoretical efforts support the claim that the responsibilist model provides the most adequate account of the proprieties of genetic counseling.