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Genetic Counseling: Helpful or Harmful?

By FABIHA CHOWDHURY & MANRUCHI PADDA

A faint ring reaches into your ear as your face is grazed by a rolling breeze, carrying a smell so pungent it irritates your nose. As you survey the menu carefully you notice the variety --- the variety in loaves of bread, sauces (chipotle or mayo?), spices, meats, cheeses, and vegetable toppings. A different kind of feeling takes up your mind: total and complete domination.


Here behind these very green walls, you hold the remote control --- from deciding the soup texture to the complementary selection of chips. It is a fully customizable experience for you to get the most optimal sandwich experience you can. After all, it would seem perfect to you because you chose everything on it, right?


When planning for a potential pregnancy, or even during/after it, parents often opt to participate in genetic counseling to obtain more information on how genetic conditions may affect their families. Parents tend to find genetic counseling to be a useful tool because it provides parents with a clear picture of how past or potential genetic conditions may affect their offspring --- but there have been some recent debatable ethical issues with this process. Much of the controversy has to do with the swaying influence counselors truly have as their guidance could lead to parents opting for genetic engineering of their children, creating an entirely distinct moral issue.


One of the main ethical issues that comes with consulting genetic counselors is the likelihood of receiving false-negative or false-positive results. According to the Journal of Midwifery & Women’s Health, some genetics tests are only 60% accurate, therefore leaving a 40% chance that a patient receives a false result. This would lead to further complications, as genetic counselors offer specific treatment plans which may occasionally depend on the result of the genetic test. These treatments could range from complete lifestyle changes to potentially harmful medications that are prescribed when they are not necessary.


There is also a large ethical conflict with identifying pregnant patients through genetic testing. Counselors often face ethical issues once they are left to reveal whether one or both parents are carriers of a medical condition. If the test results show that the unborn child has genetic anomalies, patients may want to opt for an abortion rather than carry a child to term. This aspect of genetic counseling, along with genetic testing, has continued to be a highly debated topic in bioethics. Genetic counselors are in an especially difficult position because their profession revolves around providing treatments or future plans for their patients based on findings regarding their genetics, so disclosing information regarding the probability of having a child who is a carrier of a genetic disease would cause bring ethics into question when talking about options such as abortion.


This would further go into the idea of whether the parents would want to keep their child while knowing that they are carrying a genetic disease that is being passed on from generations. While it is up to the patient’s discretion to keep their child or not, patients have previously opted to abort their child once learning that their child could carry a genetic disease.


When considering any sort of counseling it's important to recognize the potential and existing biases of professionals within the field. Studies have shown that implicit bias in genetic counselors is associated with negative markers of communication within minority client sessions and can contribute to racial disparities in the process of genetic counseling. Considering the collosal leverage such counselors have on the delicate procedure of childbearing it becomes important to examine how their attitudes and undisclosed discretions towards certain racial identities and traits impact the next generation of civilization. Since much of the general population lacks a coherent understanding/ grasp of genetics-based concepts they will rely predominantly on these professionals to guide them in their significant journey.


As people continue on with seeing genetic counselors to be informed of their pregnancy, it is no doubt that these very counselors have to study the fine line of ethics because they are helping their patients plan out next steps in light of the genetic conditions that a family may have. The suggestions that the genetic counselors choose to provide must be in accordance with a consistent ethical law, and they must face ethical issues, such as the previous ones that we have discussed, on a daily basis. Until the accuracy and overall “fine line” is drawn to reduce as much bias in the field as possible, we are left with the ethically questionable field that is genetic counseling.


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