One of the hallmarks of medical genetics is non-directive counselling. Therefore, I was dismayed to read the case for selective paternalism in genetic testing in Wired’s Neuron Culture. In most cases, genetic tests only provide information and patients need to determine if they want the information and/or what to do with it. Genetic counsellors should help patients understand the impacts of the information.
I’m defining paternalism as a medical professional advising a patient on the best course of action. I’m a fan of medical experts telling a patient what to do when:
- It is best for public health. Examples: vaccines, reporting sexually transmitted infections
- There is an obvious treatment. Example: bone sticking out of arm after fall
- You can save a child’s life. Example: providing blood transfusions to children of Jehovah’s Witnesses faith
But medical genetic testing doesn’t usually fit into these categories and often provides difficult information without clear treatment.
One of the hardest things to teach the medical students is that genetic tests should be optional. Read more
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