362
1995 ; Eliason et al. 2000 ). The four values rated most highly by the participants
were benevolence (concern for others), self-direction (independence), achievement
(personal success), and universalism (protecting the welfare of all).
13.2 Professional Values
The National Society of Genetic Counselors (NSGC) states its primary professional
values in its Code of Ethics (found in Appendix B). The NSGC Code of Ethics pro-
vides an overview of counselors’ obligations to themselves, patients, colleagues,
and society. “Each section of this code begins with an explanation of the relevant
relationship, along with the key values and characteristics of that relationship. These
values are drawn from the ethical principles of autonomy, beneficence, nonmalefi-
cence and justice, and they include the professional principles of fidelity, veracity,
integrity, dignity and accountability” (Appendix B). It is important for all profes-
sionals to be able to identify their personal values, those of their profession, and
those of the organizations in which they work. Knowing these values can help you
decide what is an appropriate response in each situation and identify where there are
conflicting expectations you must consider when choosing how to respond.
Ethical challenges are challenges to our personal and professional values. They
are part of everyday practice for genetic counselors. As noted above, The NSGC
Code of Ethics (Appendix B) provides an overview of counselors’ obligations to
patients, to society, and to themselves. Genetic counselors will face some ethical
dilemmas because of these multiple, and at times conflicting, obligations. In some
instances, what is best for a family or for the broader society is not what is best for
an individual patient. Honoring one principle (such as respecting patient autonomy)
might mean ignoring other obligations (like acting fairly). Value conflicts occur
when counselors experience the tension of competing values or when patient expec-
tations and counselor values conflict (Abad-Perotin et al. 2012 ; Alliman et al. 2009 ;
Bower et al. 2002 ; Gschmeidler and Flatscher-Thoeni 2013 ; McCarthy Veach et al.
2001 ). In such instances, you will need to select the principle(s) most important to
a particular situation to guide your actions.
In the following section, we describe six ethical principles that might be used as
a basis for decision-making.
13.3 Guiding Ethical Principles for Health Professionals
Beauchamp and Childress ( 2012 ) describe principles from moral philosophy as a
guide for health professional behaviors. These principles are based on respect for all
persons as intrinsically valuable.
13 Professionalism: Ethically Based Reflective Practice