© Springer International Publishing AG, part of Springer Nature 2018 33
P. McCarthy Veach et al., Facilitating the Genetic Counseling Process,
https://doi.org/10.1007/978-3-319-74799-6_2
Chapter 2
Overview of Genetic Counseling: History
of the Profession and the Reciprocal-
Engagement Model of Practice
Learning Objectives- Appreciate major aspects of the history of the genetic counseling
profession. - Recognize the tenets, goals, and values comprising the Reciprocal-
Engagement Model (REM) of practice for genetic counselors. - Describe some genetic counseling strategies and behaviors for meeting
REM goals.
2.1 History of Genetic Counseling
Genetic counseling as a recognized, independent medical profession remains rela-
tively young. Nevertheless, people have used genetic information for quite a long
time throughout history to make medical and reproductive decisions. For instance,
the Talmud advises against circumcising brothers of bleeders, and in most cultures
throughout history, incest is forbidden. Historically, people made associations by
observing patterns of disease in families, even though they did not understand
why these diseases happened (Walker 2009 ; Weil 2000 ). Although there were, and
still are, many nonscientific beliefs about the causes of disease, information from
such observations was sometimes used to prevent the same problems in future
children.
During the turn of the twentieth century to the mid-1900s, genetic counseling
became the purview of public health and took on the mission of social reform.
Heredity was credited as the cause of not only medical conditions but also of many
social problems such as poverty, crime, and mental illness. The field of eugenics
had dawned, and it was quite a public social movement (Sorenson 1993 ). In an
early publication, Sorenson ( 1976 ) describes this movement as a mission: “It was
Arcadian to the extent that many within the movement looked to the past as an
ideal and they were attempting to reconstruct an assumed lost purity of the
American race, or to recapture the simplicity of an earlier form of social existence.