201- Ask yourself, what is a good decision? McCarthy Veach et al. ( 2001 ) found that
most of the genetic counselors they interviewed felt comfortable when their
patients made decisions that would not cause them harm, were consistent with
their cultural backgrounds, and seemed to work for those particular patients. The
hardest decisions were those perceived by the genetic counselors to be cavalier
(e.g., terminating a multiple pregnancy after years of infertility because the cou-
ple wanted only one child). One major ethical/professional challenge you likely
will face is refraining from talking patients out of decisions with which you
disagree.
7.5 Closing Comments
In this chapter, we suggested several strategies to help you walk with your patients
through the difficult genetic counseling process. First, you will provide relevant
information to help them be informed, recognizing that some of your information
(e.g., about risk) may not be fully understood, believed, or have the same meaning
for the patient as it has for you. Then, for many patients, you will help them use the
information you provide and other relevant information to come to a decision that
is best for them. Decisions are complex. Patients select certain options for numer-
ous reasons, some clear, some not so clear. And they often choose options that are
different from what you think they should choose. Remember that what seems to be
an irrational decision to you may be the best choice for your patient. It is also
important to remember that you can’t fix situations that aren’t repairable—some
patients’ decisions come down to trying to do the best they can in an impossible
situation.
7.6 Class Activities
Activity 1: Stigmatizing Words (Dyads or Small Group Discussion)
First, students brainstorm words that could communicate a negative message or
stigmatize the patient when presenting risk information (e.g., mutant).
Process
The whole group generates a list that the instructor writes on the board.
Next, the students identify alternative words/brief phrases for each word they
identified as negative or stigmatizing.
7.6 Class Activities