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The movement was also Utopian in that it looked to the future as an opportunity to
improve men and society, through selective breeding, immigration, and social
planning. In both its Arcadian dreams and Utopian fantasies, it looked to genetics
as the method” (p. 474).
The general public as well as psychologists, medical professionals, and politi-
cians were eager to use this new science of genetics to improve the human race,
believing this goal would benefit everyone. In the early 1900s, many states in the
USA had laws mandating the sterilization of the mentally defective. Informed con-
sent was not involved, and over 60,000 people were sterilized involuntarily (Stern
2009 ). “Inferior” ethnic groups were not allowed to immigrate, and by the 1930s
these ideas were well accepted not only in the USA but also in many other countries
as well. In Germany, these ideas became the horrible excuse for killing many people
considered to be inferior. This part of the history of genetics in medicine and public
health is important to remember because it may still color the public perception of
the profession of genetic counseling. Although less so today, many people may be
reluctant to seek genetic counseling, fearing they will be told not to have a child
because of their “bad” family history.
Additionally, the potential for genetic discrimination often remains a perceived
risk, affecting patient decisions about testing and genetic counseling. Maio et al.
( 2013 ) studied awareness and perceptions of the Canadian public about genetic coun-
seling and among other results, found that, “a sizable proportion of participants also
felt that a purpose of genetic counseling was to prevent inheritable disease and abnor-
malities, advising couples regarding whether to have children, and helping couples
[have] children with desirable characteristics” (p. 768). Riesgraf et al. ( 2015 ) studied
the public’s perceptions and attitudes about genetic counseling in a rural midwestern
area and found that “Respondents generally seemed to understand how genetic coun-
seling is performed and delivered. For example, a majority agreed genetic counseling
is confidential and genetic counselors provide emotional support and receive special
training...A majority also agreed seeing a genetic counselor would not lead to loss of
insurance or a job, and genetic counseling would not be used to help expecting par-
ents choose the gender or eye color of a future child. These findings differ from previ-
ous studies on genetic testing which showed genetic discrimination and eugenics
were substantial concerns among members of the general public in Finland and the
UK...While these data may reflect a difference between the perceptions of genetic
counseling versus genetic testing, they may also reflect a changing climate in the
years since the earlier research was conducted or cultural differences” (p. 575).
In 1947, Dr. Sheldon C. Reed coined the term genetic counseling. He delineated
the three requirements of genetic counseling: (1) knowledge of human genetics; (2)
respect for sensitivities, attitudes, and reactions of clients; and (3) teach and provide
genetic information to the full extent known (Reed 1955 ). This era of genetics
marks a significant turn where the scientific community took ownership of the prac-
tice of genetic counseling and adopted the belief that individuals should make deci-
sions for themselves about their genetic risk. In commenting about the Preface of
the first edition of the very first book published on the practice of genetic counsel-
ing, Counseling in Medical Genetics, Reed ( 1980 ) writes, “The first edition was
2 Overview offiGenetic Counseling