The genetic counseling before prenatal diagnosis: a moral obligation

Abstract

Prenatal diagnosis has now become a common medical practice, and is considered an undispensable mean in order to accertain serious embryo-fetal malformations or the presence, even in the pre-implantation embryos, of genetic conditions associated with genetic diseases or syndromes. It is clearly recognized, also by official documents, that prenatal diagnosis must be preceeded by genetic counseling, and that genetic counseling is to be considered a true medical action. In fact, the genetic counseling offers the physician the opportunity: 1. to establish whether any “indication” for the diagnosis exists; 2. to decide whether it can actually and fruitfully be done; 3. to furnish the woman or - better - the couple, in a comprehensible way, all the informations needed for an “informed” and “free” decision about making or not the prenatal diagnosis; and 4. to prepare and assist the couple all through the difficult period of the waiting of the results and mainly after their communication when painful decision are to be made. As any other medical action, the genetic counseling requires preparation, continuous adjournment and a great sense of responsibility that demands attention to all deontological and mainly ethical aspects involved.