Genetic counseling is a service provided in centers where genetic tests are carried out. The practice is complex since it is associated with numerous ethical dilemmas. The process of genetic counseling encompasses pre-test counseling and post-test counseling tailored to enable the customer to come to terms with the results of the test and make an informed decision (Gallo, Angst, & Knafl, 2009). The underlying idea is that a counselor should avail all the relevant information that would allow an individual to make an informed decision; at no point should the counselor make a decision for the client.
Case 1
The ethical dilemma in the case is whether to perform the test or not. The parents are at liberty to make individual decisions regarding whether to abort a child; the case is particularly justifiable for a fetus is homozygous for the mutated gene that code for the achondroplasia trait since the disorder is debilitating and such children are more likely to die at an early age (Santrock, 2017). Conversely, the dilemma is introduced by the fact that the couple plans to abort a health child who does not possess any of the mutated genes that codes for the achondroplasia trait. Although the couple has the autonomy to decide whether to about or not, the fact that health fetus will be harmed, the principle of non-maleficence will have been infringed (Gallo, Angst, & Knafl, 2009). Therefore, the dilemma stems from the obligation of the counselor to protect the wellness of the health fetus while still respecting the autonomy of the couple.
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As a genetic counselor, I would not conduct the test since the couple plans to harm a healthy fetus, an act that would go against the ethical principle of non-maleficence. I think the difficulty experienced by dwarf parents in raising normal-sized children is not enough justification for terminating the pregnancy of a healthy fetus. By declining to do the tests, I will be upholding the principle of beneficence because it is my moral obligation to the healthy child to ensure unnecessary harms comes to him.
On the other hand, the couple might contest that since they are the parents of the unborn healthy child and since they are the ones that will encounter the struggles of raising a normal-sized child, it should be up to them to decide the fate of the pregnancy. The principle of autonomy supports the position of the couple because they are in the right state of mind and are responsible for the baby. Since I do not agree with this position because I think it goes against my professional obligation, I would recommend the couple to another genetic counselor.
Case 2
In the case scenario, the genetic counselor faces the dilemma of revealing the paternity to the wife since that is not the point of the tests, the paternity to the husband because it may cause a strain on the marriage yet the test was not focused on determining the paternity, and finally, the father of the child diagnosed with Cystic Fibrosis (CF) since he may not know he is a carrier of CF, which may pose a health risk (Gallo, Angst, & Knafl, 2009). On the other hand, he did not contract the facility to conduct the tests.
In light of the fact failure to disclose the paternity to the wife and husband may harm the family psychologically, since both will be in constant fear of siring a child with CF, revealing such information is vital. Therefore, I would tell the wife about the paternity issues and ask for her consent to reveal the information to the husband. I will not reveal the findings of the test to the father because he did not contract the center to do the tests because I have a responsibility to ensure the confidentiality of the information.
Conversely, the husband and the father may contents that by failing to inform them about the result I will be violating the principle of non-maleficence since I will be allowing harm to come to them. The husband will be continuously worried and the father may not know he has CF. References
Gallo, A. M., Angst, D. B., & Knafl, K. A. (2009). Disclosure of genetic information within families: how nurses can facilitate family communication. The American journal of nursing , 109 (4), 65.
Santrock, J. W. (2017). A topical approach to lifespan development . New York : McGraw-Hill.
