The public, the primary physician, and genetic counselling

This article reviews the literature regarding variables that affect that likelihood that genetic counselling will be either requested by clients or suggested by primary care practitioners. Results of current research indicate that use of genetic counselling may be hindered by a lack of knowledge on the part of both physicians and the public, by such psychological barriers as fear of genetic disease and its attendant stigma, by cultural values that stress reliance on fate or God's will, by medical values that deemphasize clients' emotional needs and disease prevention and that stress active intervention by the physician, and by financial consideration. The findings suggest the need for research on 1) knowledge of and attitudes toward genetic disease, genetic counselling, and genetic screening among the general public, 2) variables affecting the public's response to genetic counselling and genetic screening programs in different socio-demographic communities, and 3) physicians' value systems and their effects on physicians' use of genetic counselling.