Parental guilt: The part played by the clinical geneticist

Parents of children born with a disability often suffer feelings of inappropriate guilt and shame. Although some genetic counselors see their main task to be that of diagnosis and education, they also aim to relieve these feelings of guilt and shame. Little is known about the process of genetic counseling, and whether or not counselors achieve this aim. An exploratory study of one clinic, and one geneticist working with 30 families, using video recordings and taped interviews, indicated that this particular doctor sometimes succeeded in reducing guilt, either intentionally or unintentionally, but on one occasion guilt was iatrogenic, and increased rather than decreased. Further research is needed to examine other types and other styles of genetic counseling so that in future iatrogenic guilt can be avoided, and the distressing aspects of inappropriate guilt and shame reduced as much as possible.