[The importance of counseling in the context of prenatal diagnosis]

Counseling plays a central role of the utmost importance in the doctor-patient/client relationship in medical genetics. Historically, its development may be described as a paradigm shift from eugenics via preventive medicine to a more psychosocial understanding as a communication process, which aims at individually bearable, autonomous decisions. The widely accepted conception of non-directiveness in genetic counseling has implications for the rights of patients and clients as well as for the duties of those offering and performing genetic diagnosis and counseling. In the context of prenatal diagnosis, genetic counseling has its special role as a framework to prevent ethically unacceptable automatism and to safeguard the interests of the individual patient/client. In view of the marked lack of adequate counseling capacities, increasing the potential of prenatal genetic diagnosis requires the development of different, possibly new concepts for counseling in this area.