Abstract
AbstractThe principle of non-directiveness remains an important tenet in genetics. However, the concept has encountered growing criticism over the last two decades. There is an ongoing discussion about its appropriateness for specific situations in genetics, especially in light of recent significant advancements in genetic medicine. Despite the debate surrounding non-directiveness, there is a notable lack of up-to-date international research empirically investigating the issue from the perspective of those who actually do genetic counselling. Addressing this gap, our article delves into the viewpoints and experiences of medical geneticists in Germany and Switzerland. Twenty qualitative interviews were analysed employing reflexive thematic analysis. Participants’ responses revealed substantial uncertainties and divergences in their understanding and application of the concept. It seems to cause distress since many geneticists stated that the principle was difficult to put into clinical practice and was no longer ethically justified given the increasing likelihood of therapeutic implications resulting from genomic testing outcomes. The insights provided by our qualitative empirical study accord with the ongoing theoretical debate regarding the definition, legitimacy, and feasibility of the principle. An adequately nuanced understanding and application of non-directiveness seems crucial to circumvent the risks inherent in the principle, while promoting patient autonomy and beneficence.
Funder
Freiwillige Akademische Gesellschaft
University of Basel
Publisher
Springer Science and Business Media LLC
Reference55 articles.
1. Bartels D.M., B.S. LeRoy, P. McCarthy, A.L. Caplan. 1997. Nondirectiveness in genetic counseling: a survey of practitioners. American Journal of Medical Genetics 72(2): 172–179.
2. Biesecker B.A., K.F. Peters, R. Resta. 2019. Advanced genetic counseling: Theory and practice. New York: Oxford University Press.
3. Bjerring J.C., and J. Busch. 2021. Artificial intelligence and patient-centered decision-making. Philosophy & Technology 34(2): 349–371.
4. Bosk, C. 1993. The workplace ideology of genetic counselors. In Prescribing our future: Ethical challenges in genetic counseling, edited by D.M. Bartels, B. LeRoy, A.L. Caplan, 25–38. New York: Aldine de Gruyter.
5. Braun V., and V. Clarke. 2006. Using thematic analysis in psychology. Qualitative Research in Psychology 3: 77–101.