Healthy, happy, rational: reflections on genetic counselling in the GDR

Abstract

The development of genetic counselling in the German Democratic Republic (GDR) was closely connected to a well-established system of prenatal care and a process that placed reproductive decisions in the hands of women. It was embedded in the pronatalist reproductive policy of the GDR and a narrative of medical and (socialist) humanistic progress. As in other countries at that time, it promoted the goal of avoiding the birth of children with disabilities and was hence based on ableist premises. In this paper, I focus on communicative aspects of genetic counselling, as it was established in the 1970s and 1980s in university and district clinics. Thus, on the one hand I explore the communication of genetic counselling to the public; and on the other, I study the communication processes in genetic counselling centres themselves. In contrast to the USA, where the ‘genetic counsellor’ became established as a professional identity in the 1970s, there was no distinct profession of ‘genetic counsellor’ in the GDR. Instead, counselling was practised by physicians or biologists with a special interest in human genetics. This resulted in a strong emphasis in these clinical encounters on diagnosis and technical solutions, as well as an educational impetus. I propose that an important goal of genetic counselling in the GDR was to generate a sense of ‘rationality’ in prospective parents. To achieve this, those advocating and giving counselling explicitly sought to distance this practice from the eugenic ideas of the past, and to dispel superstitious ideas of heredity and religious ideas of fate. In addition, they attempted to alleviate emotions such as fear and guilt. It was in that context that counselling physicians and biologists provided interpretations of genetic findings, risk figures and disease values. I show how different interests and experiences shaped these and how risk evaluations structured counsellor-counsellee communication.