Ethical dilemmas in clinical genetics

This paper discusses the results of a survey of medical and paramedical opinion relating to various difficult ethical issues in clinical genetics. These include the confidentiality of the doctor-patient relationship, prenatal diagnosis and termination, and Huntington's chorea. It is suggested that this method provides a useful means of assessing what is ethically acceptable in contemporary society.Questionnaires on dilemmas in genetic counseling were distributed to 446 health professionals, and 144 replies were received. In response to questions about disclosure, 63% thought that the employer of a worker at risk should be informed, but only 29% would disclose a genetic defect to at-risk relatives without permission. A majority believed that selective abortion is permissible when a fetus is likely to be severely handicapped; a majority also thought that the genetic counselor can offer advice when asked, or even "thrust" advice on patients. Almost all the respondents favored the development of a predictive test for Huntington's chorea.