Genetic counseling: 'rationality' is in the eye of the beholder

Genetic counseling: 'rationality' is in the eye of the beholder "Genetic counseling is preventive medicine and should be so regarded," wrote Claire Leonard, MD, Gary Chase, MD, and Barton Childs, MD, all of Johns Hopkins Hospital, in an article entitled "Genetic Counseling: A Consumers' View" (N Engl J Med287:433, 1972). They further emphasized that "parents should be given information that will help them to make rational decisions about further reproduction." Unfortunately, these and other investigators came in for a bit of a jolt. The counselees' grasp of genetic information was poor, they found, and reproduction decisions frequently were based on factors other than risk. "Indeed," they summarized, "the families who continued to reproduce could not be distinguished by their knowledge from those who did not." Cecil O. Carter, FRCP, and colleagues in the Medical Research Council Clinical Genetics Unit, England, found that the couples they studied (LancetI:281,