Riddle of the Elephant Man

Riddle of the Elephant Man | Genetic Counselling | Genetic Testing | Find Out More

Dr Martin Brookes

January 2004

Genetic counselling

Genetic counsellors now form an integral part of the health care system. Working in association with GPs, geneticists, nurses, surgeons, psychologists and social workers, they inhabit that uncomfortable realm of uncertainty where health and genetics collide. Angela Arnold, a genetic counsellor at the Royal Free Hospital in London, deals primarily with people who have a history of cancer in their family. Some of her patients have developed the disease already, whereas others are worried about getting cancer later in life. But her work also embraces people with any concerns about the genetic health of themselves, their family or their future children. Whatever the particular circumstances, however, the overall objective is always the same. 'The goal,' she says, 'is to guide people through a decision-making process in a non-directive way.'

Non-directive is the mantra of genetic counselling. While most medical professionals are happy to hand out instructional advice to their patients, counsellors pursue an entirely contrary philosophy. There are no simple prescriptions on offer. Instead, it is the counsellor's role to educate and inform, preparing a patient for what might lie ahead.

People arrive in Angela Arnold's office via a variety of routes. Some may have been referred by their GP or surgeon, especially if a family history of a disease is suspected. Others may have been alerted to a particular disease by press reports on the radio, television or in a newspaper. Some may simply be curious about their own particular circumstances. The counsellor's job is to review the family history with the patient, and provide information and guidance germane to each individual case. Only in those cases considered to be high risk will the counsellor discuss the possibility of a genetic test.

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