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Providing solutions-defining problems: the imperative of disease prevention in genetic counselling

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  • Koch, Lene
  • Nordahl Svendsen, Mette

Abstract

Common sense states that problems make people look for solutions. This article proposes the contrary, i.e. that solutions provide the framework within which certain problems can be stated and handled. Drawing on observations of cancer genetic counselling in Denmark and official recommendations concerning the practice of genetic counselling, this article explores how the new prophylactic possibilities become the lens through which risk factors are identified and defined as problems that require action. In particular, the question of how new possibilities to prevent hereditary disease challenge the traditional non-directive ethos of clinical genetics provides the occasion to analyse governmentality processes in clinical genetic dialogues. The article argues that an imperative of choosing disease prevention in genetic counselling transforms the notion of non-directiveness as well as the notions of autonomy and informed consent. The transforming event is the transmission of expert knowledge on genetic risk from counsellor to counsellee. This process of knowledge transmission creates autonomous individuals who, through the medium of choice, consent voluntarily to take personal responsibility for themselves and their relatives. Conceived as a health technology, genetic counselling is a practice through which hegemonic knowledge claims about saving lives by acting responsibly is created. Disease prevention as the solution to increased risks comes to stand out as the right way of relating to oneself, the family, and society.

Suggested Citation

  • Koch, Lene & Nordahl Svendsen, Mette, 2005. "Providing solutions-defining problems: the imperative of disease prevention in genetic counselling," Social Science & Medicine, Elsevier, vol. 60(4), pages 823-832, February.
  • Handle: RePEc:eee:socmed:v:60:y:2005:i:4:p:823-832
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    References listed on IDEAS

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    1. Williams, Clare & Alderson, Priscilla & Farsides, Bobbie, 2002. "Is nondirectiveness possible within the context of antenatal screening and testing?," Social Science & Medicine, Elsevier, vol. 54(3), pages 339-347, February.
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    Cited by:

    1. Barberić Lara, 2013. "Genetic Knowledge and Genetic Reproduction Technologies as New Modes of Governance – are We Witnessing a New Form of Eugenics?," Croatian International Relations Review, Sciendo, vol. 19(69), pages 33-54, December.
    2. Huniche, Lotte, 2011. "Moral landscapes and everyday life in families with Huntington's disease: Aligning ethnographic description and bioethics," Social Science & Medicine, Elsevier, vol. 72(11), pages 1810-1816, June.
    3. Weiner, Kate, 2011. "Exploring genetic responsibility for the self, family and kin in the case of hereditary raised cholesterol," Social Science & Medicine, Elsevier, vol. 72(11), pages 1760-1767, June.
    4. Miller, Fiona Alice & Giacomini, Mita & Ahern, Catherine, 2008. "Contending visions in the evolution of genetic medicine: The case of cancer genetic services in Ontario, Canada," Social Science & Medicine, Elsevier, vol. 67(1), pages 152-160, July.
    5. Clarke, Angus & Sarangi, Srikant & Verrier-Jones, Kate, 2011. "Voicing the lifeworld: Parental accounts of responsibility in genetic consultations for polycystic kidney disease," Social Science & Medicine, Elsevier, vol. 72(11), pages 1743-1751, June.

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