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BOOK REVIEWS by EDWARD D. GARBER* Genetic Counseling: Facts, Values and Norms. By A. M. Capron, M. Lappe, R. F. Murray, T. M. Powledge, S. B. Twiss, and D. Bfrgsma. New York: Alan R. Liss, Inc., 1979. Pp. 344+xii. $34.00. Genetic counseling has emerged from medical genetics as a formal profession, providing a specialized service to clients. This volume of articles is addressed more to genetic counselors than to genetic counseling and provides a broad background for aspiring and practicing genetic counselors. Five articles are concerned with "Appraising the Legitimacy of Genetic Concepts," eight articles with "Genetic Counseling in Psychological and Social Perspectives," and six articles with "Moral, Social and Legal Problems in Genetic Counseling." Professional geneticists have long known that heredity is complex, and simple answers are a rare commodity. The great advances came from the study of monogenically determined characteristics and obvious chromosomal aberrations . When the experimental organism is readily manipulated, complex questions can be dissected into comprehensible components. The environmental impact in the broadest sense can be minimized during development. When the species cannot be manipulated, answers to questions must be guarded, hedged, and surrounded with caveats. The experimental geneticist is not concerned with counselor-client relationships, moral obligations, social problems, licensing, or malpractice. The section appraising the legitimacy of genetic concepts is a short course on the shortcomings of medical genetics in providing unequivocal or foolproof answers to clients by the genetic counselor. In other words, biochemical assays, amniocentesis, and karyotyping may be wonderful but there are problems . This section informs the genetic counselors that they face the same problems that confront physicians and patients. Perhaps, excellent courses in fundamental genetics and human genetics would be more to the point in the training of genetic counselors than extensive readings in genetic counseling. The section on genetic counseling in psychological and social perspective reminds the genetic counselor that the client is human. According to Levine (Genetic Counseling: TL· Client's Viewpoint), "Most clients are in the 20s and 30s, from middle and upper income levels, and above average in education." These clients want information in terms of background, risk in having a "defective" child, amniocentesis, and the other obvious questions prior to making a decision. It *Barnes Laboratory, Department of Biology, University of Chicago. Permission to reprint a book review printed in this section may be obtained only from the author. Perspectives in Biokgy and Medicine · Spring 1981 | 503 would seem that the proper responses to the questions require a multitalented counselor with access to a programmed computer terminal or membership in a large supporting team. Licensing genetic counselors implies an accredited curriculum monitored by an accredited agency. This problem is merely identified in this section, not addressed. The third section is devoted to moral, social, and legal problems in genetic counseling and does not seem to follow the other sections. Clients for genetic counseling pay for the service to reach decisions and resolve the problem. The National Genetic Diseases Act has no meaning to this clientele. Public policy relates to the greater clientele, the public. This volume is clearly required reading for professional and amateur genetic counselors. The counselor-client and physician-patient relationships are comparable in terms of outcome of poor training and experience on the part of the counselor. The genetic counselor, however, has to appreciate the relationship without the training afforded to the physician. This volume lights a large candle. Cytogenetics and Cell Genetics. Vol. 22, no. 1-6. Winnipeg Conference (1977). Fourth International Workshop on Human Gene Mapping. Basel: S. Karger AG. Pp. 730. $49.25 The classical cytogeneticists working with corn, barley, or mouse who cooperated by assigning specific chromosomes to different colleagues should get some satisfaction in this volume by noting that the human cytogeneticists have followed their example. Of course, there is one significant difference. Who could have imagined that sexual crosses would not be involved? And, who would have thought that the discovery of the parasexual cycle in the fungal speciesAspergillus nidulans would provide the theoretical foundation for assigning genes to specific chromosomes or chromosome arms? The fourth International Workshop on Human Gene Mapping has produced a volume containing two plenary presentations , 10 separate committee reports...


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