Nondirectiveness — Facts, Fiction, and Future Prospects

Summary

Nondirectiveness is the generally required and professed standard for genetic counseling. However, studies are lacking in the field of human genetics and in other disciplines which address either the theory or practice of this type of communication in the context of genetic counseling. Moreover, there is no indication that the further development that this concept has undergone has been acknowledged in human genetics. This could be due to the historical development of genetic counseling, its inherent conflicts and often undefined goals, and the latent need of human geneticists to defend themselves against being accused of eugenic tendencies. Nondirectiveness and directiveness, however, can neither adequately describe what takes place in genetic counseling, nor can they — according to their original meaning — be used to define an ethical standard of genetic counseling.

An experiential approach is described, in which counseling is seen as a process of influence, which is wished by all the persons involved, during which activities are oriented towards the experience of the client, and which allows the counselor to communicate openly and directly with the client.

This paper critically discusses various aspects of nondirectiveness, the dealing with this concept in recent statements and investigations, the relationship between the demand of nondirectiveness and the current practice of genetic counseling, and the structural (societal) context. It is concluded that the experiential approach in genetic counseling can uphold the principle of ethics, which nondirectiveness demands and, at the same time, prevent the inevitable and unresolvable contradictions.