Based on your readings, how do you think developments in genomics would influence the further development of genetic counseling? In which areas would be most impacted and how genetic counselors can adapt to these impacts?
In the article by Ormond, the transition from single-gene-focused genetic counseling and testing to a full genomic medicine approach will likely induce differences in the scope, approach, and process of genetic counseling. The article underscores the importance of obtaining “tailored” family histories in providing anticipatory guidance regarding what a genomic study may identify or may find out.
I realized genomic counseling shows a lot of promise. It may serve as an avenue for us to discuss the future of our patients in terms of prevention. As a result of broader testing, we may be able to focus on a more anticipatory or preventative approach, as opposed to the traditional diagnosis-focused approach that has been employed in genetic counseling.
Based on Ormond’s article, I am made to understand that the progress in genomic medicine might require genetic counselors either to subspecialize to master the increasing amount of genetic information or to become clinical generalists to assess the full range of information a genome will provide. Education and informed consent would also have to be significantly revised to accommodate the presumed newly emerging approaches and tests in genomic medicine and counseling. Much research needs to be done in terms of what patients want to know about genome testing for them to give their consent. We must also find out which of these approaches are most effective and useful for decision-making in patients undergoing genetic testing and which educational approaches are available to address the varied learning styles of patients.
Proficiency in variant interpretation and understanding the laboratory and bioinformatics process is a must for genetic counselors. The article highlighted the strong focus on individual autonomy and non-directiveness around genetic testing decisions and future medical management. I realized that genetic counselors would need to enhance their existing knowledge and skills in preparation for the evolution of genomic counseling and at the same time preserve the core principles of values-based decision making for patients while promoting patient health outcomes (already observed in genetic counseling). As genomic medicine and counseling evolve, so must we.