The last century's technological advances have granted us an astounding amount of insight into the genetic codes and microscopic structures that make us who we are. A combination of curiosity and concern has led many to explore their own genetic heritage in greater depth, and one can understand the appeal of seeking professional guidance to gauge the inherent mental health risks posed by one's lineage. In the (approximately) 20 years since researchers began to focus more intently on the hereditary aspects of mental illness, psychiatric genetic counseling has grown into a field which, while nearly invisible to the average citizen, could grow exponentitally larger in the near future. Like other practices designed to predict and, in some cases, artifically shape the course of human life, it raises nebulous ethical questions about the power we have over our own development the dangerous precedents that could be set by its expansion.
A genetic counselor's trade consists of examining hereditary data and advising patients about the likelihood that they, their children or members of their family will develop psychiatric disorders at some point in their lives. At the root of the issue lies a crucial question: what will patients gain from the very imprecise information they receive at these sessions? And how will they respond if they believe that this news warrants decisive action? Counselors themselves affirm that current science is unable to predict these disorders with any real precision, but the human tendency toward a near-superstitious reliance on fate may overshadow this inconvenient fact. While one's chances of developing schizophrenia are, for example, somewhat higher if a parent, grandparent or sibling has the disorder, our ability to predict its development is still extremely imprecise, and given percentages may do more to facilitate hypochondria than to satisfy curious patients or help them make the healthiest choices for themselves and their families. As our understanding of the human genome progresses, our ability to predict psychiatric abnormalities will undoubtedly improve. But will these advances further the thorny genetic engineering scenario? Will parents experiment with their children's biological markers in order to reduce the likelihood of adolescent bipolar disorder or schizophrenia? What of the subsequent results and their influence on unrelated aspects of the affected child? These potential treatments will not come to fruition in the next few years, but arguments about their implications will no doubt intensify in the meantime.
One of the most important roles a counselor can take is that of the personal therapist/advisor who downplays parents' exaggerated fears about their children. Shock literature and sensationalized news stories may encourage unproductive paranoia on the part of these individuals, but the fact that the parents of an autistic kid may voice concern about future children developing the disorder is understandable. And if they require professional counseling to relieve these worries and make a slightly-more-informed decision about the future of their families, so be it. The image of a loving couple deciding not to have a baby due to the remote possibility of their child developing some form of mental illness is harrowing - and, given the current interest in prenatal testing, it will most likely grow more common in the near future. Some genetic counselors remain unsure about the developing popularity of their field. They believe that, while patients may voice an interest in seeking out such tests, many grow tepid when the opportunity arises due to a fear of undesirable results.
In answer to the most common genetic queries, we can state with absolute certainty that children of patients who suffer from certain mental illnesses will in some way be more likely to develop the same conditions than those in the general, unaffected population. Most parents must be aware of this, and they need to be especially sensitive to the development of related symptoms in their young offspring. Early intervention can prove decisive in these cases, but they shouldn't need a counselor to tell them that.
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