ABSTRACT
A competent physician is not only characterised by scientific knowledge and technological skill. In order to be recognised as a comprehensive expert of health care and despite an increasing tendency to specialisation he or she has more and more tasks in clinical counselling because the patients must give their informed consent before a treatment can be started. It is a misunderstanding to mix up the counsellor’s neutrality with the ideal of scientific objectivity. The sharp contrast between neutrality and paternalism gives no chance for a more benevolent interpretation of unavoidable asymmetries in situations of counselling. The choice of the counsellor determines to a considerable degree the result of a conversation. Ethicists, therapists and genetic counsellors must be aware of their duty to offer at least some elements of concrete problem solving and decision-making.
