ABSTRACT
Over 2,000 years ago, the oracle of Delphi demonstrated the fundamental problems of truth telling. The dilemma and the often tragic outcome of interpreting potentially predictive information are well documented and have many parallels with prediction in medicine. To be a counsellor in modern genetic counselling means to be an expert with many talents. Not only is expertise in medical genetics very important, but so too is a real understanding and meeting of the very complex individual needs of the counsellee and their family. Furthermore, nowadays genetic counselling has important implications regarding ethical, political and legal aspects. The risks taken by the counsellor as well as the counsellee are manifold. In general, the occurrence of the disease at risk is remote and the accuracy of predicting the ‘truth’ is usually very low. Many competing risks, mostly unknown, will arise over time and interfere with today’s interpretation. The responsibility of the truth-teller is to lead the well-informed counsellee to a shared decision and thus avoid unnecessary harm. In this chapter some of these duties of the ‘truthteller’ will be explained and discussed.
