ABSTRACT
Genetic counselors in the United States are almost exclusively guided by the principle of client autonomy in their interactions with counselees. The primary concern of genetic counselors is the interests of their clients. The essence of the counselor’s role is that of fact provider; the essence of the counselee’s role is that of value provider. A fact/value division of labor between a health care provider and a patient—client presupposes a distinction between facts and values; a fact/value distinction presupposes a particular view of objectivity. Rejecting the features of the traditional view entails rejecting the understandings of autonomy, value neutrality, and nondirectiveness that presuppose a fact/value distinction. The science argument stresses the practical interdependency of facts and theories. The ethics argument sees all human activity (including science) as determined by the interests and values of those wielding social and political power.
