Prenatal diagnosis: when the clinician disagrees with the patient's decision.
OBJECTIVE
Recent reports of prenatal diagnosis of cleft lip and cleft palate resulting in pregnancy termination have raised questions about the appropriateness of such decisions. This review attempts to clarify the importance of nondirective counseling and define the role of the clinician, especially in the face of difficult and often controversial decisions.


METHODS
Genetic counseling literature was reviewed to clarify the role of genetic counseling in prenatal diagnosis within the framework of different counseling approaches.


CONCLUSIONS
The ultimate decision regarding pregnancy outcome and management, including termination, belongs to the pregnant couple. Clinicians will often have their own thoughts about what decisions they would make when faced with certain clinical situations. However, the responsibility of clinicians is to help the couple make their own decisions based upon their personal religious, moral, and cultural values.
Saal
Howard M
HM
Clinical Genetics, Division of Human Genetics, Children's Hospital Medical Center, Cincinnati, OH 45229, USA. saalhm@chmcc.org.
D000028:Abortion, Induced; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002971:Cleft Lip / Q000175:diagnosis; D002972:Cleft Palate / Q000175:diagnosis; D003376:Counseling; D003469:Culture; D003657:Decision Making; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis*; D005817:Genetic Counseling; D006801:Humans; D009014:Morals; D010358:Patient Participation; D010817:Physician-Patient Relations; D011247:Pregnancy; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D012068:Religion and Medicine