Challenges of Pre- and Post-Test Counseling for Orthodox Jewish Individuals in the Premarital Phase.
The Jewish community has traditionally taken ownership of its health, and has taken great strides to raise awareness about genetic issues that affect the community, such as Tay-Sachs disease and Hereditary Breast and Ovarian Cancer syndrome. Thanks in part to these heightened awareness efforts, many Orthodox Jewish individuals are now using genetics services as they begin to plan their families. Due to unique cultural and religious beliefs and perceptions, the Orthodox Jewish patients who seek genetic counseling face many barriers to a successful counseling session, and often seek the guidance of programs such as the Program for Jewish Genetic Health (PJGH). In this article, we present clinical vignettes from the PJGH's clinical affiliate, the Reproductive Genetics practice at the Montefiore Medical Center. These cases highlight unique features of contemporary premarital counseling and screening within the Orthodox Jewish Community, including concerns surrounding stigma, disclosure, "marriageability," the use of reproductive technologies, and the desire to include a third party in decision making. Our vignettes demonstrate the importance of culturally-sensitive counseling. We provide strategies and points to consider when addressing the challenges of pre- and post-test counseling as it relates to genetic testing in this population.
Division of Reproductive Genetics, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine and Montefiore Medical Center, 1300 Morris Park Avenue, Block (Mazer) Building, Room 623, Bronx, NY, 10461, USA. esther.rose@einstein.yu.edu.|Program for Jewish Genetic Health, Bronx, NY, USA. esther.rose@einstein.yu.edu.
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Rose
Program for Jewish Genetic Health, Bronx, NY, USA.|Department of Genetics and Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA.
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Schreiber-Agus
Division of Reproductive Genetics, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine and Montefiore Medical Center, 1300 Morris Park Avenue, Block (Mazer) Building, Room 623, Bronx, NY, 10461, USA.
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Bajaj
Division of Reproductive Genetics, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine and Montefiore Medical Center, 1300 Morris Park Avenue, Block (Mazer) Building, Room 623, Bronx, NY, 10461, USA.|Program for Jewish Genetic Health, Bronx, NY, USA.
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Klugman
Division of Reproductive Genetics, Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine and Montefiore Medical Center, 1300 Morris Park Avenue, Block (Mazer) Building, Room 623, Bronx, NY, 10461, USA.|Program for Jewish Genetic Health, Bronx, NY, USA.
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Goldwaser
D003376:Counseling / Q000379:methods*; D003657:Decision Making; D005260:Female; D005817:Genetic Counseling / Q000379:methods*; D020022:Genetic Predisposition to Disease / Q000517:prevention & control; D005820:Genetic Testing; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D007599:Judaism; D008297:Male; D008393:Marriage / Q000208:ethnology*; D064186:Prenatal Education / Q000379:methods*; D012945:Social Values / Q000208:ethnology
Genetic counseling; Genetics; Jewish law; Orthodox Jewish