Ethical Issues In Counselling

Superior Essays
Counselling Discussion:
Health ethics comprises four general principles, which aim to guide morally acceptable behavior in clinical practice. These four principles are autonomy, beneficence, non-maleficence, and justice.
• Autonomy: the right to make own decisions
• Beneficence: the promotion of good and preventing harm.
• Non-maleficence: do no harm
• Justice: treating everybody equally and fairly
(Uhlmann, Schuette & Yashar, 2009)
In the genetic counselling setting, the nature of genetic information and its implications for family members can raise challenges in balancing the rights of individual clients and families whilst adhering to these principles (Schneider, 2002).
As a result, Genetic Counsellors are required to develop critical skills
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In FAP, medical interventions before age fourteen are not of benefit except in rare particular mutations such as codon 1309 mutations where polyposis onsets early (Kattentidt-
Mouravieva, den Heijer, van Kessel & Wagner, 2014).
I wondered why they needed to know this information now as opposed to waiting until the child was old enough to able to be involved in the process. My primary assessment was that Sharlene’s autonomy; a person’s right to make or exercise a selfdetermining choice without cohersion, would be taken away (HGSA Guidelines,
2014). Such is the case in a study conducted by Duncan et al (2010), where young people reported that FAP pre-symptomatic testing was a major life event however they had little undertaking or part in the decision-making process or room to exert their own autonomy. This concept of adolescent participation has also been discussed by Robertson et al., (2001).
I also considered how it would be for Sharlene to be the only child whose FAP carrier status was not known. I wondered whether this could result in potential harms on her childhood, and on her sense of well-being as a member of her family where the
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Life expectancy due to FAP has significantly improved based on family screening and prophylactic surgery. If a mutation is not identified through genetic testing, linkage studies are used to identify affected foetuses.
Surveillance:
The recommended surveillance for FAP is flexible sigmoidoscopy from ten-tofifteen- years of age on a 1-2 yearly basis (Kennedy, Potter, Moir & El-Youssef,
2014). In this case, Sally’s children had been recommended to start screening at fourteen-years-old unless they experienced any symptoms. Once polyposis is confirmed, prophylactic surgery should be arranged preferably before twenty-yearsold.
If surgery is not performed, then an annual colonoscopy is recommended (Rozen
& Macrae, 2006). The Eviq Guidelines (2014) report there is no evidence for the use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) to prevent colorectal cancer
(CRC) in this situation however there has been data to suggest that the intake of the non steroidal agent sulindac can reduce polyp number, however it is not known whether this in turn reduces cancer formation (Nugent, Farmer, Spigelman,
Williams & Phillips, 1993). Studies have shown that delayed intervention can

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