Abstract for presentation at 11th International Congress of Human Genetics

Background: For any couple, it is often a time of distress, anxiety, and grief following the fetal diagnosis of abnormality. Genetic counsellors are familiar with the interventions that may help a couple at this difficult time. Addition barriers to effective genetic counselling may exist when the counselling occurs in a cross-cultural context. Lum (1985) identifies four potential barriers that may effect counselling, institutional variables, client variables, counsellor variables, and client-counsellor variables.
Case: A Muslim couple attended for genetic counselling in the 12th week of pregnancy. Ultrasound indicated fetal akinesia deformation sequence, most likely due to Lethal Multiple Pterygium Syndrome.
Issues:
• Cultural assumptions and stereotyping
• Cultural awareness and sensitivity
• Consanguinity
• An Islamic perspective on issues of termination of pregnancy, prenatal testing, family and fertility
Outcome/Strategies: Identifying the patients’ values and working from within that context, rather than the counsellor’s frame of reference enables the counsellor to be congruent with the patient, which is essential for effective counselling. A number of additional strategies may be employed to address the barriers that may be present in cross-cultural counselling. Extra effort may be needed to establish rapport and ensure the patients’ understanding of the reason for referral and clinic procedures. Interpreters need to be accessible, appropriate, and reliable. Counsellors need to be culturally competent, aware and accommodating of the couples’ practices and beliefs that may impact on the counselling process.
Discussion: Culture and religion may influence any couples decision-making in the genetic counselling process. Exploration and acknowledgment of these influences demonstrates that the counsellors respects these beliefs, and values their importance to the counselling process.