Table 2.

Pre-Test Genetic Counseling

Topics to Address
• Explanation of the basic principles of heredity, genes, genetic disease and testing
• Potential benefits to patient and family with a genetic diagnosis
• Likelihood of results, and explanation of positive, negative and indeterminate results
• Likelihood of secondary or incidental results
• Cost of testing
• Potential for findings regarding paternity
• Potential for discrimination by community, employer or insurer, and existing legal protections
• Explanation of broad benefits and drawbacks by testing modality (Table 1), with focus on the tradeoffs involved with genome-wide approaches (i.e. increased diagnostic sensitivity versus increased potential for nonspecific findings, and increased costs)
• Implications for insurability