教育講演13
神経内科医に必要な遺伝カウンセリング
吉田 邦広
信州大学医学部神経難病学講座〔〒390―8621 松本市旭3―1―1〕
With the increasing knowledge of the molecular bases for neurological disorders, neurologists are now often required to administer genetic testing and to present the resulting information effectively in clinical practice. In the neurologic clinical setting, genetic testing of affected individuals is usually taken into consideration for a correct diagnosis, but is rarely undertaken in healthy individuals to determine genetic risks for their life planning. Genetic counseling is indispensable for genetic testing because test results may cause serious distress for patients and their family members (referred to as "clients" in the counseling session). Genetic counseling is the medical process of communication that helps clients understand the nature of the genetic disorder and the options open to them in management and family planning. Through the counseling process, clients are given both the medical information and psychosocial support necessary for their own decision-making. Thus, the aim of genetic counseling is to support the client's decision-making process regarding genetic testing, and to avoid unfavorable actions after disclosure of test results. In the broad sense, genetic counseling is a part of ordinary clinical practice for patients with hereditary neurological disorders because neurologic clinical practice includes education and psychosocial support for patients. But clients seeking predictive genetic testing, which includes complicated ethical and psychosocial issues, should be referred to more specialized genetic counseling clinics that take a multi-disciplinary approach. The counseling process is not a one-way transmission of medical information by neurologists, but consists of two-way communication between patients and neurologists. It is therefore crucial for neurologists to master communication skills, particularly those involving active listening and empathic understanding, in order to conduct effective genetic counseling in clinical practice.
Full Text of this Article in Japanese PDF (284K)
(臨床神経, 51：865−867, 2011)
key words：遺伝カウンセリング，遺伝子診断，心理社会的支援，積極的傾聴，共感的理解
（受付日：2011年5月20日）
