Skip to main content
Log in

Wisdom, casuistry, and the goal of reproductive counseling

  • Published:
Medicine, Health Care and Philosophy Aims and scope Submit manuscript

Abstract

Reproductive counseling includes counseling of prospective parents by obstetricians, clinical geneticists, and genetic counselors regarding, for example, the use of assisted reproductive technologies, prenatal testing, and preimplantation genetic diagnosis. Two different views on wisdom and the goal of reproductive counseling are analyzed. According to the first view, the goal of reproductive counseling is to help prospective parents reach a wise decision. A specific course of action is recommended by the counselor in contrast to other possible alternatives. According to the second view, the goal of reproductive counseling is not to help prospective parents reach a wise decision but to help them reach their own decision wisely. It is the prospective parents who should make the decision, and it is their value commitments that should be decisive. It is argued that the second approach is to be preferred to the first. It combines respect for autonomy with a recognition of the need for assistance in decision-making. Both the first and second views relate the goal of reproductive counseling to wisdom. A problem is, however, what wisdom more precisely means — there are many different views. A casuistic view of wisdom is investigated. This view roughly defines wisdom as practical prudence in dealing with particular cases. What characterizes a casuistic decision-making method is elaborated in more detail. Applied to the second view, a casuistic view of wisdom implies that the counselor should encourage prospective parents to take into consideration the nature of the particular problem at hand, the context of the problem, their own individual identities, their personal value commitments, and various alternative perspectives, values and arguments.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Bernhardt, B.A. et al.: 1998, 'Prenatal Genetic Testing: Content of Discussions between Obstetric Providers and Pregnant Women', Obstet. Gynecol. 91, 648–655.

    Article  PubMed  CAS  Google Scholar 

  • Biesecker, B.B. and T.M. Marteau: 1999, 'The Future of Genetic Counselling: An International Perspective', Nature Genetics 22, 133–137.

    Article  CAS  Google Scholar 

  • Brody, B.A.: 1988, Life and Death Decision Making. Oxford: Oxford University Press.

    Google Scholar 

  • Brody, B.A.: 1988, The Ethics of Biomedical Research: An International Perspective. Oxford: Oxford University Press.

    Google Scholar 

  • Clarke, A. (ed.): 1994, Genetic Counselling: Practice and Principles. London: Routledge.

    Google Scholar 

  • Johnson M.: 1993, Moral Imagination: Implications of Cognitive Science for Ethics. Chicago: University of Chicago Press.

    Google Scholar 

  • Jonsen, A.R.: 1995, 'Casuistry: An Alternative or Supplement to Principles?', Kennedy Institute of Ethics Journal 5(3), 237–251.

    PubMed  Google Scholar 

  • Jonsen, A.R. and S. Toulmin: 1988, The Abuse of Casuistry: A History of Moral Reasoning. Berkeley: University of California Press.

    Google Scholar 

  • Juengst, E.T.: 1995, ' "Prevention" and the Goals of Genetic Medicine', Human Gene Therapy 6, 1595–1605.

    PubMed  CAS  Google Scholar 

  • Karp, L.E.: 1983, 'The Terrible Question', American Journal of Medical Genetics 23, 359–362.

    Google Scholar 

  • Lippman, A. and B.S. Wilfond: 1992, 'Twice-Told Tales: Stories About Genetic Disorders', American Journal of Human Genetics 51, 936–937.

    PubMed  CAS  Google Scholar 

  • Mao, X. and D.C. Wertz: 1997, 'China's Genetic Services Providers' Attitudes towards Several Ethical Issues: A Cross-Cultural Study', Clinical Genetics 52, 100–109.

    Article  PubMed  CAS  Google Scholar 

  • Marteau, T.M., J. Kidd and M. Plenicar: 1993, 'Obstetricians Presenting Amniocentesis to Pregnant Women: Practice Observed', J. Reprod. Infant Psych. 11, 3–10.

    Google Scholar 

  • Marteau, T. et al.: 1994, 'Counselling Following Diagnosis of Fetal Abnormality: A Comparison between German, Portuguese and UK Geneticists', Eur. J. Hum. Genet. 2, 96–102.

    PubMed  CAS  Google Scholar 

  • Marteau, T. and M. Richards (eds.): 1996, The Troubled Helix. Social and Psychological Implications of the New Human Genetics. Cambridge: Cambridge University Press.

    Google Scholar 

  • Murray, T.H.: 1996, The Worth of a Child. Berkeley: University of California Press.

    Google Scholar 

  • Nordgren, A.: 1998a, 'Ethics and Imagination: Implications of Cognitive Semantics for Medical Ethics', Theoretical Medicine and Bioethics 19(2), 117–141.

    Article  PubMed  CAS  Google Scholar 

  • Nordgren, A.: 1998b, 'Reprogenetics Policy: Three Kinds of Models', Community Genetics 1, 61–70.

    Article  PubMed  Google Scholar 

  • Nordgren, A.: 2001, Responsible Genetics: The Moral Responsibility of Geneticists for the Consequences of Human Genetics Research. Philosophy and Medicine series Vol. 70. Dordrecht: Kluwer Academic Publishers.

    Google Scholar 

  • Penchaszadeh, V.B. and B. Beiguelman: 1998, 'Medical Genetics Services in Latin America: Report of a Meeting of Experts', Rev. Panam. Salud Publica 3, 409–420.

    PubMed  CAS  Google Scholar 

  • Shiloh, S.: 1996, 'Decision-Making in the Context of Genetic Risk', in: T. Marteau (ed.), pp. 82-103.

  • Strong, C.: 1997, Ethics in Reproductive and Perinatal Medicine: A New Framework. New Haven: Yale University Press.

    Google Scholar 

  • Toon, P.D.: 1993, 'After Bioethics and towards Virtue?', Journal of Medical Ethics 19, 17–18

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nordgren, A. Wisdom, casuistry, and the goal of reproductive counseling. Med Health Care Philos 5, 281–289 (2002). https://doi.org/10.1023/A:1021105606636

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1021105606636

Navigation