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To: Multiple recipients of list HUM-MOLGEN <HUM-MOLGEN@NIC.SURFNET.NL>
Subject: ETHI: genetic counselors
From: Hans Goerl <GENETHICS@delphi.com>
Date: Sun, 16 Jul 1995 21:53:13 -0400

Three more valuable contributions to this discussion

Date: Fri, 14 Jul 1995 09:12:03 -0400
From: Ian McIntosh <imcintos@WELCHLINK.WELCH.JHU.EDU>

The Dutch system certainly appear to be the best controlled and most
equitable. It is a pity that people in the US will not be able to benefit
from such a system since this society seems unwilling to adopt healthcare
distributed on the basis of need rather than ability to pay.

Iain McIntosh, PhD
Johns Hopkins University


In New Zealand, we have only two qualified Clinical Geneticists,
soon to rise to three (I believe).  There are only 2 counsellors
for the whole country.  With a population of 3.5 million, and the
WHO recommendation of a minimum of 1 Clinical Geneticist per 0.5
million, we are short by at least 5.  This is a desparate
shortage, and the key problem seems to be that in our radically
reformed health funding system few hospitals (or Crown Health
Enterprises, as they are now known) seem willing to make the
investment in genetic services.  This is partly due to myopic
management systems and poorly defined funding arrangements, but
also due to a lack of appreciation by many clinicians of the need
for Clinical Geneticists and Counsellors.

The Clinical Geneticists we have are both overseas trained, and
assuming we can convince the appropriate parties that our genetic
services are headed for 3rd-world status unless something is done
rapidly, then we will continue to depend on overseas training
programs to fill this need - as I suspect is the case for many
small countries.  It is interesting that in discussions about the
shortage of qualified staff here, the comment is frequently made
that even if you can get funding for a position, it is unlikely
you will be able to fill it due to a world-wide shortage of
geneticists.  Perhaps that is not the case....? Are there any
unemployed geneticists/counsellors out there?



NNNN   NN  Martin A Kennedy (E-mail = mkennedy@chmeds.ac.nz)  ZZZZZZZ
NN NN  NN       Cytogenetic and Molecular Oncology Unit          ZZZ
NN  NN NN           Christchurch School of Medicine            ZZZ
NN   NNNN              Christchurch, New Zealand              ZZZZZZZ
                Phone (64-3)364-0880   Fax (64-3)364-0750

Date: Fri, 14 Jul 1995 09:07:49 -0700
From: Robert Resta <bc928@SCN.ORG>

Reagarding Isa Samuels question about the qualifications of genetic

In the US, all genetic counseling training programs provide intense
training in genetics as well as counseling. In addition, genetic
counselors must pass the same board examination in medical genetics as MDs
and PHDs. And certainly the genetic knowledge base of genetic counselors
exceeds that of virtually all non-geneticist physicians and nurses.

Ignoring the social and psychological impact of genetic information upon
individuals and their families is, at best, bad medical practice and at
worst borders on medical malpractice.

For better or worse, genetics is playing an increasingly
important role in medical care. Expansion of genetic counseling
services in the medical care system is urgent. Whether governments and
health care companies decide to pay for such services remains to be seen.

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