Genetic Counseling Communication: A Discourse‐analytical Approach

Srikant Sarangi, Cardiff University, Cardiff, UK

Published online: September 2006

DOI: 10.1002/9780470015902.a0005630

The rich and complex communication process that constitutes the activity of genetic counseling has largely remained a black box. Genetic counseling can encompass topics as diverse as the natural history of a genetic disorder, its treatability, lay genetic awareness, psychosocial aspects of coping, reproduction choices, the ethical and legal consequences of decisions, and privacy issues concerning the circulation of genetic information. Given this embedded nature of the communication process, a discourse-analytical approach is an attempt to uncover the structural and thematic organization of genetic counseling as a situated speech event.

Keywords: discourse analysis; activity type; decision-making; risk explanation; uncertainty; probability; nondirectiveness; professional neutrality

Figure 1. The components of DISCOURSE.
Figure 2. An integrated model of activity analysis (Sarangi, 2000).
Figure 3. Interlocking themes in genetic counseling discourse.
Figure 4. Interplay between the two types of uncertainty and probability.
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 References
    book Cameron D (2001) Working with Spoken Discourse. London, UK: Sage.
    book Clarke A (1997) "The process of genetic counselling: beyond non-directiveness". In: Harper PS and Clarke AJ (eds.) Genetics, Society and Clinical Practice, pp. 179–200. Oxford, UK: Bios Scientific Publishers.
    book Fox R (1957) "Training for uncertainty". In: Merton RK, Reader GG and Kendall PL (eds.) The Student Physician: Introductory Studies in the Sociology of Medical Education, pp. 207–241. Cambridge, MA: Harvard University Press.
    Fraser FC (1974) Genetic counselling. American Journal of Human Genetics 26: 636–659.
    Kessler S (1997) Psychological aspects of genetic counselling, xi. Nondirectiveness revisited. American Journal of Medical Genetics 72: 164–171.
    book Lappe M and Brody JA (1976) "Genetic counselling: a psychotherapeutic approach to autonomy in decision making". In: Sperber MA and Jarvik LF (eds.) Psychiatry and Genetics: Psychosocial, Ethical, and Legal Considerations, pp. 129–146. New York, NY: Basic Books.
    Levinson S (1979) Activity types and language. Linguistics 17: 365–399.
    Michie S, Bron F, Bobrow M and Marteau TM (1997) Nondirectiveness in genetic counseling: an empirical study. American Journal of Human Genetics 60: 40–47.
    Rapp R (1988) Chromosomes and communication: the discourse of genetic counselling. Medical Anthropology Quarterly 2: 143–157.
    book Sarangi S (2000) "Activity types, discourse types and interactional hybridity: the case of genetic counselling". In: Sarangi S and Coulthard M (eds.) Discourse and Social Life, pp. 1–27. London, UK: Longman.
    Sarangi S (2002) The language of likelihood in genetic counselling discourse. Journal of Language and Social Psychology 21(1): 7–31.
    Sarangi S and Clarke A (2002a) Constructing an account by contrast in counselling for childhood genetic testing. Social Science & Medicine 54: 295–308.
    Sarangi S and Clarke A (2002b) Zones of expertise and the management of uncertainty in genetics risk communication. Research on Language and Social Interaction 35(2): 115–137.
    book Sarangi S and Roberts C (eds.) (1999) Talk, Work and Institutional Order: Discourse in Medical, Mediation and Management Settings. Berlin, Germany: Mouton de Gruyter.
 Further Reading
    book Atkinson P (1995) Medical Talk and Medical Work. London, UK: Sage.
    book Drew P and Heritage J (eds.) (1992) Talk at Work: Interaction in Institutional Settings. Cambridge, UK: Cambridge University Press.
    book Carnap R (1949) Logical Foundations of Probability. Chicago, IL: Chicago University Press.
    Chapple A, Campion P and May C (1997) Clinical terminology: anxiety and confusion amongst families undergoing genetic counselling. Patient Education and Counselling 32: 81–91.
    book Erickson F and Shultz J (1982) The Counsellor as Gatekeeper: Social Interaction in Interviews. New York, NY: Academic Press.
    book Greatbatch D and Dingwall R (1999) "Professional neutralism in family mediation". In: Sarangi S and Roberts C (eds.) Talk, Work and Institutional Order: Discourse in Medical, Mediation and Management Settings, pp. 271–292. Berlin, Germany: Mouton de Gruyter.
    book Kneale W (1949) Probability and Induction. Oxford, UK: Clarendon Press.
    book Labov W and Fanshel D (1977) Therapeutic Discourse: Psychotherapy as Conversation. New York, NY: Academic Press.
    book Peräkylä A (1995) AIDS Counselling: Institutional Interaction and Clinical Practice. Cambridge, UK: Cambridge University Press.
    book Rapp R (1999) Testing Women, Testing the Fetus: Some Social Impact of Amniocentesis in America. New York, NY: Routledge.
    book Reichenbach H (1951) The Rise of Scientific Philosophy. Berkeley, CA: University of California Press.
    book Silverman D (1997) Discourses of Counselling: HIV Counselling as Social Interaction. London, UK: Sage.
    Wolff G and Jung C (1995) Nondirectiveness and genetic counselling. Journal of Genetics Counselling 4: 3–25.
    van Zuuren FJ (1997) Uncertainty in the information provided during genetic counselling. Patient Education and Counselling 32: 129–139.

Related Sub-Topics:

Bioethics | Genetic Counseling | Health Care
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Article Title: Genetic Counseling Communication: A Discourse‐analytical Approach
 
How to Cite close
Sarangi, Srikant(Sep 2006) Genetic Counseling Communication: A Discourse‐analytical Approach. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1002/9780470015902.a0005630]