Challenges for providing genetic counselling in Colombian genetic clinics: the viewpoint of the physicians providing gen
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ORIGINAL ARTICLE
Challenges for providing genetic counselling in Colombian genetic clinics: the viewpoint of the physicians providing genetic consultations Clemencia Rodas-Pérez 1 & Angus Clarke 2 & John Powell 3 & Margaret Thorogood 1
Received: 26 January 2015 / Accepted: 13 May 2015 / Published online: 19 June 2015 # Springer-Verlag Berlin Heidelberg 2015
Abstract This study explores the provision of clinical genetic services in Colombia, in order to promote improvements in these services. We carried out semi-structured interviews with 20 doctors working in genetic clinics, and we report the challenges in providing genetic counselling that they have identified. Education and training in genetics in Colombian medical schools were described as inadequate, and interviewees found that many of their medical colleagues knew too little to be able to refer appropriately to a genetics service. The doctors interviewed recognised their own limitations, including lack of knowledge, absence of training in communication skills and the strong influence of religious beliefs on the consultations of some colleagues. There may also be communication problems during the consultation: patients may fail to understand the explanations given or to accept the incurable nature of genetic conditions. There are also problems with access, because genetic services are not covered by the health insurance system in Colombia. More training in genetics is required at medical schools in Colombia, at the undergraduate and postgraduate level. There was a consensus that most medical specialities are limited in their knowledge, awareness and understanding of genetics. Furthermore, many medical geneticists did not believe that other health professionals should work as genetic counsellors. These findings may assist in the This article is part of the special issue on BGenetics and Ethics in Latin America^ * Clemencia Rodas-Pérez [email protected] 1
University of Warwick, Gibbet Hill Road, Coventry, UK CV4 7AL
2
Cardiff University, Cardiff, UK
3
University of Oxford, Oxford, UK
development of improved genetic counselling services in Colombia and in the establishment of an enhanced academic curriculum of basic and clinical genetics at Colombian universities. Keywords Colombia . Genetic counselling . Doctors’ views
Introduction Although developing countries such as Colombia have started to apply genetic knowledge within health care, this is usually approached from the perspective of clinical diagnosis, with not enough attention to genetic counselling issues or to access to laboratory genetic investigations. Genetic services were first established in Colombia in 1964, predominantly in association with research projects. Since then, regular genetic services have started in ten Colombian cities, predominantly based in university hospitals and private institutions located in the central regions of the country. The main private and public universities have their own genetic clinics and laboratories, and some engage in collaborative resea
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