Paper short abstract:

The paper examines the consequences of so called “predictive” or “pre-symptomatic” genetic testing on the institutional landscape of genetic counselling and on ideas about “good counselling” in Austria.

Paper long abstract:

While genetic reasoning has a long tradition in biomedical research and clinical practices, the development of so called "predictive" or "pre-symptomatic" genetic tests, which became available for clinical diagnostics from the early 1990ies onwards in increasing numbers, gave it a new turn. For the first time gene mutations which were held as causal factors for the development of "late onset diseases" such as Corea Huntington or familiar breast cancer became diagnosable long in advance of any manifest disease symptoms. Amongst other consequences these new prognostic possibilities transformed the ways of how genetic counselling services are institutionalised and practiced. In Austria the availability of genetic tests e.g. led to the establishment of a new type of genetic counselling which is characterised by a specialisation on particular hereditary diseases and the incorporation of genetic counselling in more broader programmes of medical care. This paper examines how this development took place in Austria and shows its impact on the institutional landscape of genetic counselling and on ideas about "good counselling".