Genetic Counseling in the Muslim World: The Challenges

Genetic counseling is the process in which an individual or a family obtains information and advice about a genetic condition that may affect the individual, his progeny, his relatives, or the family as a whole. Based on this knowledge, he can take the pertinent decision regarding marriage, reproduction, abortion and health management. Genetic counseling includes five themes, medical management, risk determination, risk options, reproductive decision making, and support services. Public health authorities are increasingly concerned by the high rate of births with genetic disorders especially in developing countries where Muslims are a majority. Therefore, it is imperative to scrutinize the available methods of prevention and management of genetic disorders. Genetic counseling involves a partnership of physicians, genetic counselors, and genetics support groups. The majority of clinical geneticists subscribe to the principle of non-directiveness: information about risks, natural history, treatment, and outcome are presented in a balanced and neutral manner, but decisions about reproduction are left to the family. In the Muslim World and in the Kingdom of Saudi Arabia (KSA) it involves many challenges, as it has to be carried within the context of religion and culture, according to Islamic ethical and cultural background of the individual, with community-based genetic counseling in one’s own language, in the presence of paucity of expertise, resources and technology. We are at a time of unprecedented increase in knowledge of rapidly changing technology. Such biotechnology especially when it involves human subjects raises complex ethical, legal, social and religious issues. A WHO expert consultation concluded that "genetics advances will only be acceptable if their application is carried out ethically, with due regard to autonomy, justice, education and the beliefs and resources of each nation and community". Islamic teachings carry a great deal of instructions for health promotion and disease prevention including hereditary and genetic disorders, therefore we will discuss how these teachings play an important role in the diagnostic, management and preventive measures including: genomic research; population genetic screening, including premarital screening, pre-implantation genetic diagnosis, newborn screening; assisted reproduction technology; stem cell therapy and genetic counseling.