Informed consent when taking genetic decisions.

Developments in genetics with diagnostic, pre-symptomatic and predictive testing involve significant changes in the decision-making process, because of the complexity of genetic information and the difficulty related to understanding the causes and mechanism of genetic diseases, ethical, psychological and social implications (psychological stress, anxiety, discrimination in employment and assurance, difficulties in interpersonal relationship), and indirect involvement of third parties. When taking genetic decisions, the patient should receive all the information about the objective and the type of the test, the hypothetical risk, the possibility of obtaining unexpected results, possible psycho-physical repercussion, and means of support for the long time that might pass between the diagnostic predictions and the possible onset of the disease: genetic counseling is a complex but essential operation for acquiring the informed consent of the patient. The outlined peculiarities of the process for informed consent in genetics requires the adequate training of medical personnel to manage the relationship with the patient in these complex cases.