Genetic counseling and its ethical issues in Japan

Genetic counseling in Japan differs from that in Western countries. A major reason is based on the concept or definition or understanding of "family." The Japanese concept of the range of family is far broader than Western people think. The genetic problems to be settled are more complicated; the related emotional and ethical issues are also serious. Genetic counseling services are at nearly 300 facilities with different activities. Most genetic counselors make an effort to solve genetic and physical problems and the emotional or ethical issues of their clients. Because Japanese clients, especially women, who have an affected child with genetic disorder, often feel guilty, they often are afraid to have their genetic problems made known and prefer to keep them secret. This attitude is based on the traditional and emotional upbringing of the Japanese. The existence of a genetic disorder in a family is thought to be shameful, not only for the person affected, but for all members of the family, like losing face, losing family name, or having bad blood. Therefore, a counselor is required to work through such psychological problems, which are derived from traditional ethical thought and must be solved. The World Health Organization (1) has suggested that the importance of "respect of individual" and "integrity of family" as the ethical principles that should be obeyed by a counselor in their practices. Most of Japanese wish to maintain their family peacefully within broad range. So, it is believed that the harmony or concordance is one of most respectable principles to do so. In Japan the principle in a broader sense is called Wa. This standard is based on Buddhism and was proclaimed by Prince Regent Shotoku (574-622) in the Constitution. It continues in the Japanese mentality.