Empathic communication skills help motivate understanding of safety, significance of harms, impact on succeeding generations, and social consequences.

Prognostic uncertainty about risk creates demand for ongoing communication and facilitated reflection about goals and values.

Direct-to-consumer genetic testing requires that physicians share decision making with patients, not order unnecessary tests or interventions, and refer to genetic specialists when necessary.

Pregnant women at high risk for heritable diseases need support and nondirective genetic counseling.

Protecting patients rather than informed consent should be the goal when the complexity of information overwhelms patients’ decision-making capacity.

Noninvasive prenatal testing arguably constitutes a form of eugenics in a social context in which certain reproductive outcomes are not valued.

Physicians should provide women considering abortion after Down syndrome screening with unbiased information and not attempt to influence their decision.

The estimated reduction in risk of ovarian cancer for any woman undergoing opportunistic removal of the Fallopian tubes is up to 50 percent, but whether removal is more beneficial than ligation has not been established.

Though they claim to, direct-to-consumer genetic tests may not correctly identify an individual's ancestral background, and thus may overstate or understate one's risk for heritable disease.

Chromosomal microarray analysis reveals many gene variants of unknown significance. The uncertainty about these variants—might they be deleterious or are they benign?—complicates genetic counseling.