NSGC Code of Ethics

The NSGC Code of Ethics is the professional code of conduct for genetic counselors who are members of the National Society of Genetic Counselors. Originally adopted in 1992 and most recently revised in April 2017 (with prior revisions in December 2004 and January 2006), it is the canonical statement of professional standards for the field.

The Code is built on the foundational ethical principles of autonomy, beneficence, nonmaleficence, justice, fidelity, veracity, integrity, dignity, and accountability, a broader set than the four-principle biomedical ethics framework, reflecting the relational nature of genetic counseling practice.

The Code organizes professional responsibility into four sections, each defined by a relationship the genetic counselor holds:

1. Genetic counselors and themselves
2. Genetic counselors and their clients
3. Genetic counselors and their colleagues
4. Genetic counselors and society

This is distinct from:

• Biomedical ethical principles (autonomy / beneficence / nonmaleficence / justice); see Ethical Principles
• Scope of practice (what services a counselor is authorized to provide); see Scope of Practice
• Informed consent (the operational application of autonomy); see Informed Consent

The Code of Ethics describes how to conduct yourself; scope of practice describes what services you may provide.

This section addresses the counselor's own competence, integrity, and self-care:

1. Acquire balanced and accurate information needed for each professional situation
2. Pursue continuing education on practice guidelines and standards
3. Practice within the scope of the profession and recognize the limits of one's own knowledge
4. Represent credentials and experience accurately
5. Adhere to conflict-of-interest guidelines and disclosure mechanisms
6. Disclose circumstances that could affect professional judgment
7. Avoid using institutional position for personal gain
8. Maintain physical and emotional health adequate to support professional performance

This section governs the counselor-client relationship and is grounded in respect for client autonomy:

1. Provide services within the scope of practice, free from personal bias
2. Clarify roles, disclose conflicts, and describe services accurately
3. Serve all clients regardless of age, culture, religion, language, sexual orientation, or gender identity
4. Enable clients to make informed, voluntary decisions, free from coercion
5. Respect the client's beliefs, relationships, and cultural traditions
6. Refer clients to another counselor when personal values would impede counseling
7. Maintain confidentiality and the security of client information
8. Avoid exploiting clients

This section addresses professional conduct toward peers, supervisees, and trainees:

1. Share knowledge and mentor colleagues and trainees
2. Respect the knowledge and competence of colleagues from genetic counseling and other disciplines
3. Encourage ethical behavior in colleagues
4. Ensure that supervisees are given responsibilities appropriate to their training and competence
5. Maintain professional boundaries that prevent exploitation of colleagues, students, or trainees
6. Take credit only for actual professional contributions
7. Acknowledge the work and contributions of others
8. Make employers aware of the counselor's ethical obligations

This section addresses the counselor's responsibilities to the broader public:

1. Oppose policies that lead to genetic discrimination
2. Serve as a reliable expert source on genetic counseling for the public, media, and policymakers
3. Educate the public about genetic advances and their societal implications
4. Promote ethically responsible genetic research
5. Adhere to applicable laws while advocating for change when laws conflict with the public interest

• The Code is values-based, not rule-based. Sections list aspirational professional standards, not enforceable disciplinary rules. (Disciplinary processes for board-certified counselors live with the American Board of Genetic Counseling (ABGC), which publishes a separate, narrower Code of Conduct used in disciplinary review.)
• The four-section structure mirrors the relationships in practice. Many ethics scenarios can be diagnosed by asking which relationship is in tension (counselor with self, with client, with colleagues, or with society), and that points you to the relevant section.
• Conflicts of interest appear in Sections I, II, and III. Disclosure is the default response; recusal or referral is the appropriate next step when the conflict is unmanageable.
• The Code is a values document; biomedical ethics principles are an analytical framework. A scenario may invoke both: e.g., a client who refuses to inform at-risk relatives raises autonomy (biomedical) and Section II.4 (informed, voluntary decision) and Section IV.1 (the broader societal interest in cascade testing). Knowing which framework you are reasoning within helps avoid muddled answers.
• Confidentiality (Section II.7) is not absolute. It is bounded by legal duties (mandatory reporting, duty to warn in some jurisdictions) and by the client's own decisions to disclose. The Code does not override legal obligations.
• Cultural responsiveness (Section II.3, 5) is a stated obligation, not a "nice to have." This is part of the formal Code, not just best practice. See Cultural Humility.

• A counselor is offered an honorarium by a lab to give a talk recommending the lab's specific test. This invokes Section I.5 (conflict-of-interest disclosure) and Section I.7 (no personal gain from professional position). The counselor should disclose the relationship, present multiple comparable testing options, and not preferentially recommend the sponsoring lab.
• A counselor's personal religious beliefs would lead them to discourage a particular reproductive choice. Section II.6 directs the counselor to refer the client rather than provide counseling that would be biased by the counselor's own values.
• A pregnant client speaks limited English and asks her husband to interpret rather than use a professional interpreter. Section II.4 (informed, voluntary decision) and Section II.7 (confidentiality) both argue for a professional interpreter: family members may filter or omit information, and confidentiality cannot be assured. The counselor should explain why a professional interpreter is preferred and offer one as the standard option.
• A genetic counseling student asks if they can co-author a paper using data their supervisor collected. Section III.6 (take credit only for actual contributions) and Section III.7 (acknowledge contributions of others) shape the answer: authorship should reflect the student's actual contribution to the work.
• A counselor is asked to comment publicly on a sensationalized news story about a genetic finding. Section IV.2 (serve as a reliable expert source) supports engagement; Section IV.3 (educate the public) supports framing the comment to clarify rather than amplify the sensationalism.

• The 2017 explication paper (Vlasak et al., Journal of Genetic Counseling, 2017) walks through the changes from prior revisions and is the standard secondary reference. The 2001 explication (Benkendorf et al., Journal of Genetic Counseling) covered the original 1992 Code.
• The ABGC Code of Conduct (separate from the NSGC Code) governs disciplinary review for board-certified counselors and is narrower in scope: it focuses on conduct that would warrant action against certification.
• The NSGC Code of Ethics is published openly at nsgc.org/About/Code-of-Ethics-Conflict-of-Interest/Code-of-Ethics.