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PRACTICAL GENETIC COUNSELLING (SEVENTH EDITION)

When I started my training in clinical genetics in the 1980's, Professor (now Sir) Peter Harper was one of the leading influences. His textbook, at that stage in its second edition, was ‘The’ guide to genetic counselling, and I remember purchasing the third edition in 1988, hot off the press. This edition has not changed in the tried and tested format of three sections – Part 1 provides and excellent overview of ‘general aspects of genetic counselling’ , Part 2 gives details of ‘specific organ systems’, and Part 3 details the ‘wider picture’, and also includes an excellent appendix and glossary of terms. Although I am now supposed to be an ‘expert’, I occasionally refer to the 6th edition in my bookshelf to check some facts and approaches, and suspect I will do the same with this book if my colleagues haven't pinched it off my bookshelf to do the same. This text is not geared for genetic specialists however, and the generalist, GP or specialist nurse will all find this book the equivalent of the experienced hand on their shoulder, helping guide their consultation smoothly through the usual can of worms that hereditary conditions usually have. 
 
The book's strength is in the title. It deals with genetic counselling – the approach that health specialists should take when dealing with families with hereditary disorders. The first part of the book should prove extremely useful in setting the context of counselling for those in medicine, nursing and other health specialties where genetic information is increasingly creeping into their practice, and who are unsure about the approach they should take. The experience of Harper's lifetime skills in counselling comes through the pages clearly. General practitioners who think they have the scientific facts at their fingertips, might find a copy in their practice library a useful tool in helping tailor their (and their trainees) approach to dealing with the complex web of interactions that initiating genetic referrals on families usually reveals, and help shorten the gap between theoretical knowledge and practice at the coal face of the consulting room. 
 
The sections on individual systems has particularly helpful chapters on neurological disorders, hearing loss, skin and eye, and reflects Harper's personal interest in Myotonic dystrophy and Huntington disease, and his invaluable experience from years of counselling in genetic clinics comes through. 
 
Harper mentions in the preface that this will be the last edition in this format due to his retirement. Where will the book go next? I think for the next edition the audience probably needs to be defined. Increasingly generalists and specialists are looking online so a web version might encourage the new web-savvy breed of trainees in all disciplines to take a look. There are weaknesses in the 7th edition in areas outside Harper's personal interests. The chapter on cancer genetics doesn't contain much helpful information and needs considerable revision. – Counsellors looking to find what the BRCA1 gene does will find it limited and recent advances in other cancer genes aren't mentioned – and when the majority of referrals to our own service are cancer, and an increasing number are cardiac genetics, then new co-authors need to be brought in to help the book to survive in the era of instant knowledge. 
 
Overall this book continues to be an excellent and invaluable source of guidance for those starting out on their task of dealing with hereditary disorders, which now involve so many areas of disease.