A patient’s personal beliefs about abortion change the risk–benefit determinations for genetic counseling and, to a lesser extent, for fertility treatment. Physicians must not assume, however, that a patient who is opposed to abortion in the abstract will not consider abortion if she is personally faced with a high probability of giving birth to a child with a severe defect. All women, even those who are opposed to abortion, should be offered all appropriate testing and counseling. This does not mean that a physician should advocate abortion. Ideally, a patient should receive the necessary information about genetic diseases and the risks of fertility treatment without reference to either her or her physician’s views about abortion. The woman’s personal views about abortion should shape the risks that she is willing to assume of conceiving a child with a genetic disease, the prenatal testing to which she will consent, and under which circumstances, if any, she will terminate a pregnancy.

Physicians who do not perform abortions because of personal ethical beliefs should ensure that their beliefs do not compromise their patients’ right to choose an abortion. In addition to providing every patient full information, the physician should arrange an easy referral system so that a patient who chooses an abortion can obtain it without unnecessary delay or expense. Conversely, physicians who support abortion as a valid therapeutic technique must not force their views on their patients. They must be prepared to respect the wishes of a woman who, after being fully informed of the risks and benefits of pre- or postconception testing, chooses to bear her child without regard to potential genetic diseases.