This paper addresses two competing perspectives choice and responsibility for the individual undergoing genetic resting and counselling, and the tension between them. A comparison with models applied to vaccination demonstrates the changes in ethical frameworks considered appropriate over time. The move from choice to responsibility, it is argued, is due to a number of reasons, including the value impact of new technology, which affect how concepts are interpreted. From a contrast between choice and coercion, with autonomy interpreted as self-determination, there has been a shift, through autonomy versus paternalism, to tensions between choice and responsibility, which depend on rival notions of autonomy. Thus, while the public health model of vaccination has been problematised, and the individual choice model in genetics has been questioned, the challenge to choice in the genetic context however tends not to be framed explicitly in public health terms so much as in the form of individual responsibility and solidarity.
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