In the first chapter, An Ethical Framework for Genetic Counseling in the Genomic Era, Leila Jamal presents a novel framework designed to guide genetic counselors in making recommendations to patients who undergo genetic testing. The development of this framework is in response to the ever-broadening scope of the genetic counselors’ role, against a backdrop of an historical emphasis within the genetic counseling (GC) profession on nondirectiveness. With her framework, Jamal suggests that genetic counselors have ethical license to offer more directive recommendations to patients in certain circumstances, especially when recommendations are based on clinical expertise; informed by patients’ emotions, preferences, and values; and when relevant, their family members’ input. Jamal’s work offers the GC profession one useful path forward when faced with real-world problems, whether occurring in the clinical, research, or industry setting.