Informed Consent: Adoptive Parent Health History

Yesterday I hit on how open adoption provides adoptees with continued and updated access to their genetic health history provided that all parties respectfully participate in the flow of information. Today I plan to get a bit more controversial as I branch off on the topic. A unique conversation of sorts has been happening on the forums and I think it needs further attention. Due to the fact that adoptive parents can have access to the expectant parent’s health records, either by what the expectant parent has filled out or actual health records from the OBGYN, shouldn’t these expectant parents also have equal access to such information?

For those about to say, “But adoptive parents have to go through an extensive home study so that information is known and readily available,” I offer you the voices of those who have posted on the thread.

From a birth mother:

It never occurred to me to ask about their health history, looking back now, I feel very ignorant about having not! I just assumed that if they were able to adopt, that meant that they were healthy (mentally and physically). So much is hindsight for me though, their age is a bit of a factor to me now and it wasn’t then.

From another birth mother:

I was not offered the view the home study. I was also told that there were no ‘medical issues’ and that the family had a ‘normal life expectancy’.

From an adoptive mother:

I was wondering about that. Honestly, our agency never even shared our HS with us. I wonder how much they share with the expectant parents? Since we are going to try and start the whole process again, this is a question I believe I will ask!

Simply put, just because adoptive parents have gone through the arduous process of a home study doesn’t mean that the birth parents will be privvy to any of that information. Some agencies or attorneys have been known to gloss over the topic, telling expectant family, like the example above, that everything is fine with the health of the adopting family. What, exactly does “fine” mean?

I had to demand access to the adoptive parent’s home study because my unethical agency didn’t want to offer up the goods. When I did receive it, certain bits of information were blacked out. Furthermore, in their health history, unlike my health history, it offered no information about biological relatives and their medical information. As I said, they knew that my grandmother had diabetes and my grandfather had cholesterol and heart problems. However, on the flip side, I had no clue that J’s family has a long-standing and continuous history of severe heart problems.

Some have argued that it’s not as important for birth parents to know about medical issues of the adopting family because the adoptive family uses the information to best care for the child. However, birth parents making the decision to place their child in a family forever might want to know if there are any health considerations that would cause them to be unable to properly parent after an extended period of time. Things like a history of familial mental health issues and severe heart problems, even if they are a generation or two removed, could help a birth parent best make a decision that they felt was in the best interest of their child.

Frankly, the double standard of the flow of this information is somewhat alarming. We watch as waiting families screen out mothers who have used drugs or have a family history of mental health problems however birth parents are not being afforded the same right. As I stated before, a personal health history can change over time. Knowing the health history of immediate relatives can be an indicator of things to come. If a birth parent is placing a child in part because she wants to remove her child from a history of mental health problems within her own family and unknowingly places that child into a family who has a history of the same issue (or worse!), what good has been done? Does the placing mother then feel like a failure? That the system has thus failed her and her child?

Anything less that full disclosure is simply unacceptable. This is another area of specific adoption reform that would change things in adoption for the better. When we allow expectant parents access to all of the information needed so that they can make the best decision for their child, we will be acting in an ethical fashion. Until that point, we’re not only mistreating these expectant parents but their children as well.

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For more, read:

1. One True Benefit to Children from Open Adoption.

2. Learning About Your State’s Laws and Statutes.

3. Ethics in Adoption – Part Two – by Jan Baker.

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