Workshop 2.3: Adoptee Access to Records, History and Searches: Adopted People and the “Right to Know”

Ethics and Accountability Conference
Sponsored by Ethica and Evan B. Donaldson Adoption Institute
October 15-16, 2007

Bullet points for discussion during Workshop 2.3:

• How do current laws and practices support or impede adopted persons’ access to information about themselves?
• What “rights” should adopted persons have to such information? How should their “rights” be balanced against those of other parties to an adoption?
• How should access to records and history, as well as search, be thought about from an international perspective?

Panelists:

Frederick F. Greenman, Jr. is the legal advisor and former Director to the American Adoption Congress. He is also the Treasurer and a director of the Evan B. Donaldson Adoption Institute. A prominent adoption activist, he was the senior counsel to amici curiae in the historic case, Doe v. Sundquist, which upheld the 1995 Tennessee Adoption Act. He also assisted counsel in the Oregon litigation, Does v. Oregon, that upheld the ballot initiative and statute in that state which granted adoptees access to their original birth certificates. Mr. Greenman has participated in various state and federal lobbying efforts, most recently concerning ratification and implementation of the Hague Convention on International Adoption. His interest in the subject stems from having surrendered a daughter for adoption at her birth and with whom he reunited 15 years ago. Mr. Greenman, a Harvard graduate, currently is a sole practitioner specializing in copyright related litigation in addition to issues relating to adoption reform.

Marley Greiner is the co-founder and executive chair of Bastard Nation: the Adoptee Rights Organization, the largest adoptee rights organization in North American. Ms. Greiner’s work has focused on the right of all adult adoptees to access their original birth certificates upon request without restriction. She was actively involved in Ballot Measure 58 in Oregon and legislation in Alabama and New Hampshire which restored the right of adult adoptees to access their original birth certificates. Ms. Greiner also is considered an expert on “safe haven” laws. Since 2001, she has published and edited Baby Dump News, a weekly e-chronicle of newborn abandonment and neonaticide. Ms. Greiner’s additional adoption interests include the relationship between adoption and Biblical America and the portrayal of adoption in film. She maintains the blog, The Daily Bastardette . Ms. Greiner holds a BA in English and Political Science from Malone College, and an MA in American History from the Ohio State University.

Pam Hasegawa, born Rolande Sygne Hampden, has been involved with adoption reform since joining ALMA (Adoptees’ Liberty MovementAssociation) in 1973, NJCARE (NJ Coalition for Adoption Reform and Education) in 1991 and the American Adoption Congress in 1996. Her commitment to rectifying the injustice imposed by the sealed records system on persons living adoption keeps her involved as a grass-roots lobbyist and adoption educator. The “letter to the editor” has become her favorite genre; presenting experiential workshops for adoption professionals and parents with Betsy Forrest and Penny Partridge is an ongoing delight; and working with younger members of the adoption constellation who commit their hearts, minds and energy to adoption reform is a constant source of joy for her. She has been sustained in the long journey toward truth, both personal and communal, by the grace of God, deep friendships forged out of a common understanding of the need for truth in adoption and her family’s abiding support for her work as a “professional volunteer” in the adoption arena.

Elizabeth Samuels is a professor of law at the University of Baltimore School of Law, where she teaches courses in the areas of constitutional law and family law. She is a graduate of Harvard College and the University of Chicago Law School. The subjects of her research and publications include the history of adult adoptees access to original birth records and the current state of laws governing mothers’ consents to the adoption of their newborn infants. Her public service activities includes consulting with adoption law reform advocates as well as other civil rights work.

Elizabeth Samuels

Elizabeth Samuels covered the history of adult adoptees’ access to their own records. Her theory is that it helps us to understand where we are if we understand how we got here. She became interested in this subject because her sister relinquished a child and they met when her birth niece became an adult. She wondered why it was thought beneficial to make records closed. To her amazement, it hadn’t been thought beneficial for adult adoptees and there were different reasons that had led to the closing of records.

Statutory adoption is relatively recent historically. The first state adoption statute was in the mid-1800s. It wasn’t until the 1920s that essentially all states developed a statutory process for adoption. Initially, all records were open. In the early 1900s there was a movement among the states to protect the privacy of the participants i.e., confidentiality (closing records to the public). In the 1930s and 1940s states began moving toward the amended birth certificate where the child was documented as having been “born to” the adoptive parents. It was also during this time that states began sealing records not just from pubic inspection but from inspection by the parties: adoptive parents and birth parents. The primary reason was to protect adoptive families from interference or harassment from birth families. Surrender papers during this time contained promises not to seek out the child or harass the adoptive family. Adoptive parents, on the other hand, were often given documents with identifying information.

In 1953, the National Conference of Commissioners on Uniform State Laws developed the first uniform adoption act recommended to states. They clearly recommended that court and birth certificate records be closed to the public and parties but that they should be accessible to adult adoptees and they were in most states at that time. And as late as 1960 in more than half the states, adults adopted as children still had access to records with identifying information. After 1960, 4 states closed records to adoptees, 6 in 1970s and 7 did not close until after 1979. Even in closed states, records could be opened by court order without notice to or participation by birth parents.

Obviously there was a huge change in attitudes from the 1950s to 1970s. Why? There were a complex confluence of factors that led to this result with no easy answers:

• Closing of records to public and parents helped create and endorse the idea that secrecy was a normal part of the process



• Post- WWII emphasis on women fulfilling traditional roles: staying home and having lots of children



• Psychoanalytic idea at least for young white unmarried women that they were suffering from a mental and moral disorder that led to their pregnancy that could be cured if they placed the child with a “normal” family



• Emerging idea that adult adopted persons who were interested in finding out about their origins were also suffering from a mental disorder.
  

Nowadays, substantial numbers of adult adoptees find out information outside of the government though many spend years and resources doing so. Looking at this history, it’s a relatively short period that adoptees have not had access. It was really an experiment that has proven more harmful than beneficial.

Marley Greiner

There are a number of reasons why original birth certificates of adoptees remained sealed in all but a handful of states:

• Well-funded industry lobbies such as the National Council for Adoption



• Powerful marginal lobbies such as the National Right to Life Committee, Family Research Council, ACLU, Planned Parenthood and various feminists who believe adult adoptee identity rights endanger their own social and political agendas



• Politically influential adoptive and birth parents



• Reactionary and back scratching politicians



• Political lethargy

Right to identity and public records have no traction in the political landscape unless they intersect with high priority issues such as abortion or privacy rights and then they intersect only negatively. Adoptees are expected to shut up and be grateful for allegedly being made middle class and not tossed in a dumpster or reared in a trailer park. Those who press for records access are blamed for “disappearing adoption privacy rights”. “Adoptees are destroying adoption.”

Adoption reformers continue to defeat themselves by compliantly accepting less than what they want: baby steps that lock out people. They feel that compromise is progress, something is better than nothing. But there is no precedent for these bad laws to be changed later. Compromisers tend to legitimate and frame their arguments in the ideology and language of the opposition. They accept the faulty social construct of the triad and its false doctrine of competing rights, balanced rights and special rights. Without the core ethic of an absolute right to birth certificates and identity for all adoptees, reformers support institutional protectionism. Their compromise is obstruct rights and information for all and the opportunity for reunion for those who seek it.

Leave no one behind. 10 years ago Bastard Nation was founded on the guiding principle that access to original birth certificates, identity and history is a natural right, not a privilege doled out by the state. Reasons for wanting birth certificates are immaterial because they are based on desire not the right to possess them and the unredacted information in them. We have the right to the facts of our births, origins and adoptions. Adoptions were imposed and contracted upon us without our knowledge and consent by the state, then that same state seals our information and refuses to acknowledge our right to that information or even that we existed prior to our adoptions. The non-adopted need not justify why they want their vital records nor are they forced to ask for their parents’ permission, grovel before a judge, join a government registry, seek mental health counseling or spend years getting a bill passed to get them. They have a presumed right to their own birth certificates and can do with them what they please. All arguments for access then must flow from the presumed right of all adoptees to unrestricted access and possession of their true birth certificates, not just the majority class. Otherwise the right of anyone to possess their own birth certificates is not a right but a favor the state grants to some.

The real issue therefore moves from personal desire to political rights and adoptees’ relation to the state. Who owns your identity, you or the state? In Oregon, two years after Bastard Nation (BN) was founded, it had its first victory with the passage of Ballot Measure 58, in which the people decided that Oregon adoptees had a right to their own birth certificates. When BN initiated the campaign, adoption reformers wrung their hands and said “you’ll throw us back 20 years!” They forgot to mention in their 20 years of activisim they had failed to open one single state to full access and in fact had mucked things up so badly with compromise legislation such as contractual birth parent disclosure vetos and tiered access that it will be virtually impossible to gain unrestricted access in those states without major league wrangling, if ever.

BN's victory in Oregon was followed by legislative restoration in Alabama in 2000 which was BN's bill and New Hampshire in 2005 where BN worked with others to pass unrestricted access. Earlier this year folks in Maine unconnected to Bastard Nation who previously considered compromise got a clean bill passed which will open records for all in 2009. Exact figures are unavailable, but since at least 1999, at least 14,000 adoptees have received their birth certificates under the Just Say No to Compromise Policy. Holding the line works. Conversely, compromise legislation slugs endlessly through the pipeline amended out of recognition in a vague attempt to please an unpleasable opposition that insists the status quo continue ad infinitum.

False triad concept. Adoptee rights advocates are bogged down with the concept of the adoption triad: the first parents, the adoptive parents and Baybee Bumble, the adoptee, all of whom allegedly have competing rights that must be balanced. Translation: adoptees lose. The triad characterizes the entire adoption structure as a nuclear unit; in reality, it hides information as well as people: for example, grandparents, cousins, siblings, fosterers, and institutions central to the adoption experience -- agencies, social workers, facilitators, marketers, politicians and the marketplace. There are a myriad of complicated relational permutations concealed by “the triad.” Once the other actors are introduced, we see hidden power relationships based on chronology of events, economics, class gender, race, market demand and other factors. The triad concept moved from a sociological to a political discourse where it became manipulated by those living below the water line: private business, adoption professionals and their government security force: the state which ultimately defines what adoption is and can force its will on the rest of us. For example, first mothers were morphed from threat to the adoptive family to courageous women who need protection from their adult offspring. In response, the state and the adoptocrasy colluded to develop an aggressive claim of bureaucratic promises to first mothers asserting that their anonymity is protected by sealed records, thus creating a new privacy right which has nothing to do with privacy. When documented evidence of these promises or even the desire for them was not forthcoming, the adoptocrasy countered that although there was nothing in writing, promises are implied.

These and other claims to make records sealed are ludicrous. Surrender does not equal adoption. Privacy and confidentiality do not equal anonymity nor do sealed birth records. Under normal circumstances, competitive rights and their balancing is a problem only when there are a conflict of rights. Since there is no right to anonymity to one’s own offspring and there is a presumed to one’s own birth certificate, there is nothing to balance except in the minds of the secret keepers. What adoptocrats really want when they toss around competing rights, implied promises and confidentiality is protection from their commercial misdeeds and their continued control over other people’s personal information. This is all about institutional power. The false doctrine of competitive balance, special rights discourse foisted by the below the water line players on the above the water line people most affected by adoption is a false flag operation. Ron Morgan in his essay “Adoption is a Five-Legged Stool” writes: “The beauty of the Triad, at least to the fourth and fifth leg, is that it renders their agency invisible. The state and its quasi-agents, the professional adoption class, can float divinely over the pell mell and gore, offering definitive commentary and altering the rules of the game. It's a tidy racket."

This tidy racket played out in Massachusetts recently when a reform organization packed with a professional adoption class rejected a clean bill and accepted a replacement pushed by politicians and a handful of adoptees that restored the right of access to some, keeps all future records open, but continues to seal the records of other adoptees between certain dates in order to protect the privacy rights of first parents who surrendered children between those dates. By doing so, reformers legitimated implied promises of confidentiality debunked years ago; a lie they insist we must respect. The message is clear: adoptees have no genuine right to their birth certificates or their personal information even their advocates agree.

The triad with its plea for balanced rights forces compromise and corrupts the core principle of adoptee rights to records, identity and autonomy. Without an ethical cannon of absolute inclusion and no compromise, the rights of adoptees will continue to be balkanized and adoptees will continue to be treated as a separate class undeserving of their own records.

Records access is a social justice issue and I think it needs to be framed that way.

Audience Discussion

What are the impacts of current laws that impede access?:

• Lack of medical history



• Not being able to have a copy of one’s own original birth certificate impedes knowing ethnic and religious heritage



• Files are different. Agency has one file, the government has its own files. The files are different or incomplete. Information is selectively edited.



• Inability to verify one’s own birth day, county in which one was born, lack of historical truth.



• In a private adoption, there is a record the lawyer has which is more likely to be thrown out earlier than a record in an agency.



• A lot of adoptees have problems getting passports. Person whose birth certificate is filed more than one year after birth can’t use that birth certificate as appropriate evidence.



• Closed records create a market for information because information is restricted.



• Information can be sold to those who can afford it or have connections to get it. That unequal access is unjust.



• Adoptees say it makes them feel like second class citizens, perpetual children.



• Totally discriminatory including within the adoption community, for example, foster children generally have access and some international adoptees arrive with their original birth certificates.



• Impedes access for future generations.



• Impedes guarantee of ethical practices.



• Those in open adoption say they have their children’s birth records, but if something happens to them, can’t get them back.



• Siblings do not know they are siblings. Possibility of incest being permitted.



• In international context, if government doesn’t keep records and agency destroys records, then there are no records. In Hague regulations, all open access provisions are governed by state laws in the US. So if adoptee comes from abroad into a state with closed records, then that record gets closed even if the Convention gives access.

What are ways to make changes?

• adopteerights.net is having a nationwide demonstration in New Orleans on July 22, 2008 to coincide with the National Conference of State Legislators.



• The American Adoption Congress has a legislative packet that is helpful.



• When any kind of law comes up about adoption, one can testify as a citizen. At least write a letter. In off years try to form relationships with representatives.



• From Ethica’s standpoint, people who oppose opening records have a sophisticated way of notifying all their supporters when a bill is coming up and they flood legislators with calls. There is potential to tap into the adoptive parent and other supporter communities who believe this is not right. We can work together to come up with a similar system to flood legislators with calls.

Fred Greenman

Several things have developed to deal with mothers who don’t want their identity known. Oregon and three other states have contact preference forms. In a closed adoption, a birth mother has no assurance or warning she will not be found. The only case of harassment he is aware of occurred in New York which has the most tightly sealed records. If her child wants contact and records are opened, all statutes set a minimum age of at least 18 – her feelings may change over time which is what typically happens. In states with contact preference forms, the experience has been no reported problems.

Current state of law regarding adoption access statutes. Originally had 48 closed records states (all but Kansas and Alaska). 6 have granted access. 4 of them subject to a contact preference form. Delaware has a disclosure veto -- 19 filed in entire state since 1999. In 1996, Tennessee because the first state to retroactively open records. Birth certificates had false or meaningless info because of Georgia Tann, so the Tennessee statute gave access to entire adoption file. In another 12 states, access to original birth certificates or identifying information depends on the year of birth based on the argument that birth mothers were promised confidentiality. A number of states have a confidential intermediary system.

The whole process of secrecy starts mechanically with the original birth certificate and sealing and alteration of it into an amended birth certificate which shows the adoptive parents as simply the parents. This practice was started in 1928 by Georgia Tann who was perhaps the most notorious baby thief. She sold at least 5,000 children and at one time was the most prominent adoption practitioner in the country. She is the origin of this problem.

All these varying systems are for better or for worse constitutional in the US.

Ontario passed a statute which granted retroactive access to identifying information to adoptees and birth parents. There was a decision holding that statute unconstitutional. Not clear if ruling will be appealed. The ruling is weak because in Ontario, adoptive parents have always had access to original birth certificates and one plaintiff is a birth father. Paternity suits are not defended on grounds of privacy.

Usha

Workshop 3.1: Information Sharing Prior to Adoptive Placement: What is Required and What is Ethical?

Ethics and Accountability Conference
Sponsored by Ethica and Evan B. Donaldson Adoption Institute
October 15-16, 2007

Bullet points for discussion during Workshop 3.1:

• What do prospective adoptive parents have a right to know?



• What medical, social and background information should professionals be required to find, share with, and interpret for prospective adoptive parents?



• How can ethical practice in sharing information with prospective parents best be promoted?

Panelists:

Bruce Boyer is a Clinical Professor and Director of the Civitas ChildLaw Clinic of the Loyola University Chicago School of Law. He has taught and practiced in the area of children’s law for almost twenty years, specializing on issues in the areas of child welfare, child custody, and adoption. He also has taught courses in juvenile law, trial advocacy, ethics, and administrative law. Professor Boyer is the author of numerous articles on issues relating to children and the law, includingethical issues in representing parents in child protection hearings and the right to counsel in termination of parental rights cases. He is currently a member of the Evan B. Donaldson Adoption Institute’s Board of Directors and a member of the Illinois Supreme Court Commission on Professionalism. He has served as Chair of the American Bar Association’s Steering Committee on the Unmet Legal Needs of Children. Prior to his position at Loyola, Professor Boyer taught for 12 years at the Northwestern University School of Law in Chicago, where he served as Supervising Attorney of Northwestern’s Children and Family Justice Center.

Dr. Dana Johnson is Professor of Pediatrics, member of Division of Neonatology and Director of Research and Education for the International Adoption Clinic at the University of Minnesota. Dr. Johnson’s research focuses on the short- and long-term effects of early childhood institutionalization on child health and development. Dr. Johnson serves on the Editorial Boards of Adoption Quarterly and Adoptive Families Magazine and is a Senior Research Fellow in the Evan B. Donaldson Adoption Institute. He has authored over 200 journal articles, book chapters and abstracts.

Nora O’Farrell is the Director of Adoptive Families Together (AFT), a parent-run program of the Massachusetts Society for the Prevention of Cruelty to Children (MSPCC). As director of AFT, Ms. O’Farrell oversees the provision of education, advocacy, training, and support to families, professionals and communities about the unique circumstances inherent in the adoption experience. Her experience includes collaboration with child welfare agencies, working with children and youth with behavioral health issues, and providing post adoption support for families.

Johana Oreskovic is the Director of Post-Professional Educational Programs and International Students Services at the University at Buffalo Law School where she also teaches courses in adoption law. Her primary interest is the regulatory framework within which international adoptions are conducted. Professor Oreskovic has widely lectured on the use of the Immigration and Nationality Act’s visa fraud prosecutions and child trafficking for purposes of international adoption. She is a member of the Board of Directors of Ethica.

Dana Johnson
Dr. Johnson was trained as a neonatologist. A little over 25 years ago occurred Indiana’s Baby Doe case involving a baby born with Down’s Syndrome. The parents were counseled by two physicians. Their obstetrician had experience with raising a handicapped child in his own life. This doctor said the child would lead a painful and miserable life. Their pediatrician said the opposite, that the child could live a happy life. The baby could not eat, so by not treating the child, the child would starve. The Indiana court system said the family made a choice between two competing opinions and the parents could choose. The baby died while the case went to the Supreme Court. In response, the Reagan Administration enacted Baby Doe Regulations which said food could not be withheld from children because they were handicapped. This infuriated the physician community for intruding into the decision-making process. In the Baby Doe case, there was not a well-reasoned process in decision making because bad info was provided to the parents.

Our response at that time was to suggest that we have ethical propositions on which to base decision making. That might be something to apply to ethical decision making in the adoption context:

• 
  
  
  What do we believe about the children, the obligations of prospective adoptive parents and obligations of the agency? Starting with the preamble of the United Nations Convention on the Rights of the Child, a child has the right to grow up in permanent family and add to that: “where their needs are met.”



• 
  
  
  Primary obligation of parents: to be involved and make a decision



• 
  
  
  Primary obligation of the agency -- advocate for the child. The decision should be child centered.



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  A decision to adopt requires sufficient assessment and parental involvement in the decision-making process. There needs to be a conscious decision-making process and not be treated like a matter of fate. Parents need access to those who can help them make a decision. The agency should be an advocate for the child by obtaining the necessary information for the child and giving it to the prospective adoptive parents in an understandable form. They need to facilitate the family’s decision as to whether they can parent that child. And they need to provide sufficient time to make that decision. It is unethical to provide 24 hours and say another family is waiting. Agencies can’t abandon children who they find difficult to place.



• 
  
  
  What information is really helpful? What families are concerned about at the time of adoption is not the information they are concerned about 5 years later. Parents become interested in behavioral issues 5-10 years after adoption. Some information is more helpful than others. For example, apgar scores are useless. However, nice pictures are very helpful. For example, with photos, can predict fetal alcohol syndrome much better. With respect to preadoption evaluations, we need to develop evidence-based information that will help us predict and help families make a decision. Head circumference at the time of arrival, length of institutionalization and growth after arrival all help predict IQ, but when all those factors are put in a regression equation, only 17% of information available before adoption predicts variance in IQ, and information available after adoption only gets up to 25%. We will inevitably never be able to predict what will happen in the future. So do medical evaluations help at all? Yes. He has looked at over 2300 kids adopted in Minnesota by 1600 families who had medical evaluations before adoption: found much higher rating of viewing international adoption as a way to build a family, much more appropriate expectations of what was going to be coming ahead and fewer behavioral problems in the kids.

O’Farrell

• 
  
  
  Adoptive Families Together is a program from a parent’s perspective but is child centered. It consists of a mix of people who have adopted through the Department of Social Services (mostly older children and mostly identified as special needs), domestic infant children and internationally adopted children. There are a lot of prospective, foster and guardian families.



• 
  
  
  The process should start with expectant parents. Parents must think about the child and family long before the child arrives. A child’s original family and the people who cared for them before us should be honored. As adoptive parents, it’s our duty and responsibility from the beginning to start thinking about not just about our needs.



• 
  
  
  Adoptive parents have a right to know everything. Ethically, prospective adoptive parents should talk to a counselor type person who can help them figure out what kind of children they can parent. Professionals in the field can then use that information to do the match. It gives expectant parents a false sense of control to base their placement decision on letters from prospective adoptive parents.



• 
  
  
  She advises prospective adoptive parents not to look at pictures because they will have an immediate reaction either positive or negative. Oftentimes the pictures are old. That said, prospective adoptive parents need to know the complete story on a non-identifying basis. It’s up to the agencies and attorneys to get the full story. Agencies need to take the time to really get to know the kids.



• 
  
  
  We are the custodians for the adopted persons, but as they get older, it is they who will determine where they want to go in terms of connecting with their wholeness. It’s not our decision to close contact, it’s up to our children. We don’t need to be threatened by families of origin.



• 
  
  
  Regarding post-placement services, adoption is a lifelong process for all of us. It’s a responsibility of society to do a better job of supporting all types of families. How can adoption be supported so that it doesn’t get pathologized?
  

Oreskovic
Discussed information sharing within the context of international adoptions. All her comments deal with the current legal framework. The situation may change following adoption of the Hague. The rules she is discussing will continue to apply to non-Hague countries.

1. What do prospective adoptive parents have a right to know in the context of international adoption?

They have the right to make an informed decision about whether they can parent a child based on available, medical, social and developmental info. What do we mean by a right and how can a rights-based analysis be framed in a way that takes into account the diversity of experiences and cultural norms reflected in international adoption? Her definition begins with the premise that in the Western legal system, the contours of a right are often determined by balancing the interests of all concerned in a transaction. In international adoption, this would be the adoptive parents, the child, the birth parents and possibly, the placement agency. Other things that need to be balanced are things like (1) the ability of orphanages, especially in impoverished countries to create and maintain records, (2) the ability of the sending country and its social welfare structure to the extent one exists, to gather maintain and provide information, taking into account different norms surrounding relinquishment and illegitimacy. The contours and scope of the right will vary widely among countries. Therefore, prospective adoptive parents deserve as much information as is available, but they also deserve from the agency truthful disclosure prior to selection of the country or disclosure from the agency to the extent there is limited availability of information and the consequences to parenting that child flowing from that lack of information. Adoptive parents, before they enter the process, have a right to know what they can know before they select a country and agencies have a responsibility to disclose truthfully the information they have at their disposal.

2. What medical and social background information should agencies be required to gather and disclose?

There are sometimes impenetrable barriers at sending countries to information. The orphan definition in the Immigration and Nationality Act for purposes of issuing visas really incentivizes the anonymous abandonment of children. For example, it is very difficult for a single parent to relinquish a child in many countries and if we want to facilitate the process, it is best to not have any information at all. All kinds of ethical problems flow from this. Who or which entity is in the best position in the process to obtain, share and interpret information? This implicates question 3.

3. How can ethical practice best be promoted?

In the context of an international adoption, it is the adoption agency that is in the best position to obtain the information required to allow for informed consent. Because of its role in the process, the agency has an affirmative duty to all triad members to ensure that it works continually in the context of the sending country to expand the realm of knowable information, provided that it doesn’t put vulnerable parties at risk in their own countries (for example, single parents) because: (1) the agency is likely to have the best contacts within the sending country, and (2) agencies are organized in lobbies so they are in the best position to leverage the U.S. government which can in turn leverage sending countries to provide more information.

Too often in the international adoption context, agencies fail to satisfy the ethical duty to obtain and expand the amount of knowable information because the relationship between agencies and adoptive parents is by and large controlled by contract, not statute.

• 
  
  
  It has become the norm for contracts in international adoption to include extremely broad exculpatory clauses which in effect absolve the agency of any duty whatsoever to obtain accurate medical, developmental and social information on the children offered for placement. When challenged, courts have routinely upheld the validity of exculpatory clauses.



• 
  
  
  A typical international adoption contract she found provides: “I release and discharge x agency from any and all causes of actions, claims, demands, damages, costs, loss of services and expenses which may arise now or in the future as a result of my attempt to adopt a child. My release includes but is not limited to the potential claims as set forth below: We will not be held responsible for physical or mental problems to which the child may be predisposed or may develop in the future. I release the agency from any actions or charges implemented by the U.S. or foreign country which may result in additional cost, procedures, delays or timeframes. We hold harmless the agency, its employees, agents and board of directors from any situation which may occur in regard to our personal safety within the sending country and from claims which we may have for emotional injury suffered from the adoption process.” The contract lists a number of diseases. “We have acknowledged that we have received all information available to the agency.



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  In a contract based system, rights and responsibilities are determined through negotiation. Prospective adoptive parents have no power whatsoever. What can be done to facilitate access to and sharing more knowable information? Agencies should be required through the contractual and negotiation process to meet certain baselines. Adoptive parents, with some assistance, could negotiate clauses holding agencies responsible for a bare minimum, for example, undertaking due diligence to determine whether a child does in fact satisfy the U.S. orphan definition, vet in country personnel to ensure the child was not procured by improper payments, in countries that permit video and testing, that the agency took all available steps to obtain accurate info and provide prospective adoptive parents with avenues of legal redress instead of signing contracts of adhesion. This is unlikely to happen in the future but it is necessary to allow informed consent.
  
  

Questions:

1. Is there anything that can be done to guard against the falsification of information?

Oreskovic: In the international adoption context, there are many children who are legitimate orphans under the U.S. definition. It requires more effort and time and it is more of a concern not to make the process quick and easy but to make it legal. For example, in Cambodia it was easier to cook up birth certificates because agents were too lazy to obtain the information.
O’Farrell: On the domestic side, this involves the field of social work and accepted practice in how we’ve evolved into the adoption business. For infant adoptions, what information do we need to know and how do we develop a trusting relationship with the expectant parent? If they tell the truth, will the child not be placed with the best prospective adoptive parent they found for that child? Is there a safe environment to talk with the agency or attorney? For older child adoptions, it is negligence on the part of social welfare system that they are not getting more assessments and evaluations for the children. They are not putting together the full story for the children. Ethically, they need to do a better job of getting the real truth and real information so it can be passed on to the adoptive parents.

2. The founder for Friends in Adoption, a domestic placement agency commented that she works on the premise that people coming for services want a healthy baby and healthy family. They are not adversarial, but should work together. She has found that presented that way, people are forthcoming and the integrity of adoptive couple and the pregnant mother is there. If they cannot get information, typically from the biological father, the grandparents can be a wealth of information. So they will go to the extended family to try to get accurate information.

She also feels strongly there is a responsibility that adoptive parents care take the adoption until the child can care take the adoption for himself. Not to have available information around issues of addiction and mental illness is a disservice to the child. So they explain that to the biological family, not to be judgmental, but better prepared for the child to grow up healthy.

As an agency director, she doesn’t have a legal right to determine who can and cannot adopt beyond the criteria set forth in the home study process and procedure. Many times she has felt a family is not the right family to qualify for adoption, but she has been told she cannot disallow an adoption by the family.

Her agency began with a handshake but because society is so eager to sue, she now has a service agreement which requires sign off on every line of expectations.

3. Any advice for how to help state agencies understand the importance of knowing the child’s full history prior to matching?

O’Fallon: Training and supervision for agencies which means resources, schools of social work, and expectations of standards of care. Trauma evaluations are useful. Time of placement is critical for prospective families because once the adoption is finalized, records are closed. Prospective families are perceived as demanding if they ask for information which can jeopardize the placement.

4. David Brodzinsky commented that it’s one thing to share information and it’s another to interpret it. Information has to be provided in a way that’s useful. Most agency personnel and attorneys are not expert enough to provide updated information. Agencies are beginning to recognize they are not sure how to present information in a way that’s useful to prospective adoptive parents. It’s important that we not just focus on the issue of the right of prospective adoptive parents to have information, but that they have information they can use. What does risk really mean? It’s difficult to predict from medical or psychosocial information to long term outcomes.

O’Fallon: This is applicable to attachment issues where kids have difficulty trusting adoptive parents. She doesn’t know if families are presented information around when kids have poor caretaking from age zero to 1, multiple moves and many factors that may affect the ability to trust. Placing agencies and social workers have the responsibility to give the big picture.

With prenatal exposure to drugs and alcohol and attachment, parents have the most difficult time understanding what will happen and how they will have to treat children differently.

5. Dr. Dana Johnson commented that the trend has been towards informing families of complicated medical issues especially for children who have been institutionalized. Adoptions used to be low risk medically because many children were in Korea, from single parents who were in foster care. With adoption opening up to Eastern European countries, it has become much more difficult for parents to understand the effects of malnutrition and early deprivation. Expectations are the key issue.

Regarding absolving agencies, he has been involved with a lot of wrongful adoption suits. Most of the time, the families who are suing had the information in their hands but didn’t go to get it interpreted.

Behavioral and emotional issues often relate to drug and alcohol exposure. A child who cannot communicate or communicate in an adverse way is where families get stressed as opposed to medical conditions like hepatitis or cerebral palsy.

If families are scared out of programs, that is not a bad thing.

6. A person who operates a domestic adoption program asked for feedback on some of her practices. She doesn’t routinely show photos of newborns because they represent all that is hopeful and then the prospective parents don’t listen to the child’s background. She has found that alcohol is far more devastating than any other substance, but because it’s legal, she also finds that many birth parents underreport so she tells prospective adoptive parents that because of the birth parent’s lifestyle, she believes there is far more use.

O’Fallon: Suggests a parent-to-parent model, so prospective parents can meet other parents of kids with FAE issues.

7. A mother commented that she was not hearing ongoing information being mentioned. The flow of medical information is very important as an ongoing resource. If a mother who relinquishes is a young woman, her medical history consists of when she had chicken pox and later, after relinquishing, she could develop heart disease or cancer or illnesses that might be important to know. What is the ethical responsibility of agencies to pass on that information? She knows that they don’t in most cases.

Is there any ethical responsibility for information to be passed the other way? The author of The Same Smile relinquished a child and a subsequent child developed leukemia. She begged that information to be passed on and it wasn’t. Seems to be an ethical responsibility on the part of agencies both ways.

Moderator: From a legal perspective, no law would allow for enforceability of post-adoption info.

Johnson: Should agencies be collecting DNA from birthfather and mother at time of domestic or international adoption and archiving it to the day when we can do an analysis of the genome?

O’Fallon: Open adoptions would eliminate these problems. It’s secrecy and closed records that are creating this situation.

Oreskovic: For pre-adoption medicals, is there any research that demonstrates a different developmental trajectory among internationally adopted children, especially boys who don’t fall into clinical populations? For example, short-term post-institutional issues that may affect relationships with other children, maturity levels, etc.? Johnson replied that the problem is that the research deals with populations, not individuals. There is some data regarding long-term issues for children adopted from institutional settings. Risk factors have to do with deprivation early in life in terms of physical and sexual abuse. There are genes with only one copy in males that will predispose them to more conduct disorders if abused early in life if a certain enzyme is present. Other studies have shown no boy/girl differences except attention issues for males getting into early adolescence issues and having more behavioral issues.

8. A domestic agency worker commented that she knows of no other way to practice ethically than to pass on information from the birth family. If they have a birth parent who has placed more than once and doesn’t place with the same family, she immediately put both families in touch with each other. Her agency started contracting with a cord blood banking business. A lot of families are banking cord blood to help with medical issues later on.

Usha

Workshop 4.3: Ethical Issues in New Reproductive Technologies

Ethics and Accountability Conference
Sponsored by Ethica and Evan B. Donaldson Adoption Institute
October 15-16, 2007

Bullet points for discussion during Workshop 4.3:

• Which ethical issues in adoption should apply to the professionals, donors and recipients of new reproductive technologies – and which should not?


• Are there aspects of new reproductive technologies that raise questions related to “the best interest of the child”?


• Are there ethical issues that require attention regarding donors’ and recipients’ participation in these technologies?


• What laws, policies and “best practices” should be applied to reproductive technology practitioners, donors and recipients in the U.S.?

Panelists:

Jean Benward, LCSW is a psychotherapist with over 25 years of experience in the areas of adoption, infertility, and donor conception. In her private practice, she works with adoptive families, adoptees, and individuals considering use of donor gametes for family formation. In 1994, Ms. Benward joined the American Society of Reproductive Medicine (ASRM), where she has spoken at several symposia and postgraduate courses. She served as a member of its Mental Health Professional Group (MHPG) Executive Committee for seven years, is former MHPG chair and former co-chair of its donor registry task force. She has presented at conferences of the ASRM, the American Society for Bioethics and Humanism, the Evan B Donaldson Adoption Institute, the American Adoption Congress, and Resolve. Ms. Benward currently is co-president of the Board of Directors of the Sperm Bank of California and has been a consultant on the Sperm Bank’s identity release task force for seven years. Her clinical background includes several years as a clinical supervisor and adjunct professor, training graduate students in child and family therapy and providing consultation to the staff of child treatment programs. Ms. Benward holds an undergraduate degree from Barnard College and a graduate degree from the Columbia University School of Social Work.

Naomi Cahn is Associate Dean for Faculty Development and John Theodore Fey Research Professor of Law at George Washington University Law School. Her areas of expertise include family law, reproductive technology, and adoption law. She has written numerous law review articles on family law and other subjects, and has co-authored several books, including Contemporary Family Law (Thomson/West 2006), Families By Law: An Adoption Reader (NYU Press 2004), and Confinements: Fertility and Infertility in Contemporary Culture (Rutgers University Press 1997). Her current project is a book tentatively titled, The Parent Plan: A Legal Examination of the Means of Collaborative Reproduction (forthcoming NYU Press). She is the Legal Intersections Co-Editor of Adoption Quarterly. From 2002 to 2004, Professor Cahn was on leave in Kinshasa, capital of the Democratic Republic of the Congo. Prior to joining the faculty at George Washington in 1993, Professor Cahn practiced with Hogan & Hartson in Washington, DC, and as a staff attorney with Philadelphia’s Community Legal Services, where she represented clients in the abuse and neglect system.

Bill Cordray is an architect practicing in Salt Lake City, Utah and an advocate for people conceived through donor insemination (DI). Mr. Corday was born through DI conception in July 1945; at age 37, his mother disclosed his conception. Since that time, he has been an outspoken critic of reproductive technologies in the media, at conferences, on the Internet, and on an interpersonal level. His work focuses on eliminating secrecy within DI families, promoting early disclosure to children, ending anonymity in gamete donation, and proclaiming the retrospective right of access of DI adults to the identity of their mother’s sperm donor. Mr. Cordray’s web site seeks to give a voice to the rapidly growing numbers of DI adults who want to speak freely about their experiences. Mr. Cordray regularly presents at conferences on DI. He has appeared in television interviews and documentaries in Utah, in the US national media, and in the media of Canada, Germany, France, the United Kingdom, Australia, and Japan. Mr. Cordray holds a BA in English and a Masters in Architecture from the University of Utah.

Susan Golombok is Professor of Family Research and Director of the Centre for Family Research as a member of the Faculty of Social and Political Sciences at the University of Cambridge, England. Her research examines the impact on children’s social, emotional and identity development and on parent-child relationships when children are reared in new family forms. Her work has focused on these issues in relation to lesbian mother families, solo mother families, and families created by assisted reproduction procedures such as in vitro fertilisation (IVF), donor insemination, egg donation and surrogacy. Professor Golombok is the author of Parenting: What really counts? and co-author of Bottling it up, Growing up in a lesbian family and Modern Psychometrics.

Adam Pertman, Executive Director of the Evan B. Donaldson Adoption Institute, is also the Associate Editor of Adoption Quarterly, the premier professional journal in its field, and is the author of Adoption Nation, which was named Book of the Year by the National Adoption Foundation and has been reviewed as “the most important book ever written on the subject.” He was nominated for a Pulitzer Prize for his writing about adoption in The Boston Globe, where he was a senior reporter and editor for 22 years before turning his career toward adoption. Pertman’s other honors include: the Angel in Adoption Award from the U.S. Congress; the Special Friend of Children Award from the American Academy of Child and Adolescent Psychiatrists; the Friend of Adoption Award from the ODS Adoption Community of New England; the Dave Thomas Center for Adoption Law’s first award for “the nation’s greatest contributor to public understanding about adoption and permanency placement issues”; the American Adoption Congress’ first award to the journalist who has done most to inform our nation about adoption and “for his eloquent witnessing of contemporary adoption”; and the Year 2000 Journalism Award from Holt International Children’s Services.

Jean Benward

• Her professional career started 25 years ago working with adoption issues. 15-20 years later, her professional focus moved to reproductive technology issues especially donor conceived families


• People in adoption tend to feel strongly about the similarities between adoption and donor conception. Professionals and families affected by donor conception tend to not feel that adoption is a model that can be translated.


• Similarities between adoption and donor conception:
  Premises and belief that there is shame and secrecy, families formed this way dealt with stigma and isolation, power held by professionals, birth parents deemed invisible and deemed important to banish them from families they helped create.
  In 1970s, begin to see the voices of adoptees and birth parents resulting in grassroots change in adoption practice. Openness is valued, birth parent connections deemed important and of significance to adoptees, families are supported in the larger community with resources, laws changed, and adoptees are supported in search.
  Donor conception is pretty much the same since when it began until relatively recently. There is an emerging change in how people think about donor conception. ASRM goes on record of advocating disclosure of donor conception to offspring. Now seeing grassroots efforts outside of professionals where people are seeking to connect with each other. Identity release programs guarantee offspring identifying information about sperm donors. Abolition of anonymity is becoming increasingly widespread around the world. In other countries, donors cannot be anonymous.
  In the environment in which donor conceived families live, there is a tremendous amount of stigma and emotional impetus behind fear of disclosure.


• How are donors viewed? As biological fathers? People in adoption tend to put them in same category as birth parents, but donors go into this not thinking of offspring as children of the type one nurtures and lives with. On the other hand, they have significant meaning to offspring and vice versa but we don’t have a vocabulary for understanding these connections. Offspring and donors will help create the context for understanding these connections.


• Ethics – both fields face identical issues, for example, the role of commercialism, how the practice is market driven, participants are subject to exploitation, professionals still assume power in the transactions, and issue of openness.

Naomi Cahn

• Her husband is an adoptee who searched about 10 years ago and that has influenced her perceptions in much of this field. Before he searched, she went through a reproductive technology clinic where donor eggs were suggested. She did not go that route, but her reaction guides her as she thinks through much of this.


• Similarities between adoption and reproductive technology: forming families with outside help. Issues of tort suits that overlap with respect to misrepresentations, issues of fertility tourism, and overlap in professionals involved in both fields.


• Enormous differences between adoption and reproductive technology: Completely different sets of regulations. Adoption is in many ways far ahead of reproductive technologies. Fundamentally different assumptions in each field: adoption at least pays lip service to best interest of child. Best interest of the child is not a hallmark of reproductive technology world. Children’s interest are starting to assume more importance as offspring are coming forward, but it is a very consumer-driven field as a result of lack of regulation. To create a new adoptive relation requires a court order but there is practically no legal involvement in the context of reproductive technology.


• Statistics in the reproductive technology field: There are more than 400 fertility clinics nationwide, $3 billion annual business, in 2004 130,000 IVF cycles in the U.S. with 50,000 IVF babies born, half a million frozen embryos, the Society for Assisted Reproductive Technology estimates 9,000 donor egg children born in the U.S. in 2005, and an estimated 30,000 donor sperm conceived children born annually. Language in both fields is evolving as there is more sensitivity. Sperm providers and egg providers are not donors.
  Unlike adoption, where from the mid 19th century has been distinguished by laws, gamete technology developed with secrecy and little regulation. First known donor conception was in the late 19th from a physician on a woman who never realized there was a donor outsider her husband.


• Market forces are strong and well entrenched and there is not same advocacy for best interest of the child. Little incentive to regulate this field further because clinics make a lot of money and parents are willing to pay a lot of money in order to have children. Gamete providers are often in this to make money and so regulation will affect their source of income and many donor conceived children don’t know they are so there is no strong advocacy group there, either. Federal law regulates the safety and health of donated tissue including sperm and eggs which are regulated primarily against transmission of AIDS. About 35 states deal with parenthood issues when it comes to sperm, only 4-5 states when it comes to eggs and only 1-2 states when it comes to embryos: Louisiana and Florida. There is some movement to limit prices but studies show it is not successful because there is state oversight over adoption but not the reproductive technology system.


• For the future, secrecy in both areas is starting to crack a bit. Parenthood issues to be resolved.
  

Bill Cordray

• Donor insemination in his point of view is a form of adoption. He has a problem with perceiving it as something else. It comes from the fact that the language is determined by the medical profession so people are asked to believe all we are dealing with are tissues. When we see sperm, think original father; embryos, original families; eggs, original mothers. Sperm, eggs and embryos are part of adoption too.


• DI people don’t have much of a voice. He is reluctantly taking that role because few are doing it. He wants to take command of how language is forming and how we see ethical issues by humanizing it. He is tired of being infantilized. He doesn’t want to use best interests of child for determining ethics, but rather, the best interests of vulnerable human beings who have no say in how contracts or transactions are occurring.


• DI has sociological and psychological issues that the medical profession does not see because they see the end as the baby in the cradle.


• 2 other common axioms:
  1. adopted person is anyone who has no connection to genetic parents, therefore, he considers himself an adopted person because he doesn’t know who his birth father is
  2. DI people have a right to know about their origins and have this info disclosed to them. This is not happening in many DI adoption families. He likes to focus on DI because it is the primary way reproductive technology families are being formed.


• Differences between DI and traditional adoption: Lack of regulation. There are contracts signed by donors and by prospective adoptive parents that require they not try to find the identity of the other person. Legal aspects are strange because the medical profession is treating it in a laissez faire manner in the U.S. so anything the doctor does is right and ethical because they have a code of ethics, but in reality, it has evolved into a business and is the least regulated of all medical branches and technically is not medicine. Anyone can be involved in donor insemination with a turkey baster.


• Best practices and laws that should apply: There should be independent counseling that ensures true informed consent. The lack of informed consent is astounding. Clinics don’t even know the truth of what it means to be conceived through anonymous gametes. Part of human fabric, texture and makeup of child and should not dehumanize it.


• We need mechanisms to ensure disclosure and take away liberty of contract clinics enjoy because it is not a valid legal stance in the medical profession. These records need to belong to the courts like in adoption. Records ought to be considered a property right of identity to offspring. It’s about time we started honoring the United Nations Convention of the Rights of the Child.


• As in adoption, DI individuals don’t have their original birth certificates either.
  
  

Susan Golombok
Discussed ethical issues with respect to different kinds of reproductive technology:

1) “high tech” families – involves, procedures such as IVF, ICSI, and sometimes gamete donation. Kinds of concerns raised:

• Theory that parents who have gone through years of infertility and have a very much wanted child will be overprotective parents and will have high expectations of their child or themselves as parents which causes tension and stress in family. In summarizing findings of many studies worldwide, these concerns about these families are unfounded. If anything, studies show quality of relationships are in a sense more positive.


• One area where there is a problem is in high number of multiple births. 1% of natural births result in multiples. With high tech procedures, usually 25-33% of pregnancies result in multiples. With multiples, there is an increased rate of prematurity and health related problems, disability and psychological functioning e.g., language development and for parents themselves, especially those who have triplets or more, experience extreme stress with large numbers of children growing up at same age. Some European countries have legislated only 1-2 embryos can be transferred whereas there is no legislation in the U.S. Should the number of embryos that may be transferred be limited?

2) gamete donation

• A number of groups have carried out large scale studies of children conceived through gamete donation. Generally, the children don’t seem to be in any way experiencing psychological problems as a result of this method of conception but a striking finding is that a majority of parents until recently have not disclosed donor conception origins. More recent studies have shown disclosure to children in very early years seems to be the best way. There is a movement toward openness.


• Donor siblings, donors and parents are making contact. Some have found up to 55 siblings. When there has been contact, there has been generally a positive experience.
  

3) Non-traditional families – includes same sex parents and single heterosexual women who have conceived through donor insemination.

• We now have 30 years of research for same sex parents with no evidence of problems that were thought would arise


• There is less research available with respect to single parents.

4) surrogacy

• One study in UK follows children at ages 1, 2 and 3 with NIH funding to study at ages 5 and 7.


• Should restriction be placed on the number of embryos that may be transferred? Should offspring have access to the identity of donors? Who should be donors, for example family members? Should donors be paid? Should parents be screened?
  
  

Questions:

1. Adam Pertman commented that he could not understand how one could not tell the child about the donation. How do they deal with their medical history?

Cordray: He is creating his own research on the attitudes of donor-conceived adults.

2. A member of ASRM and RESOLVE commented on the importance of counseling. She has had women who are pregnant through egg donation who are considering abortion because they have not been helped with their feelings and they feel like they are carrying an alien. ASRM took the position of advising disclosure to children last year.

Benward: Having been on both sides, she notes that families conceived by donor conception still face a huge amount of stigma and hold a lot of pain whereas it’s easier for adoptive parents to find support. The idea of overprotectiveness represents a stereotype and stigma and disapproval of families formed thru ART. There is a great deal of unacceptance and negative assumptions about parents who have conceived through ART.

Cahn: More recent studies on adoptive families have found little difference in parenting and in fact, parenting qualifies as extremely good.

3. A director of an adoption program in California presented a dilemma she faced. A couple approached her agency to adopt. They had two children from her eggs and her husband’s brother’s sperm and they were not going to tell the children. Now they wanted to adopt and were open to open adoption. She made a decision to say no to that family because she felt like their children were adopted too and she was concerned the adopted child would find out. The family was incredulous. She felt her responsibility was the best interest of adopted child and there was no shortage of families because the child was a newborn.

Cordray: Commented that this happens quite a bit in DI families.

Someone commented that increasingly folks getting donor insemination are getting counseling and can get them to a point where they are open to disclosure. It’s harder for family to keep the secret over the long haul. Often, 5-10 people know outside the child.

4. A student at Duke University/adoptee commented that shame and stigma is not an option for lesbians who are trying to get pregnant. She also asked for feedback on fertility tourism where industries are developing in places like India and people are traveling from wealthier countries to other countries. She has serious concerns about this as an adoptee.

Cahn: studies show same sex parents or single parents are most likely to disclose facts of conception to their children. Regarding fertility tourism, there are the same issues of exploitation as in adoption. It is also a way of completely escaping regulation. In adoption, have to finalize the relationship, but not in fertility tourism

Golombok: Paradoxical because in some countries, surrogacy has become regulated or subject to legislation so people travel to other countries where it is allowed.

5. A mother/lawyer asked if there are studies following surrogates and egg donors to see how well they are doing? The egg donor is having invasive surgery and is in desperate need of independent counseling, but women usually give eggs because of big bucks and do not get independent counseling and are every bit as vulnerable as birth mothers.

Cordray: They are birth mothers.

Golombok: Egg donor studies have been done by Andrea Braverman. Vasanti has taken the lead in following up with 34 surrogate mothers two years after birth of the child.

Benward: Have seen egg donors interviewed and screened. It does them a disservice to see them as victims. They are adult, competent women who should be treated as such. Granted, as fees go up, it induces women to lie or do it if they otherwise wouldn’t. She has met many women over the years who like the money, but that isn’t the only reason they do it. It is not easy to find egg donors and many who have donated have thought about it for a year, researched it and talked to family about it.

6. A self-identified queer/bastard wanted to address the language issue. As an adopted person, it is painful to hear Bill say we are not children. It is very difficult in these conversations to hear that the people who are the result of these processes are children and don’t have legal rights. It would be really nice if they were treated as free agents within the course of these conversations. Words like “offspring” and “children” are very difficult to hear from her perspective. Concerned about language like “donor” because so much comes down to money and calling them donors hides that.

She has looked into the way the U.S. is treating frozen embryos. There are a set of laws prohibiting frozen embryos from being destroyed. In Louisiana, embryos can be defrosted to be implanted in a married woman for the prospect of pregnancy. One and only option is that embryos end up in snowflake adoption which is really embryo transfer.

Usha

Workshop 2.5: Supporting Adopted Children After Adoption: What are Their Post-Placement Needs?

Ethics and Accountability Conference
Sponsored by Ethica and Evan B. Donaldson Adoption Institute
October 15-16, 2007

Bullet points for discussion during Workshop 2.5:

1. What are the most important needs of adopted persons after adoption – both in the short and long term?
   
   
   
2. To what extent to current practices and policies respond effectively to these needs?
   
   
   
3. What new services and supports are needed to ensure that the needs of adopted persons are met?

Panelists:

Carrie Kent is the Director of Research for Ethica, Inc. and an adoptive mother of two children, Jack and Desiree. She is active both locally and nationally in issues related to openness in adoption, as well as transethnic placement. She has been co-owner of the XcultureAdopt list for four years and has spoken at the 1999 Traverse City Open Adoption Conference, the fall 2000 LifeGivers Workshop at Higgins Lake, Michigan, and the 2003 Open Door Society spring conference. In her “day job,” she is head of Research Services at Harvard University’s Widener Library, and is an as-of-yet unpublished novelist.

Joyce Maguire Pavao, Ed.D., LCSW, LMFT, is the Founder and CEO of Center For Family Connections, Inc. (CFFC - est. 1995) in Cambridge, MA and New York. Dr. Pavao has done extensive training, both nationally and internationally. She is an adjunct faculty member in psychiatry at Harvard Medical School, and has consulted to various public and private agencies, schools, and the court system. She works closely with individuals and families created by adoption, foster care and other complex blended family constructions. She has developed models for treatment and training using her systemic, intergenerational, and developmental framework, The Normative Crises in the Development of the Adoptive Family. Her book, The Family of Adoption, has received high acclaim. Dr. Pavao has received many awards and honors, including the Adoption Excellence Award for Family Contribution (2003) and the Angels in Adoption award (2000).

Debbie B Riley is Executive Director of The Center for Adoption Support and Education, Inc. (C.A.S.E.), an independent post-adoption organization in the Baltimore-Washington area and co-author of Beneath the Mask: Understanding Adopted Teens. Since 1993, her work has focused exclusively on the field of adoption. She has created a continuum of post-adoption programs in the Washington, DC area and a variety of innovative and effective programs to address the complex needs of families with a variety of adoption backgrounds, including public and private, international and domestic. Ms. Riley presents both locally and nationally on numerous topics related to adoption and adolescent mental health. She serves on the Research and Practice Committee of the Evan B. Donaldson Adoption Institute, the Editorial Committee for the Adoptive Families Magazine, and the Children’s Agenda Advisory Committee of the Montgomery County Collaboration Council for Children, Youth, and Families. Ms. Riley holds a Master’s degree in Marriage and Family Therapy from the University of Maryland. She is the adoptive mom of a teenage son.

Indigo Willing OAM, is a doctoral student at The University of Queensland, Australia. Her research interests include transnational families and migration, as well as links among race, culture and child welfare services. Her thesis focuses on the experiences of Australian parents who have adopted children from Asia and Africa. Ms. Willing was adopted from Vietnam into a white Australian family in 1972, and as a young adult, she received a Medal in the Order of Australia in 2006, in recognition of her work in developing the Adopted Vietnamese International community network. This network is dedicated to assisting adopted people from the Vietnam War and their adoptive families to develop stronger connections to Vietnamese culture, history and surviving/missing relatives. The network works closely with a range of adoption groups in Australia.

Debbie Riley

• When she thought about what are the most important needs of adoptees post-adoption and what extent current practices and policies respond effectively to the issues discussed by this panel, she came to the realization that adoption professionals know that there are normal but complex issues facing adopted persons, many of whom will seek professional services in charting their adoption journey.
  
  
  
• Adoption is not a one-time event but a lifelong process that warrants specialized support upon the way.
  
  
  
• Most important need of adopted persons is the funding, availability, accessibility and quality of adoption-competent mental health services. Current socio-political factors don’t ensure the availability of these services. It is the ethical and legal obligation of her field to ensure all adopted persons have access to competent mental health services. Why are the children with the most complex adoption and mental health needs being referred and seen by the least qualified experienced clinicians?
  
  
  
• The Code of Ethics of the National Association of Social Work states that when generally accepted standards do not exist with respect to an emerging area of practice, then they should exercise careful judgement and take responsible steps with respect to education, training, consultation and supervision to ensure competency in their work and to protect clients from harm.
  
  
  
• We must join together to expand the knowledge base of practitioners set the standards for competency through federal, state and local collaborations and advocate for flexible funding streams to sustain the services. Adoption competent providers can be instrumental in ensuring positive outcomes for adoptees and their families.
  
  It is our ethical responsibility to ensure that adoptive families have access to high quality adoption services.

Indigo Willing

• Shared insight from the Australian perspective.




• Since 2000 she has been working with adopted Vietnamese war orphans. She runs a search registry for people looking for relatives and notes the paucity of resources. Her doctoral studies focus on the identity construction of adoptive parents and how they negotiate problems of adoption.
  
  
  
• Australia is undergoing several adoption legislation reviews at the state level and has just had a federal inquiry into the adoption process. People are speaking up and saying things need to be changed, but who are being heard?
  
  
  
• Adoptees are highly experienced adoption educators and run excellent support groups among themselves, but they are rarely funded and rarely heard.
  
  
  
• Most common issues adopted people are focusing on with respect to post-adoption needs:
  
  
  
  
  
  
  1. Representation – the need for adoption institutions, agencies and groups etc. to allow for adult adoptee perspectives to illuminate both the strengths and weaknesses of the practices. Also a push to call for adoptee inclusion on more boards, committees and forums.
     
     
     
  2. Administration – need for tighter record keeping, inclusive fees planning for services such as searching for birth parent assistance, return visits and counseling support. A lot of uproar in Australia at the moment for fees to adopt. None of those fee increases are covering post-adoption services other than 2,000 per year for a festival where children can dress in their national costume.
     
     
     
  3. Transnational planning – providing guidance and services relating to assisting adoptees who embark on return trips. A lot of adoptees travel independently and find themselves thrown in the deep end. They are left in an incredibly vulnerable place. If so much preparation goes into bringing these children overseas, surely some preparation could exist to help them return to explore birth countries.
     
     
     
  4. Cultural strategies – offering of programs dedicated to issues such as language and cross-cultural competency. For example, the documentary Daughter from Danang illustrated a cross- cultural collision.
     
     
     
  5. Ensuring emotional and psychological capital – relates to making sure there are suitable programs and appropriately educated counselors who can assist adopted people manage issues related to their emotional well being and mental health. There is no post-adoption training for people like psychologists and family health practitioners in Australia.
  
  
  
  
• Education, if it does exist, generally consists of getting volunteer adoptees to speak about their life story. Would like to see stronger programs being built.
  

Joyce Maguire Pavao

• What adoption is not: adoption is not a problem, illness or a bad thing though it stems from what many think are problems. Society tends to view adoption as a problem. It’s very important to realize that pathologizing leads to pathology and a lot of that goes on in adoption and is that ethical?
  
  
  
• Adoption is taking on and extending or making of family by admitting others to the clan and claiming them as relatives as in marriage. It is a lifelong process and it affects the generations before and after in many direct and indirect ways. It is complex, it is never simple.
  
  
  
• Cannot focus on post-adoption needs of the child without focusing on the parents. If you don’t take care of the adults, the child isn’t taken care of. We need to provide more support and services to foster families.
  
  
  
• With respect to birth parents, it is important to pay attention not just in the moment, but post-adoption these issues go on. There’s a developmental process for birth parents. We are not doing enough for birth parents, they are hardly considered. If you care about the child, you care about all of their parents. This includes parents whose children were removed – the children are in permanent homes and messages they give those children will make a huge difference in the emotional stability of their child.
  
  
  
• For adoptive parents, there are ongoing needs. Often it comes in the guise of the children’s needs, but parents have developmental issues, including in and out of doubt about feeling genuine.
  
  
  
• Therapy is not the answer to everything. Need to provide consultations and programs and not necessarily be in therapy.
  
  
  
• Developmental issues for children – many points in time where things will come up that are quickly pathologized. Under anger lies sadness or fear. Larger community needs to have education e.g., schools where learning disabilities diagnosed are in fact teaching disabilities; medical and health professionals – rampant medications and crazy therapies done in the name of attachment, bizarre overdosing of adult medications for kids is unethical. Need to have extended family educated

Discussion from Workshop 2.5

Question 1.A person from CASE raised concerns with other mental health professionals. Instead of pathologizing adoption, they minimize and fail to recognize normal reactions to adoption. They suggest other things are going on instead of validating what is happening is normal. Are there more ideas of how to educate other professionals?

Riley: It’s been a delicate balance for many years of how much to attribute to adoption. Education is important.

Willing: She is a sociologist by training, but sees attachment come up a lot. It’s important to remind parents to keep a critical mind and do research.

Question 2. An adoptive parent/adoption worker referenced developmental stages members of the triad undergo and requested references.

Pavao: A lot of the grass roots organizations can be helpful. For example Lee Campbell of Concerned United Birthparents put together material on developmental issues of birthparents; she has a long vision of birthparenthood. There is also Romanchik’s organization. For adoptive parents, there are wonderful adoptive parent networks. Always go to the elders, parents whose children are in 30's and 40's and who have kept up with the times. Some people are better at some stages than others. The family is an organism, so it is important to see how everyone is relating to each other. Adult adoptee groups are incredibly important for people to listen to. Find people who can reflect on things.

Willing: Sometimes the diagnosis of adult adoptees is wrong. For example, low-self esteem is attributed to being separated from mothers. That may be true, but a more well rounded approach needed, for example, an examination of what else is going on in their lives like racism. Look at studies by adoptees in addition to personal narratives.

Question 3. Another adoptive parent/adoption worker wondered how we can help better prepare families in adoption by saying that post-placement services are more likely than if they had given birth to a child because there will be an added layer of issues.

Pavao: People should be trained to provide them. Important the services not all be therapy, but often need consultation and support.

Riley: We need to start advocating for the funding and that these services are accessible.

Question 4. An adoptive parent and educator said he tried to start a club for adoptees at his high school but he ran into confidentiality laws. Doesn’t know how to go about it.

Pavao: Suggest normalize it by expanding it, for example, to kids who live in complex families. Emotional and psychological issues are the same even if the legal situation is different. The kids may feel pathologized if limited to adoptees.

Riley: Look at the environment. A lot of adoptive parents don’t want their children to share they are adopted because of the stigma attached to them. See how one can create adoption sensitivity among peers.

Willing: As a teen, there might be issues of gender. At an adoption camp in Australia they showed a video with stories by intercountry adoptees who were a little older. Accompanying that they showed the movie Transformers and lots of boys came. Adoptive father groups have football days.

Question 5. Someone from Open asked what if you have parents who are in denial or who are reluctant? How do you draw these parents in?

Pavao: Help isn’t help unless you want it. No one starts out gung ho understanding all of this, but opens up along the way. Pre-adoption, prospective adoptive parents may not be interested even if they attend pre-adoption education, but they will have the information to get more help when needed. Sometimes information doesn’t take seed for awhile.

Willing: There is a real need for this. Can’t adopt in Australia without going through a state agency. Reasonably good program in the pre-adoption stage where prospective adoptive parents needs to go through education sessions, provide a life storybook, and undertake home studies. Adoptive parents have to compete for children so they join networks to learn how to get through the system and make friendships that way and then are keen to learn more, but there are not enough professionals to do the training.

Question 6. A mother said she runs an online support group for individuals who worked with her network of agencies she lost her daughter to. So she is in a position to help even though she is not a professional. What other things can she do besides recommend books?

Pavao: Suggests reading, going to conferences and lectures, support groups. Worry about the word “support groups” sometimes. Some like the information but don’t like the name. Hearing other people normalizes experiences.

Riley: Something she has found useful is journaling.

Question 7. An adoptive parent/adoption social worker asked whether there is a need for more professional standards when it comes to adoption social work in schools of social work. Should there be more standards of practice across the board?

Riley: Yes, there should be. What is an adoption-competent therapist? There is no standardization of knowledge base or core competency. It is important that we come up with standards before an outside entity does.

Pavao: Post-graduate programs are great but they are not nearly enough. Supervision is a key factor, for example, in the child welfare system people often become supervisors if they are near retirement and are going part time. There should be a lot more done to make sure people are trained.

Question 8. Adoptive parent/adoption worker ask about the importance of providing services to siblings, both biological and adoptive.

Pavao: Siblings really need support. We don’t do enough work with siblings before a placement or before removal.

Riley: Do siblings get to be a part of the process? Doesn’t want to see the child as separate from everyone else and usually siblings are left out entirely.

Usha

Ethics and Accountability Conference 2007 Photos

Here, finally, are some photos from the Evan B. Donaldson and Ethica Adoption Ethics and Accountability Conference 2007. Most of these are from the Meet the Bloggers Session and the final roundtable session (the empty chairs indicate that not everyone stayed for the final session).

If anyone who attended the conference has any photos they'd like to share, I'd be happy to add them to this slideshow if you send them to me.

Thanks!

Desiree

Workshop 1.4, Part II: Ensuring Ongoing Relationships--Practice That Opens the Door to Connections--Questions & Discussions

Ethics and Accountability Conference
Sponsored by Ethica and Evan B. Donaldson Adoption Institute
October 15-16, 2007

Bullet points for discussion during Workshop 1.4:

1. What key factors should assessments address regarding ongoing connections?
   
2. What are characteristics of successful open adoptions? What factors undermine the success of open adoptions?
   
3. How can families of origin be best educated on their importance to the children and the roles they can continue to play in their children’s lives?
   

Panelists:

Marilyn Panichi is the Executive Director of Adoptions Unlimited, Inc. She has more than 35 years of adoption and child welfare experience in administration, supervision and casework. Prior to establishing Adoptions Unlimited, Ms. Panichi was the Executive Director of the Adoption Information Center of Illinois under the auspices of the Child Care Association of Illinois. She began her career with the Illinois Department of Children and Family Services as a Child Welfare Worker and Adoption Coordinator. Ms. Panichi earned her Master of Social Work and Bachelor of Science in Psychology from the University of Illinois. She is a member of the National Association of Social Workers and the Academy of Certified Social Workers. Ms Panichi is co-founder of the Adoption Exchange Association where she currently serves as board member and treasurer.

Susan Ogden is the Director of Domestic Adoption at Adoptions Together. She has worked in education and nonprofit program management for 25 years. When she adopted her daughter Sasha in 1992, Ms. Ogden became an advocate for better understanding of open adoption. Her daughter enjoys an open relationship with her birth mother, birth sister and birth father. Their experience was featured in a New York Times article (October, 1998: Secrecy and Stigma no longer clouding adoption.) Ms. Ogden has published in Adoptive Families magazine and the Washington Post. Celebrate Adoption, Inc., an organization of triad members co-founded by Ms. Ogden, published her An Educator’s Guide to Adoption, a booklet that adoptive parents may give to their children’s teachers. The Guide, now in its fifth printing, was featured USA Today and the subject of a segment of the Rosie O’Donnell show in November, 2000. Ms. Ogden worked closely with clients of Adoptions Together in open relationships in making a video about open adoption (Adoption …Real Stories) that is used in outreach to broaden the understanding and acceptance of adoption as an option in high schools, clinics, hospitals, churches and other community organizations that work with youth and women in crisis pregnancies.

Patricia Dudley serves as Director of the Long Island Region for You Gotta Believe! The Older Child Adoption & Permanency Movement. In this position, she has successfully supervised and completed one federal grant and is currently supervising a second federal grant “The Long Island Opening Adoption’s Door To Teens Project”. Over the past five years, under Ms. Dudley’s leadership, the Long Island Region of You Gotta Believe has successfully placed over 80 of Long Island’s hardest to place teenagers into permanent adoptive families. Under her supervision, staff educates potential prospective parents from the community about the importance of continuing to maintain teens’ past relationships with former foster families, birth families, and neighborhood connections. Ms. Dudley has over 20 years experience in the field of child welfare. She is also an experienced adoptive parent having adopted two older children of a different race from the New York foster care system.

Susan Soon-Keum Cox is Vice President of Policy and External Affairs for Holt International Children’s Services in Eugene, OR. She has worked with local, national and international media for more than 25 years. In 1988, Ms. Cox was appointed by the Ministry of Health and Welfare in Korea to be responsible for media regarding adoption. She has managed media for a number of high profile situations, including the Dying Room stories from China in 1993. Ms. Cox was a member of the White House Vital Voices delegation to Montevideo as a media trainer for women in developing democracies. She also has been a guest media trainer for Women’s Campaign International’s for the Fels School of Government at the University of PA. Ms. Cox has appeared on numerous national television programs and featured in news articles. She has appeared on the NBC “Today Show,” “CNN News, CNBC News, and National Public Radio and Television, and has been featured in articles in the Washington Post, New York Times, Business Week, and Family Circle.

Workshop 1.4: Questions and Discussion:

Marilyn Panichi: In order to have some organization for our discussions, I thought we could first talk about the assessment of adoptive parents first. [Bullet point 1: What key factors should assessments address regarding ongoing connections?]. As each of the three panelists spoke, I jotted down what I thought were the important points each was making.

In terms of infant placement...

• Susan Ogden talked about embracing the birth family and having compassion for them
  
• And that the agency then supports that relationship [between birthfamily, and adoptive family and child]

In terms of teenage placement...

• Pat Dudley talked about involving birthfamily members and teens in the training of adoptive families.

In terms of international adoption...

• Susan Soon-Keum Cox really talked about being prepared and what we can do to enhance that. Adoptive families need to be prepared for open adoption, even if it doesn't start out that way at the initial placement

Question 1: from an unidentified member of the audience: "When I saw the word "assessment" in the discussion questions, I was actually thinking about the assessment that the adoptive parent needs to make in regard to the birthfamily--how to structure ongoing relationships with the birthparents when you are considering what the birthparents bring to the situation. Afterall, when it comes to assessing, you have to assess, not only adoptive parents, but also what the birthparents bring to considering openness."

Susan Ogden:

• Do you mean whether birthparents want openness or not--or whether they are capable of it?
  
  • Parents tell us often initially, that they don't want openness--but we always leave that door open for them.
    
  • Some parents are struggling with mental illness. Some are struggling with substance abuse. Many are struggling with lots of different challenges.
    
  • If they want an open adoption and they are struggling with these things, then the agency is very much involved in keeping that relationship going and in facilitating that relationship.
    
  • We're MORE involved when--when people are more challenged.

• In our 18 year history, we've had a lot of success in these relationships even when there are significant challenges.
  
  • For example, we have a mom who has fetal alcohol syndrome. She has placed two children through our agency.
    
  • Every year she has a picnic with her two children and their families.
    
  • And she takes a bus to the agency every couple of months and writes a letter to her children.
    
  • And the [adoptive] families are very compassionate towards her and send photos.
  • So, from an objective standpoint, yes, she "looks" a little scary--because she is mentally compromised.
    
  • But there, what the families are really embracing is that their children are really becoming more compassionate towards people with differences. And so they're seeing their children's spiritual capacity enlarged by that relationship.
    
  • And a couple of years ago the families told us that they can handle the meeting on their own. That we didn't have to come.
    
  • So, we typically do set it up now because she (the birthmother) doesn't have a phone, so that everyone knows where and when it's going to be, but they--the families--are managing this.
    
  • Their maturity and their compassion is really managing this.

Patricia Dudley:

• We work with older children. Most of the children who come to us have come to us because of deep loss--the termination of parental rights.
  
• In working with the birthfamilies of these children, a lot of these families didn't understand that termination of parental rights meant, termination of parental rights only.
  
  • They thought this meant that they had to stop loving, they had to stop caring, they had to stop being in contact with their children.
    
  • That is typically something that a social worker at a country agency has told them.
  
  
• Anecdotally, we placed a sibling group of four teenagers back with a birthfather who had done a surrender only because the county had threatened to bring charges against him.
  
  • The children had been with him and his wife--they were young, they were from a different country, they had different ideas of corporal punishment, his wife was a substance abuser. There were four children including a set of twins.
    
  • Dad had left. Mom's boyfriend had abused the girls. They went into care.
    
  • Dad had gone went and gotten his children back, but being a single dad and being very young, he used corporal punishment on them. He left marks on one of them. And the county walked in and took them and threatened to bring charges against him. He signed his rights away.
    
  • Within three months dad's brother and brother's wife were killed in a car accident, and so this dad ended up raising his brother's children. He went to parenting classes to learn what he needed to do and he raised his brother's children.
    
  • Again, another eight years later, his own kids are around sixteen and seventeen and had been in care all those years. His own children had been split up and were in two different residential treatment centers. The girls had been sexually abused; the boys had been sexually abused.
    
  • The oldest of his children found him through the internet.
    
  • The father was, by then, a productive member of society; he owned his own business, he had raised a family of children.
    
  • And he thought his own "babies" had been adopted and had been living happy, healthy lives. But they weren't
    
  • And we were able to go into court and get that surrender overturned.
  
  
• Anecdotally again, we just recently--for the first time in the history of New York--were able to place a 12 year old girl back with her birthfather who was able to adopt her as his own child.
  
  • At least in the history of our agency, we have never been able to have a single man adopt a single girl, but actually we did this in having a birthdad adopt his own child.
    
  • And this story happened because the child went into care. The father knew nothing about the child.
    
  • All the child knew about her father was that her mother had said a man named "John Doe" was her dad. And so the child kept talking about "my dad 'John'."
    
  • She was adopted [by strangers] at eight, but the adoption failed and she was returned back to the system. The child then went before a judge for whom our agency had actually done one of our training sessions, and this judge ordered the caseworker to actually find out who this "John" guy was.
    
  • The previous caseworkers claimed that they could never find "dad" because they had no last name.
    
  • So now, the new caseworker said to the child, do you know what this John guy's last name is? And the child was able to say right away..."yes, John Doe was my father."
    
  • They went through the phone book and found a John Doe who admitted to having relations with the mother; did a DNA test, found out he was the dad, and placed her in the home, and she was actually just adopted two weeks ago by her own dad.
  
  
• So sometimes birthparents don't even know that they have rights. They don't know that they CAN be in contact.
  
• They literally live in this assumption that they lost everything.
  
• You know we do have parents who were substance abusers when they were teenagers or young adults. But now they are in their thirties or forties, having productive lives, having their own families.....and their kids are still in foster care.
  
• We have failed them. The system has failed those kids.
  
• We are now able to reconnect them. They are able to have brothers and sisters and parents again. And to be able to be back in contact with these brothers and sisters and parents. And sometimes we are even able to place them back in their families.

Question 2: from an unidentified director of New York agency placing infants for domestic adoption: "As Pat was talking I realized that, in a way, you are at an advantage because you are building on existing relationships--you are reviving them or strengthening them--there is at least, a relationship there. Our big problem really is engaging birthparents to be involved in an open adoption. I wish that we had to do an assessment on birthparents to see which ones are capable! We just--we don't need to do that because our major issue is encouraging them, involving them, and helping them understand the value to their children of staying involved. And I just wondered if anybody has real practical tips--are there any things that you do or say or build into your practice to encourage birthparents? One thing that we try to do is to set up a post placement visit within three months--my feeling is that if we can do it early, then at least we can build on that. If you wait more than three months, it becomes scarier and scarier for these folks to reconnect. But I just wonder if you have any practical ideas..."

Susan Ogden:

• We see a real movement in birthparents wanting more open adoptions.
  
  • My hunch really is that many of them are connecting on the internet and learning there what is available.
    
  • That is now a new support community for parents that are thinking about adoption.
    
  • And so they're seeing more of what is available in terms of open adoption.
    
  • I would say that 9 out of 10 birthmothers coming to our agency are asking for some kind of openness.
    
  • So we don't have to encourage them so much because they are already asking for a level of openness.
  
  
• The vast majority of birthparents/adoptive parents are meeting shortly after placement.
  
• Most of the [birth]mothers that we get are calling us from the hospital--they've already given birth--and they are saying that they want to make an adoption plan and that they want to see an agency.
  
  • So at that very moment we say...we have lots of families that we can show you--what are you looking for, what are you thinking about, what are you wanting in terms of an open relationship?
    
  • Those are the [adoptive] families then, that we are bringing to the hospital in order to show them [the birthmothers], to think about.
    
  • Several weeks later as we continue to work with them [the birthmothers] we ask them to continue to think about what level of openness they want--that's where we begin--What level of openness do you want?

Unidentified director who had asked Question 2:

We do too. Maybe in New York City we work with such a diverse population of birth parents--a lot of birthparents are newly arrived immigrants to New York City--that this is different. A lot of our birthparents don't have a good support system, don't have access to the internet, don't have the kind of knowledge about adoption that some of our birthparents that have been raised here perhaps do.

All of our adoptive parents are prepped on open adoption. You know, we almost beat them up with it! By the time they have a baby, they very much want this.

Our problem is on the other side.

Our adoptive parents are eager. They understand the value, and then they really aren't able to have an open adoption because our birthparents really--for their own particular reasons--aren't able to enter into that kind of relationship.

Susan Soon-Keum Cox:

• I think this is something that can happen internationally too.
  
  • One solution is to provide training to the social workers who have traditionally been so protective of birthmothers--and rightfully so--but who have not encouraged them to think about having a longterm, or any kind of a relationship.
    
  • In most programs that I'm familiar with they are now encouraging birthmothers to at least anonymously write a letter. I think that begins to help them think about, at least dimly, a relationship with their child.
    
  • But then social workers can begin to give examples of adoptees who have been able to reconnect with birthfamily and talk about it in a way that isn't so fearful.
  
  
• I predict that in the next decade or so, as the secrecy in adoption in other parts of the world, diminishes in the same way that it has been slow to happen in the US--but it is happening--that there will be more birthfamilies coming forward, seeking information, and wanting to know about their children.
  
  • Therefore, it is SO incredibly important that information be preserved. Both in the sending country, but also in the records of the US agency.
    
  • Because that's the only way that you can really have any hope of bringing folks together.
    
  • And I have to say that the internet has been a huge resource for this as well.

Question 3: from Ellen Singer, a therapist and educator with The Center for Adoption Support and Education in Maryland and Virginia: "I want to say first that these are really good problems--in terms of my practice. I say good problems, because I still see birthparents that don't get preparation and don't know that openness is an option for them. It is always heartbreaking for me.

What is also heartbreaking is when I see adoptive parents that have not gotten preparation and who are "freaked out" and so upset when birthparents contact them--maybe because it was a private adoption or through an agency--and want contact, but the adoptive parents are so unprepared for that because they thought they weren't ever going to have to deal with that.

But my question has to do with what I see in my practice--and that is, that while preparation for the adoptive parents and birthparents is crucial, it is also crucial for the extended family members. I have situations where it is the grandparents of the birthparent who are going to be remaining in contact. And they have had no preparation from the agencies or from other people so that when we talk about factors that undermine the success, that lack of education, that lack of preparation, around boundaries, around relationships--on both sides--is problematic.

I just had one situation where the family was out of contact for several years because there was so much conflict that had ensued. Fortunately the adoptive parents had contacted us and we were able to mediate and facilitate those relationships and get things back on track.

So I just want to say that I'm assuming that you see this as well. There is so much lack of education, so much lack of support. In the extended family members of adoptive family members and friends and in the community, openness is still so foreign to them, that they get the message of--"What are you doing?! This is crazy! Why would you do THAT?!"

I guess I have a lot to say, but if I have to put it in the form of a question, I guess I'd say, what practices do you have to help adoptive families in open adoptions and birthparents in open adoptions, not feel so alone in the context of their families and communities?"

Marilyn Panichi

• One of the things that we have done in our Federal grant, is that we have developed a videotape that is available to anybody. It is a 15 minute video of three adoptive families that have open adoptions. Their children are teens and they talk about why it's really important.
  
  • One mom talks about a point that one of you here made, and that is, that the children can hear directly from their family, what the truth is so that they don't ever have to think that she [the adoptive mom] may have misrepresented issues.
    
  • In this case, the birthmom has ongoing contact with the adoptive daughter--she came to the daughter's high school graduation just recently.
    
  • Another family has ongoing contact with the grandmother. They see her all the time and the video shows that relationship.
    
  • And the third family, which was actually a foster family adoption, had taken the young man to visit his mom in prison for six years. She's now out of prison and she comes to the family home for all holidays. And they all talk about the fact that they have just expanded their family. They are now all one much bigger family.
    
  • So it really shows life--people who are living this.
    
  • And there is also one family of children who exited the foster care system and they have no contact with their own siblings.
  
  
• It's a Family Connections project. We use it in training court personnel, social workers, adoptive families, the youth themselves.
  
• It's a very powerful tape.
  
  
• And you...have a film about open adoption yourself?

Ellen Singer, a therapist and educator with The Center for Adoption Support and Education in Maryland and Virginia:

Yes, we do. We have a film in which we have two birthmothers talk about their open adoptions and their relationships.

Susan Ogden:

• But you know, Ellen, I think that one of the challenges is that many times the birthgrandparents aren't involved at all.
  
  • Sometimes the biological parents keep it [their adoption plan] from their family.
    
  • They don't want their family to know.
    
  • They don't want their family to weigh in on it.
    
  • Should [the birthparents' extended family] call us and demand to know, confidentiality demands that we can't even say that this person was even a client.
    
  • So, if they're involved from the beginning, yes.
    
  • Anecdotally, recently a birthgrandmother came to a placement and was a part of the placement.
    
    • Her daughter-- the birthmother--and the birthfather, did not want to be a part of the placement.
      
    • They were both teens and I think they were just feeling very raw from the experience, but the birth grandmother asked to be a part of placement, and the adoptive family was delighted.
      
    • And so, all of those updates will be shared with her [the birth grandmother] and she will be in on the visits. Even though she is not in the post adoption agreement, it has already been established that she will be a part of the visits.
    • It's really case-by-case in terms of what people are willing and want to do.
  
  
• I know that when I took my daughter to Florida a few years ago in order for her to see her birthmother--my daughter was 10. Her birthgrandparents did not want to see her. They had seen her earlier, at a couple of different junctures, and they just did not want to participate.
  
• My interpretation was that it was just too painful for them. They had lost so many years with her that seeing her for just a weekend was not going to be helpful. That's my interpretation. Maybe they were just feeling too sad about not watching her grow up.

Patricia Dudley:

• I think one of the most horrific cases that I had to work on happened when I was working with another agency. We were working with children from New York City. I had a young man who was being raised by his grandmother and she refused to adopt her grandson.
  
  • She had had her grandson since infancy and she refused to adopt him.
    
  • She could in no way fathom why she should have to adopt her grandson.
    
  • He was referred to us from a NYCity caseworker and they wanted us to find an adoptive family for him.
    
  • At that point I had just become a grandmother and I knew that I was going to be raising my daughters' children. I could see it from both sides. On the one hand I couldn't understand why I as a grandmother I would have had to adopt my own grandchildren if my daughter's children had been ordered out of her home--and the other part of it--how I would have felt if my grandchildren had been pulled from me.
    
  • The only thing I could do for this young man was to definitely find a family that would accept grandmother's involvement. And I did.
    
  • But what I couldn't understand was why this caseworker somehow and someway couldn't facilitate that this child could change his code [coat?? This word is not clear from the tape???]. He was only 9, but he was with grandma.
    
  • And it was hard--it was one of the hardest things I've had to do.
    
  • Knowing that I was going to be raising my grandchildren, how was I taking a grandchild from a woman who was an older African American woman who did not and could not understand why she had to legally adopt her grandson.
    
  • And she cried and wailed when they pulled him.
    
  • And he cried and wailed when they pulled him. It was horrible.
    
  • The only thing I could do was make sure that grandma stayed grandma.

Question 4: from an unidentified member of the audience: "My question is about international adoption, but the question would also apply to domestic adoption. When do you begin to present the idea of openness to the adoptee and how do you manage expectations?"

Susan Soon-Keum Cox:

• Well, if they're already adopted and it's obviously probably a closed adoption, one of the things that we encourage is that adoptive families continue with writing letters, sending little school pictures, keeping in touch, and sending these things to the agency overseas.
  
  • This is so that if a birthmother ever comes forward, there is the possibility [for the birthmom] to know that we [the adoptive family] would like to have contact--there's the information about her child.
    
  • I think another thing that it does for the adoptee is that it demonstrates the tangible connections that the parents have.
    
  • Anecdotally, when I went back to Korea for the first time and I saw my files, even though I had seen my records before in Oregon, it's very different from seeing them overseas in your birthcountry.
    
    • And to have them opened up and to see that, over the years, my mother had been sending letters and little pictures--I had no idea she had been doing that.
    • That was incredibly important to me that [my adoptive mother] had taken the time to do that.
  
  
• I certainly think that it's important--as early as children can understand--to talk about birthfamily. There are some wonderful resources in terms of books for children from the time they are very small up through the developmental process.
  
• I think they should always know that it [birth parent contact] is a possibility. How do you prepare them for it? I don't specifically know that you can do that...without knowing that it's happening right now or could happen.

Question 5: from an unidentified member of the audience: "My question is about children who are a little bit older and have been placed through the foster care system, where their parents might have some scary behavior during contact. I've recently had a couple of cases like that with my families where they've had phone calls where the parents were inappropriate and a little scary with the kids. Maybe things will be better later as they get used to things, but I wonder if there's a resource that I could use to put some "bumpers" on it to protect the child during telephone contact."

Susan Ogden:

• As children have been getting older in our agency--at any point we can go back to mediation and try to put some structures on it.
  
• Anecdotally, with one 15 year old adoptee, her birthfather visited her recently and she had a fantasy that her birthfather was going to be younger, hipper, and cooler than her adoptive parents.
  
  • And it turned out that he wasn't-at least in her assessment at 15 (LOL--hardly any adult is young or hip or cool!).
    
  • And he kept saying to her things like...you know, when you get older, I'd really like for you to come and live with me.
    
  • He thought he was being very expansive in reaching out, but she found she was shrinking back.
    
  • She was really having a lot of guilt about it and having difficulty processing it.
    
  • It took a lot of therapy with her afterwards. She really needed help to her give up the fantasy.
    
    • We can live on fantasies for months and they are delightful and delicious and giving them up is really difficult.
      
    • It is important to get the adoptee to talk and to help her--to lend support and help her process. That is the role of a mediator.

Patricia Dudley:

• Working with the older teens--most of our teens--know what their families are. They know what their families can do. And they do look to us for protection and for supervision.
  
  • So we can definitely say--being in open communication with that teen--how did you feel about that, what would you like us to do, etc.
  
  
• Technically we're into approval and we want an open relationship, but if that relationship is going to hurt or damage the teenager or the relationship with the adoptive family, then there are times when things need to be taken back.
  
• Speaking with the therapist, getting the therapist's input.
  
• Putting restraints in place. Maybe they can only meet where there's another adult who can say, for example--"that's inappropriate" or "it's time to cut this conversation--and you can call back later after we've had a conversation."
  
• Again, our teens are still children. They need protection.
  
• And you know, we do sometimes have to be the adults in that area.
  
  • We may need to say, "you know this is not working right now."
    
  • We need more counseling maybe. We need more therapy maybe. On the parent's part. On the teen's part.
    
  • We have to facilitate.
    
  • Sometimes, we can't let this go on any longer. There are times when we just have to be the adult and say, "This just isn't going to work right now."

Susan Soon-Keum Cox:

• In international adoption, in a reunion, it's important to make sure that you have someone that can help with this process.
  
  • Anecdotally, for example, my conversations with my birth family have all been through the filter of someone else because we don't speak the same language. And it's complicated.
    
  • I would love to be able to have a real conversation where it's just us in the room. But since my Korean is not good and their English is not good, I don't know that that will really happen.
    
  • It's been so critical to have someone who I trust who can really give the information,to interpret my thoughts to them, and theirs to me.
    
  • And if you can have constancy, if it can be the same person over time, that's really helpful.

Question 6: from Darlene Denton: If we are talking about open adoptions, is this legally binding? Are you doing this before the birthparents sign their termination of parental rights?

Susan Ogden:

• In Maryland, the post adoption agreement which is legally binding, is attached to the consent.
  
  • It's filed in court.
    
  • But it might be several months later after parental rights are terminated that a birthparent might ask for contact--and that could still be contracted. There's lots of different options.
    
  • If they go into it not wanting contact, we can still leave that door open in case they change their minds.

Darlene Denton:

Are there other states that have these provisions?

Susan Ogden:

Yes, I believe that there are other states that have this. Yes.

Unidentified member of the audience:

I know that Annette Appell from the University of Nevada at Las Vegas is speaking at the conference as well. This is an area of expertise of hers. I know that there are a number of states--they differ--but a number of states that have enforceable contracts--nobody's going to come and get the kid. But the court will intervene. Yes, there are several states, although I don't know what they are. I think it's growing, yes.[ Fleasbiting's notes from Annette Appell's session about legally enforceable post adoption contracts]

Susan Ogden:

• In my own work I have found that there is still a reluctance particularly in foster care to consider openness.
  
  
• I think the message that we've gotten from everyone on the panel is that we need to start with the assumption that openness is a good thing, and only exclude when its in the best interests of the child--rather than the opposite assumption, which has always guided us--which is that it's not a good thing except in these exceptional cases--these exceptions. We need to reverse that paradigm I think.
  
  
• One of the things that we didn't touch on, that I think is a little scary, is what happens in private adoptions when there's nobody to mediate, when there's nobody to explain, when there's nobody to pick up the pieces later, when there's nobody...when there's just nobody.
  
  • So that is just one of the frightening things that came into my mind as we were talking about how to manage these relationships and do what's best for the kids. For private adoption, for these kids, there just is no such option.
  
  
  
• Finally, I wanted to ask this question, although there's no time left to discuss it. I'll ask it anyway just so we can think about it.... :
  
  What is responsibility do the agencies have in an international adoption placement, to help sending countries understand the importance of--not openness necessarily or in terms of relationship--but in terms of gathering those stories and those things that Susan Soon-Keum Cox talked about. In terms of keeping that information. In terms of storing or archiving letters that come from whatever country is the receiving country so that archive is maintained?

The preceding are detailed notes. They do not constitute the exact words of the speakers, but a--hopefully accurate--summary of the ideas of these presentations and questions. If any of the panelists or attendees take issue with any of these summaries, please let me know so that I can correct them.

Desiree