Ethics in Adoption: A Values Framework
Presenter: Madelyn Freundlich, J.D., M.S.W., The Evan B. Donaldson Adoption Institute, New York, NY
A framework that might be helpful in addressing some of the difficult issues faced in adoption today incorporates two types of values: values at the level of the individual and values at the systems level. At the individual level, the values that can inform how adoption professionals think about the people they serve - birthparents, adopted children, adopted adults, prospective adoptive parents, and adoptive families - are: 1) Respect; 2) Autonomy; 3) Knowledge; and 4) Beneficence (a term often used to refer to well-being or a state of "good").
At the systems level, the values that can inform how adoption services are designed, delivered and evaluated are:
1) Fairness
2) Equity and
3) Accountability
Many of these values were mentioned at different points in the conference and those who suggested these values in relation to various issues that were discussed may have conceptualized them in different ways. The following is one way to think about each of these values.
Values at the Individual Level
1) Respect = Recognition of inherent worth and dignity of the individual.
If we believe that respect is a key value underlying adoption, we might ask:
- Does respect for all triad members ground adoption?
- Or, are some triad members respected more than others? In other words, are some triad members considered inherently more worthy than others?
- Are some children considered inherently more worthy than others when adoption is the plan? Does the cost of a particular adoption track our assessment of the relative worth of one child as compared to another?
2) Autonomy = There are many aspects of autonomy but one relates to the ability to make a free and informed decision about matters that deeply affect us personally.
If we believe that autonomy is a key value underlying adoption, we might ask:
Is adoption based on a concept of birthparent autonomy or the autonomy of prospective adoptive parents?
Can we say that the autonomy of a birthmother is acknowledged, for example, when a consent to adoption is taken within a few hours or a day after she has given birth to her child? Earlier in the conference, Dr. Crumbley presented an example of a parent with a child in foster care who failed to attend a mandatory court hearing. Upon learning of the consequences of not attending the hearing, this parent stated that he would have been present at the hearing had he understood the importance of his attendance. Is the autonomy of this parent recognized when it is not made clear to him that his failure to attend a court hearing will trigger a termination of parental rights petition?
For prospective adoptive parents, is their autonomy affected when an agency fails to provide them with known information about a child's background that suggests a significant risk of serious health or developmental problems?
On the other hand, does the autonomy interest of a prospective adoptive parent require that an agency leave no stone unturned in finding out any and all background information so that the adoptive parents can feel assured that the child is the right one?
3) Knowledge = One way to look at knowledge is as information which the individual can utilize to make - in the sense of autonomy - a fully informed decision.
If we believe that knowledge is a key value underlying adoption, we might ask:
Who is entitled to what information in adoption?
If an adult adoptee seeks the complete history of her adoption from an agency, should that agency withhold hurtful information to protect her - because the agency believes she is not emotionally stable enough to handle the information? Or because it would be embarrassing to the agency due to the fact that they told the adoptive family an entirely different (and inaccurate) story at the time of the placement?
4) Beneficence = Well-being or a state of "good."
If we believe that beneficence is a key value underlying adoption, we might ask:
- What does "good" really mean for an adoptee, a birthparent, or an adoptive parent?
- Whose "good" counts most? Does the old stand-by "best interest of the child" really answer that question?
- If it comes down to one triad member's "good" versus another's "good" how should the situation be resolved?
These are only a few of the issues that might be considered at the individual level.
Values at the Systems Level
1) Fairness = "Rightness" or a certain objectivity.
If we believe that fairness is a key value underlying adoption, we might ask:
- Is it "fair" to accept or reject an adoptive parent because we just don't think a person with a certain disability could be a good parent?
- Is it "fair" to decide that older children or children with certain special needs just aren't adoptable?
- Is it "fair" to keep birthfathers out of the decision-making process related to adoption?
2) Equity = Even handedness; Equal opportunity.
- If we believe that equity is a key value underlying adoption, we might ask:
- Do we believe that all children who need adoptive families are entitled to these efforts to ensure that outcome?
- Are some children easier to serve or more likely to yield higher fees? And, are services targeted to those children as a result?
- Are all prospective adoptive parents entitled to an equal opportunity to adopt? Or should some get preferential treatment based on income, age, marital status, health, sexual orientation or other factors?
- Is it acceptable to give some prospective adoptive parents greater consideration than others? And if so, on what basis?
3) Accountability = Taking responsibility for and addressing outcomes produced as a result of agency/system practices, particularly those that cause harm to those being served.
If we believe that accountability is a key value underlying adoption, we might ask:
Who exactly is accountable to whom in adoption?
Is an agency primarily accountable to:
- The adoptive parents (who pay a fee/who might be more likely to sue)
- The child (if we really believe this, what does accountability to the child mean?)
- Birthparents
- Institutional/Agency pressures: costs, the number of adoptions to be completed within certain periods of time, and speed at which adoptive placements must occur.
These are only a few of the issues for consideration at the systems level.
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