One of the most critical ethical issues in adoption is the way that adoption impacts real people: birth families, adoptees as children and as adults, prospective adoptive parents and adoptive families. Adoption has a lifelong impact and the issues are complex. There has been a shift over time in our beliefs about adoption - in areas such as secrecy, the sharing of information, and who is considered eligible to adopt - and in our views of what is ethical in adoption.

-- An Overview of the Issues

Sharon Kaplan Roszia

-- Openness from a Legal and Psychosocial Perspective

Joan H. Hollinger

-- The Ethics of Counseling Triad Members

Dr. Betty Jean Lifton

I. An Overview of the Issues

Sharon Kaplan Roszia, M.S., Kinship Center, Santa Ana, CA

The Dali Lama writes that the concept of ethics is tied to spiritual actions based on compassion and concern for others. Ethical conduct rests on the recognition that just as each of us desires to be happy and free from pain, so do others. Discontentment breeds greed, aggression and competitiveness and ethics is "a means to ensure that we do not harm others." Similarly, in discussing ethics, Jim Gritter has posed the question, "if something is not good enough for my daughter, why would it be good enough for someone else's daughter?"

The lack of a clear ethical code in the field has had a significant impact on adoption practice. The ethical considerations bearing on the impact of adoption on members of the triad are interwoven with the seven core issues developed by Sharon Roszia and Debbie Silverstein. At the heart of the core issues is the understanding that adoption begins a lifelong, inter-generational journey for all touched by it; adoption is a complex issue; and adoption does not exist in a vacuum but within a social and cultural environment that changes over time.

The Seven Core Issues

1. Loss.

Everyone served by adoption loses something before they gain anything. Adoption is a bittersweet experience. As one adoptee described it, adoption is a "paper cut to the soul." Loss in adoption is a pain that is easily dismissed by others, is well-hidden, and is not well acknowledged in a society that sees adoption as an event that solves a problem and makes it possible for everyone to move happily on. The voice of the adoptee is often missing in the adoption picture - a voice that can reveal many losses: information about health and family history, siblings, other family members, culture and country. Adoptees do not participate in decision-making but remain bound to the decisions made by others. As David Kirk notes, adoptees are "involuntary migrants." Birthparents also experience loss. One example is the birthmother who believed that her child's life was enriched by adoption but later learned that her child had fallen ill at a young age and died in an institution. Adoptive parents likewise suffer loss - loss of pregnancy, birth information and additional information that would empower them to be better parents. When their child has special needs, they may also lose friends, family support and their own mental health as they attempt to meet the child's needs. All triad members experience loss - loss of privacy, control and self-esteem.

2. Rejection and 3. Shame and Guilt.

Adoptees often struggle with the underlying questions, "Why me?" "Was there no one in all of Russia to take me?" "Was there no one in my entire extended family to care for me?" "What did I do to bring this on?" "Could it happen again?" These feelings may be accentuated when friends ask, "Why didn't your family want you?" Adoptive parents may struggle with the "whys" of infertility; the concerns that they may not be "good enough" to be picked by a birthparent; and other issues of self-esteem that are heightened by the approval process. Birthparents may experience shaming statements from others. They may feel "less than" for the decision to place their children for adoption and fear rejection if contact is attempted with their children. They may believe that their children are "better off" with people who can offer them "proper" care. Issues of disparity in power and money and racial issues may cause birthparents to feel that they are in a "one down" position and should hide from the world. If adoption practice continues its quasi-professional, lay course, even more trauma may be inflicted on birthparents. Social workers may also feel guilty and ashamed because of doubts about what is best to do as they are forced to make life-effecting decisions in the face of huge pressures. Secrecy in adoption heightens the rejection, shame and guilt for all concerned.

4. Grief.

Grief must be addressed over time. Children grieve from the time of separation from their birth families, whether in infancy or at an older age. They move in and out of grief as their losses become more clear to them. This process can trigger grief for adoptive parents and birthparents, particularly in open adoptions as they observe the child's grief. They may acknowledge the rightness of the decision but nevertheless feel the grief associated with it. If birthparents are told that everything is "wonderful," their grief cannot be expressed and they may suffer mightily. There are four scenarios that involve grief work: children are in "good" adoptions [honest, open, a good fit] and the placement decision was a "good" one [informed, honest, done with the utmost care]; children are with adoptive families that are a "bad" fit but there are good reasons that they are not with their birth families; children are with adoptive families that are a "good" fit but there were "bad" reasons for separating them from their birth families; and - the worst scenario - children are with adoptive families that are a "bad" fit and there were "bad" reasons for separating them from their birth families.

5. Intimacy.

Intimacy involves a sense of deepest self, a closeness with others, sexuality, the sense of "person as person," and feelings of self-worth. All members of the triad are impacted in relation to intimacy, as are social workers who may become numbed and hardened by the tragedies they see.

6. Identity.

In adoption, everyone changes places in the family tree. Roles change and/or are compromised by lack of information and support. Without information, there is an impact on autonomy and a complete sense of self. For adoptees, there are issues of identity confusion and genealogical bewilderment, and questions of "borrowed" identities. For birthparents, there are issues of whether they could have been a good parent for the child. For adoptive parents, there are questions of being a "real" parent. For social workers, there are also identity issues, including the title of their positions and the respective status. The highest status is often accorded to adoptive parents' workers.

7. Mastery and Control.

Adoptees may struggle with these issues and in search, experience a sense of mastery and control. There is considerable variation among adoptees with regard to what they need in this area. When empowered and given options, all triad members can more easily and healthily move along. Supportive services are needed - telephone and e-mail counseling is not enough.

Open adoption addresses the core issues - through honesty, information and clarifying options - but it does not make these issues go away. Reproductive technologies are an updated version of adoption and involve the same issues. We can reorder our behavior and our orientation, but it requires listening to the voices of our consumers. Grappling with the ethical issues can help to mitigate the impact of the core issues and create healthier adoption practices.

II. Openness from a Legal Perspective
Respondent: Joan H. Hollinger, J.D., M.A., Princeton, N.J.

If the law -- legal principles and doctrinal rules -- can sometimes resolve what appear to be irreconcilable conflicts in interpersonal relationships, why are certain aspects of adoptive relationships so difficult for the law to address? One explanation for this difficulty is that the law is a reactive system that, in the context of adoption, adheres to understandings of adoption developed many decades ago. Thus, the principle of "asserted equivalence" - which is based on the mid-twentieth century views of social workers and others, and which states that adoptive families replace a child's birth family and become "in all respects" equivalent to the birth family - has enjoyed a much longer life in the law than in the lives of actual adoptive or birth families. While the asserted-equivalence principle is increasingly being undermined by contemporary accounts of family members, as well as by social workers, psychologists, and lawyers, the law is slower to respond. This is due not simply to the reactive nature of the legal system, but also to the constitutional and common law doctrines of family autonomy and privacy which present additional barriers to judicial and legislative acceptance of a more open and flexible understanding of adoption and the many different functions it serves.

Nonetheless, the law is beginning to accept and reflect the new wisdom that the asserted-equivalence principle is not entirely beneficial. Evidence that the legal walls between adoptive and birth families are crumbling is particularly noteworthy in the following two areas:

1. Greater Openness in Contemporary Adoption Practice.

Greater openness is a part of current adoption practice and there is no going back. For example, no state laws prohibit consensual contact or communication between members of adoptive and birth families. But, do we want a world in which such contacts are legally required or in which ongoing relationships between adoptees and others are subject to judicial supervision and enforcement? This is not a question about the value to the individuals of continuing contact through "open adoption" agreements, but of whether to rely on the same legal system that put us in the asserted-equivalence box we are now trying to redesign. Because there are coercive elements in all legal interventions, the law can make it both easier and more difficult for adoption practices to muddle along informally, testing out, and perhaps even rejecting, some versions of openness. These questions are especially complex when older children are adopted from foster care. The need of these children to maintain contact with their biological parents may be more profound than in adoptions of newborns, yet there may be an equally compelling need to support the adoptive parents of older dependent children. These adoptive parents may feel beleaguered if contact becomes legally mandated, and they may prefer a period of time to establish their new family's autonomy before they reach out to those whom the state has charged with mistreating their children. By contrast, in the context of private agency adoptions, the move toward greater openness seems to have been initiated less out of regard for the needs of children than as a way to ensure the agencies' survival as businesses competing for a dwindling supply of birth parents, many of whom are seeking more open placements.

2. Greater Access to Adoption Information and Records.

Everyone now subscribes to the view that information about a child's medical and social history should be made available to adoptive parents prior to placement, and most states now require that prospective parents be given "all reasonably available information" about a child and the child's birth family. Yet, there are some ominous signs about potentially unethical practices in this area, especially in intercountry adoptions where adoption agencies may be subordinating the needs of children and adoptive families to the agencies' own economic needs. By insisting that prospective adoptive parents sign disclaimers of the agency's liability for disclosing information about children from other countries, many agencies attempt to shift the risks of children's conditions to the adoptive parents who are not in a position to conduct background investigations on their own. These agencies take advantage of legal principles to insulate themselves against any responsibility for placements that may later disrupt because the adoptive parents were not prepared to deal with children's unanticipated or unknown health or developmental problems.

Other ethical concerns arise from the political compromises that many agencies believe they have to make in order to achieve certain legal reforms. For example, the Hague Convention on Intercountry Adoption recognizes the identity and information needs of children adopted by families in other countries. However, in their eagerness to secure legislation to implement the Hague Convention in the United States, some agencies are willing to go along with provisions restricting access to identifying and non-identifying information based on the laws of our individual states. Is agency acceptance of these restrictions a "necessary" compromise in order to ensure the implementation of the much needed guidelines of the Hague Convention, or is it an unethical decision that undercuts the interests of adopted children and their families in order to ensure more business opportunities for adoption service providers? No legislation can be enacted without some compromises -- but the challenge for those concerned about the ethical aspects of adoption practice is to distinguish those compromises that are consistent with maximizing the benefits of adoption for children and their parents from those that serve only the self-interest of adoption agencies and facilitators.

Finally, some questions regarding the common adoptee refrain, "We didn't choose to be adopted, and so, at least when we grow up, the law should honor our choices." Did any of us "choose" to be part of the families in which we find ourselves? Did any of us have a choice concerning the health conditions that may run in our families? Children are, by definition, dependent and vulnerable, and do not choose their caregivers at birth or thereafter. Adoptees, unlike those who remain in their birth families, have the advantages as well as the losses that result from their migration from one family to another. As we ponder the ethical aspects of adoption, it is useful to acknowledge that the differences that follow from being adopted can enhance and enrich the lives of all of us who are touched by this complex legal and psychosocial process.

III. The Ethics of Counseling Triad Members
Respondent: Betty Jean Lifton, Ph.D., New York, NY

A key ethical challenge is the lack of unbiased, ethical counseling for members of the triad. Clinical practice now spans two worlds: individuals whose adoptions took place in the past when secrecy and confidentiality were built into the closed adoption system; and individuals whose adoptions are taking place today and for whom there are questions regarding how to respond to children's needs for information. Most therapists are not familiar with the psychology of adoption.

What is ethical counseling? There are aspects of past practice that are not ethical: advising birthmothers to place their children for adoption and telling them to go on with their lives; advising adoptive parents that the child would unequivocally bond with them; and telling adoptees that the desire to search was pathological. Past unethical agency practices include separating twins at birth and failing to inform adoptive parents about their child's true background. These practices, no longer the norm, have been replaced by other questionable practices: (1) Closed adoptions are still occurring despite an understanding of the cumulative adoption trauma that results from such decisions; (2) Lawyers are taking over the white baby business - where the money is - and will remain there as long as it is lucrative. When the money is no longer there, they will disappear, taking adoption records with them; (3) Lawyers advise adoptive parents to do what they have to do initially but then disappear when birthparents are "trouble;" (4) The Uniform Adoption Act mandates the sealing of adoption records for 99 years. Laws are always ten years behind social change and "cannot regulate the human heart."

The ethical counselor has a number of characteristics. He or she:

- is aware of the psychology of everyone in the triad.

- is an educator on adoption issues.

- informs birthparents of all options, explores with them how they might keep their child, and when they cannot, helps them understand what pain lies ahead in the decision.

- educates adoptive parents as to the effect of adoption on a child, including how adoption involves more than "getting" a child, and that the child will experience loss and grief.

- understands the issues of openness and that "semi-open" is the same as "semi-closed" as the child is not connected with the birth family.

- knows that the rights and needs of the child come first, before the rights and needs of other triad members or the system itself.

There should be a Declaration of the Rights of the Adopted Child, building on the list of rights and responsibilities contained in Betty Jean Lifton's book, Lost and Found: The Adoption Experience. These rights should be specified for children adopted as infants, children adopted internationally, and children with special needs adopted from foster care.

Working Sessions (Morning)

The following information represents the points made by the facilitators of the working sessions as well as conference participants who chose to express their views. The points noted are not necessarily the views of the facilitators nor The Evan B. Donaldson Adoption Institute. We have chosen to depict these viewpoints in a non-identifying manner in order to represent the rich dialogues which resulted from these "working" sessions.

#1) Does Adoption Respect the Interests of Birthparents and Birth Family Members?
Facilitators: Marcy Wineman Axness, Ph.D. candidate, Calabasas, CA and Barbara Shaw, M.A., Los Angeles Concerned United Birth Parents, Studio City, CA

The term parent is defined as one who gives birth to a child. The media often uses the term birth parent, with the word birth functioning as an adjective, to encompass all individuals who have given birth. In adoption, however, the noun "birthparent" was coined to refer to a parent who relinquishes a child for adoption. It is important to clarify that an individual becomes a birthparent at the time of relinquishment and is considered a parent until that moment; nevertheless, a pregnant woman in the circumstance of considering adoption is heretofore in this report often referred to as a birthmother.

When a match has been made, at what point do we start thinking of the child as the child of the prospective adoptive parents? How do the values/ethics of the prospective adoptive parents affect their approach to the adoption process and their treatment of and feelings toward the mother (prospective birthmother) of the baby on whom they have focused their hopes and attention?

At the same time, it is important to consider the experience of humans in the womb. While it was previously believed that conditions such as high blood pressure, heart disease and diabetes were the results of environmental influences, it is now believed that humans are programmed for these conditions while in the womb. Ongoing psychosocial stress on the mother during pregnancy can produce negative outcomes for babies. These include low birth weight and ill temperament - the latter of which may be, in part, due to the fact that maternal stress can lead to abnormal brain development in such areas as opiate receptors (which allow us to feel relaxed and content).

What are the effects on both the baby and mother if the mother is encouraged to emotionally relinquish the baby early on in pregnancy? What kind of stress is produced? Pre- and peri-natal psychology literature suggest that there are ongoing, life-long effects of this kind of stress, for both the baby and the mother. These emerging findings, along with cutting-edge research into prenatal programming of physiological conditions, support our strong belief that during the pregnancy and immediately after birth, we "cannot separate the interests of the baby and the mother."

In the womb, life-long templates are formed for our experiences with others and the world. Ultimately, lessons and conditions in the womb create our worlds. "As you are born, that is how you continue through the world." A Framework for Looking at the Beginning of Life In the womb: The child is affected by the psychological mood of the mother and those close to her. The mother's reaction to her pregnancy affects the child's future self-esteem. The cells carry memories of the circumstances of conception, forming the basis of self and future experiences. The child's heart is forming at about the same time the mother is discovering her pregnancy: one pre- and perinatal expert suggests that an epidemiological study would likely reveal that adoptees (and others who were "mistakes") would display higher than average levels of heart conditions. First lessons are learned and first impressions are formed: 1) I am in a safe and secure environment in which I will receive what I need. 2) I am significant and I inspire people to care for and celebrate me. 3) I deserve to be alive and be me. (It is also possible to learn the opposite.)

During the birth process, as an adoptee, Marcy Axness learned:

- she needed to separate in order to survive.

- that people are interchangeable, and leave easily.

- that she failed at her first job in life which was to get her father to marry her mother: "I couldn't just be, I had to be accomplishing something."

- "I was wrong. Maybe I didn't deserve to exist. No one saw me for who I was."

In an ethical framework, what would be the implications on a practice level if women were aware of the effects of the pre-natal environment on their babies and were counseled to bond with them during pregnancy?

Because of the stereotyping and societally-induced shame, birthmothers often live a disembodied pregnancy in an attempt to make things "right." American society has trouble inspiring and supporting the possible birthmother in her role as mother because there is a fear that it will be perceived as condoning her "mistake." The birthmother, however, must resolve the feelings of shame and focus on the needs of the child. Many birthmothers, upon learning of the importance of their relationship with their children throughout pregnancy, have said that they wished that they had been educated about this during their pregnancies.

The birthmother must have a real sense that she has actually given birth to the baby and has made the choice as the child's mother to find another family to raise him/her. She has not made a real decision to relinquish until she has been the child's mother and nurtured him/her. This knowledge not only gives the birthmother a sense of closure, but also helps adoptive families feel more entitled to parent, knowing that the birthmother was not coerced to relinquish but made a conscious and informed decision to do so.

It is common in today's practice to encourage prospective adoptive parents to be present in the delivery room and immediately become parents upon the birth of the child, including cutting the umbilical cord, picking the child up and removing the child from the birthmother's presence. Many birthmothers, who at the time of their children's births felt that they wanted the prospective adoptive parents in the delivery room, have come to realize years later that the prospective adopters' presence felt coercive and put pressure on them to "fulfill the obligation" of relinquishing their children. While this may not be the experience of all birthmothers who allow the prospective adopters to be present, the fact that many women have felt this pressure, makes it crucial to provide counseling and services throughout pregnancy so that birthmothers are informed of their rights; are assisted in assessing how the presence of the prospective adopters in the delivery room might affect them; and are aware that they are under no obligation to relinquish their children. It is equally important in this circumstance that prospective adoptive parents receive quality counseling to help them negotiate the challenge of preparing and hoping for the opportunity to parent a particular baby, while truly understanding and embracing the reality that it is not their baby until after the birth and after a considered decision on the part of the mother.

Prospective birthmothers have a right to mother their children and to take the time after birth to decide whether or not they wish to relinquish. Their babies (who are not yet adoptees and whose rights are inextricably linked to those of their mothers) have the right to remain in contact with their mothers for as long as possible after birth. This contact allows the physiological stress of the birth process to subside before the added trauma of separation is introduced and may give infants the opportunity to breastfeed, which would enable them to obtain the protective immune properties of colostrum (which is present in the day or two before breastmilk is produced).

Case Scenario #1

Jane, a single 20 year old who is five months pregnant, just lost her job. Her relationship with her boyfriend ended badly a few months ago and he is not involved in helping her decide what to do about the pregnancy. She sees a notice in the paper offering "help" to pregnant women in crisis. A private adoption attorney, whose notice Jane has answered, counsels her to place her baby for adoption. She is comforted by his reassurances that adoption could be "open" and that she will receive regular reports and photos of her baby. She relies on the lawyer to advise her of her rights in the adoption process. When her daughter is born, Jane has a change of heart immediately and tells the lawyer that she does not want to place her baby for adoption and wants to raise her child herself. The lawyer tells her that she signed a binding agreement and if she changes her mind, she must repay the adoptive family for the costs of her care that they covered during her pregnancy. She does not have the money to repay the adoptive parents and feels she has no choice but to go forward with the adoption, with the understanding that she will receive information about her child on a regular basis. After months of unanswered calls to the lawyer's office, however, she is told that the adoptive family has moved and their whereabouts are unknown.

- What issues does this case raise regarding the interests of birthparents?

- Who holds power in the decision making process regarding adoption? Who should hold power?

- Should there be "consumer protections" for birthparents? If so, what should they be?

Case Discussion

What right of birth families is never talked about by agencies on the Internet? According to Bill Betzen's website [www.openadoption.org], if a prospective birthparent has medical expenses paid through an agency/facilitator and ultimately decides not to relinquish, they have not lost the right to parent their child nor are they required to pay back expenses covered.

Concrete legal guidelines are needed for attorneys and facilitators regarding their roles in adoption practices so that there will be consequences for such unethical practices as:

- Facilitators putting great pressure on prospective birthparents to relinquish.

- Charging prospective adoptive parents large amounts of money in fees. Encouraging birthmothers to deliver outside of their home states, because they are statistically less likely to change their minds about relinquishing.

Guidelines are also needed because anyone who decides to be an adoption facilitator can currently do so without proof of knowledge, experience or certification of any kind.

One suggestion is to do what the Child Welfare League suggests and make independent adoptions illegal. However, not all agencies are ethical. Some engage in unethical practices with the idea that their agency status almost makes them exempt from criticism.

An ideal model for practice is the program at Catholic Charities in Traverse City in which the goal is for prospective adoptive parents to reach the delivery room feeling that the mother is to be respected and supported no matter what her decision; that there will be a baby for them; and that doing anything to compromise their own values or ethics would be something that could not be "rewoven."

Case Scenario #2

Christine placed her newborn for adoption one year ago. She is attending a meeting of prospective adoptive parents sponsored by the agency that handled the adoptive placement of her child. She tells the group that she is happy that she was able to give her daughter a mother and a father who can give her daughter all that she needs. She feels that she and her daughter's father were tooyoung to be parents. Christine also shares that neither she nor her daughter's father told their families about the pregnancy or the plan to place their child for adoption. The agency social worker encouraged them not to tell their families, emphasizing that because Christine was 18 and her partner was 19, the decision was theirs. Christine chose the adoptive family for her child, and she became very close to the adoptive mother who provided her with attention, care and mothering throughout her pregnancy. The social worker and adoptive mother encouraged her to think of herself as "growing a baby for this wonderful couple." The couple was in the delivery room for the birth of "their" baby. Although there is some contact with the adoptive family now, it is very limited and Christine feels that she has in many ways lost both her daughter and her best friend because the adoptive mother is no longer close to her. Christine also shares that her parents are very angry about her decision, feeling that they have lost their first and only grandchild without being given any opportunity to talk with her about her decision. Christine tells the group that she is proud of herself for having the maturity to make the decision, no matter how painful.

- What are the issue raised in this case about the interests of birthparents? Members of birth families?

- How does adoption practice in this case support or work against those interests?

- What issues are raised about the relationship between birthparents and prospective adoptive parents during the birthmother's pregnancy? What should that relationship be?

- Are there issues that should be addressed with birthparents before they enter into relationships with prospective adoptive parents?

- What is the relationship between issues affecting the interests of birthparents and birth family members and issues affecting the interests of adoptees?

- To what extent are the interests of birthfathers recognized and addressed?

Case Discussion

What is the ethical response when a birthparent does not wish the birth grandparents to be involved? Would it be appropriate to attempt to find out why the birthparents do not want their kin involved? Knowing that kin would like to raise the child, would it be appropriate to go against the birthparents' wishes and contact them? Are children being placed for adoption outside of their birth families when there are kin who are willing to care for them?

Birthmothers are called on to talk at schools and organizations, but they are often young birthmothers who are still in the "honeymoon period" of recent relinquishment. Thus, only one (possibly biased) perspective is offered. Is there an ethical dilemma in bringing a birthmother in to talk about how wonderful adoption is? What are the ethical dilemmas involved in not allowing birth family members (birthfathers included) to offer support to children?

Directions for the Future

Counseling of Prospective Birthmothers :

- The birthmother needs to know that she can love her child and that the child needs her love while in the womb. Adoption agencies should provide this kind of message.

- Important issues should be identified and incorporated into standards for counseling throughout pregnancy.

- Service providers should become more pro-active to reach expectant mothers, including by making themselves more accessible to schools and other groups.

- Social workers need to be retrained to deal with different family dynamics. They need to "step out of the box" and define what they feel is right with respect to everyone's rights.

- Because adoption is a legal practice, pregnant women have options and should be counseled in a family/children's agency and should only be referred to an adoption agency when a decision to relinquish has been made.

- A holistic approach to adoption is needed. Advocating for the birthmother every step of the way (including post-adoption services) should be standard practice.

- Counseling needs to include what we understand to be the developmental issues that occur in adoptees' lifetimes and the benefits under healthy circumstances of maintaining birth family connections.

Delivery Room Practices:

The presence of prospective adoptive parents in the delivery room should not be encouraged.
The AMA, nurses associations, obstetricians and hospital social workers should be included in discussions regarding this practice to be made aware of changing beliefs.

Ethical Practices of Facilitators/Hospitals:

There need to be consequences for unethical practices which will cause adoption lawyers and facilitators to consider such questions as, "If I do this, will I lose my license?" In the case of attorneys, the threat of being disbarred is incentive for more ethical practices. Sanctions need to be established regarding unethical practices in hospitals by doctors and nurses during the birth process. For example, sometimes nurses move birthmothers after birth to other parts of the hospital so that they will not be in close proximity to their children.

Other Recommendations:

- Provide every possible birthmother with an attorney.

- Call all agencies family service agencies instead of adoption agencies.

- Foster babies and mothers together.

- Encourage service providers to realize that each birth, pregnancy and situation is unique and respect all parties involved.

- Require training and certification of adoption professionals. Adoption is a clinical specialty, different from anything else in social welfare. Those who will be working in the field require special training which includes learning how to look for issues that clients raise in non-verbal ways. There should be a special certification for adoption service providers. There are cultural and experiential factors affecting new workers. Their key role is to educate, inform and mentor all members of the triad.

#2) Do Adoptees Have Rights?
Facilitator: Dee Dee MascareŇas, M.F.T., Encino, CA

Case Scenario #1

Ryan, a 15 year old Caucasian youngster who was adopted as an infant, is suffering from a number of psychological problems - he is having great difficulty controlling his anger, he is distrustful of others, and he continually puts himself down as "no good." After several family crises and ten years of professional counseling without success in resolving the issues, Ryan and his parents - who are also Caucasian - have begun to realize that these problems may be linked to his adoption. With Ryan's agreement, Ryan's adoptive parents have petitioned the court on his behalf to release the identity of and information about Ryan's birthparents. They are convinced, as is Ryan's therapist, that having this information will help Ryan gain a better sense of himself and help him deal with and resolve his problems. The court, however, has ruled that psychological problems of this nature do not constitute "good cause" to open sealed adoption records. The court refuses to release this information.

Should Ryan have any "right" to the information that he and his family seek?

Who should make the decision whether Ryan gets the information he wants? On what basis should the decision be made?

What values support and work against release of information under these circumstances

Case Discussion

Psychological need is not the issue in this case. The "just cause" statute should not be involved in this decision because Ryan's access to information about his birth family is an entitlement and a fundamental right. The only legal process that should be involved in this situation is the opening of the records because psychological needs have nothing to do with rights.

Because "good cause" is not defined in the statutes, judicial decisions are arbitrary. Certain judges will freely open records, while others never feel that "good cause" is met. Additionally, many judges are not equipped to make such decisions regarding children's lives as they are not educated about adoption issues.

Not only is birth information a right of the adoptee, but this information should be given to adoptive parents at the time of placement. Not doing so dishonors adoptive parents and implies that they cannot be trusted to make decisions about their own children's lives. It's not about records, but about the adopted person's civil right to have information about him/herself.

There are really two issues in this case - the right of the birthparent to maintain confidentiality and the right of the adoptee to have access to medical records. A possible solution is to give adoptees non-identifying information so that the wishes of the birthparent are respected and the adoptee has important medical information. Another approach to obtaining non-identifying information might be for a judge to contact the birth family and ask them if they would provide updated information for the records. The use of court intermediaries and social workers might ensure that everyone's rights are respected.

What is the ethically responsible way to handle cases in which birthparents were promised anonymity in the past? Many studies today show that a large majority of birthparents who relinquished in secrecy would want to have contact in some form with their children if given the opportunity. If this research is indeed representative of the feelings of most birthparents, perhaps the upholding of confidentiality contracts does not present an ethical dilemma.

Adoption is statutory, not contractual, and statutes can be changed. If practice changes - for example, if the accepted practice becomes open adoption - the field of adoption must work toward changing statutes to reflect and support those changes.

Autonomy includes the adoptee's right to be left alone.

Case Scenario #2

Sarah, a 23 year old adoptee of African American heritage who was adopted at the age of three from foster care, wants to know more about her background. She has no memory of her life before being adopted and her adoptive parents [who are Caucasian] were only told when they adopted her that she had been "neglected" by her birthmother and that her foster parents had not wanted to adopt her. Sarah returns to the public child welfare agency and asks for information about her birth family - she is not asking for identifying information but for information that would help her understand her background and her birth family history. She is also interested in learning more about the foster parents who cared for before she was adopted. She is first told that the records "can't be found." After several months of repeated requests, she is told that the records have been found. The agency, however, tells her that there is only limited information available. In reality, the agency is aware that Sarah was not "neglected" but seriously physically abused as a toddler - information that was not shared with her adoptive parents and information which the agency decides would be too "traumatic" for Sarah to hear. With regard to her request for information about the foster parents, she is told that such information is strictly confidential.

Should Sarah have the "right" to the information she seeks? Does she have a "right" to certain information but not other information?
Who should decide what background information is or is not shared with Sarah? On what basis should such a decision be made?

Case Discussion

It is probable that the agency does not want to release this information out of fear of a wrongful adoption suit being brought against them. There are many issues surrounding why children remain in foster care and how much information is given to adoptive parents at the time of the child's placement. Often this is tied to belief systems in place at the time. For example, thirty years ago accepted practice demanded that a child not be placed with a family of a different religion. Twenty three years ago, the family in this case might not have been willing to adopt an abused child. Professionals must look at practices in the past and not accuse anyone of working unethically because practitioners were probably doing what they believed to be the best thing at the time according to the standards of that time. Today, professionals must acknowledge the past, acknowledge the fact that what was viewed as good practice is no longer the case, and work toward upholding current ethical standards.

Sarah has the right to receive information about her past. Not knowing the truth has the potential to be more traumatic for her because she may imagine the truth to be much worse than it actually is. With counseling, the truth can be dealt with and be put into perspective whereas secrecy carries with it unresolved questions.

If social workers were promising anonymity to birthparents, they had no legal right to do so. The statutes have always stated that records could be opened with "just cause," not just cause with the permission of the birthparent. Originally, the records were sealed with the intention of protecting the adoptive family from the birthparent and the Uniform Adoption Act of 1953 - on which many states' laws are based - talked about protecting the child from unnecessary separation from his/her parents, not about protecting the birthparents' privacy. However, documents such as the "waiver of confidentiality" (now called a consent to contact) which required the signature of the adoptive parents and birthparents imply through their existence that there was an understanding of confidentiality.

The current trend in courts is to turn the question of sealed records over to the voters or legislators. The courts, by doing so, are saying that they see this as a political issue and not a constitutional issue. The focus must be taken off the emotional element of this issue and the field must approach it by acting politically. More research would provide solid evidence to legislators.

A "recall" on the promise of confidentiality needs to be made. It needs to be explained that there is now an understanding that confidentiality is detrimental and birthparents must be given advanced warning that records will be opened so that they can seek help if they need it.

Perhaps it would be effective to institute changes gradually. That is, change statutes to mandate open records in all adoptions which are completed from this point forward and then go back and figure out how to deal with the cases in which there was an understanding or actual contract promising anonymity.

#3) Who is a "Good" Adoptive Parent?
Facilitator: Rena Phillips, Msc, CQSW, Department of Applied Social Science, University of Stirling, Scotland

What are the criteria for selection and exclusion of prospective adopters? Does a legitimate basis for assessment exist? How can professionals share their power with prospective adopters?

Dr. Joyce Maguire Pavao mentioned in another session of this conference that homestudies are currently being conducted in the U.S. using the "white-glove test" model from the 1930s and 1940s, and she suggested that 95% of prospective adopters' applications should be approved. If the criteria for approving applications were based on matching children with families who are equipped to meet their particular needs instead of on general assessments, most applicants would be approved. More time should be spent educating and preparing prospective adoptive parents instead of assessing them, particularly because the assessment process causes applicants to become nervous which in turn, prevents them from learning.

In Britain, assessments are looked at by a legally required panel made up of social workers, adoptive families and psychologists. The panel reads social workers' homestudies of the prospective adoptive parents and recommends whether or not they will be approved to adopt. In the U.S., the parties responsible for making an assessment vary from agency to agency, with applicants being reviewed by an individual such as a supervisor, by several individuals, or by a committee.

The case studies deal with issues of inclusion and exclusion: Who do we include? Who do we exclude? What is it that would exclude someone from being considered or approved to adopt? The rejection of prospective adopters may affect them throughout their lifetime.

In Britain, there has been a great deal of media attention focused on how social workers exclude prospective adopters. In a study of 160 adoption agencies in Britain, it was found that the reasons for rejection varied at different stages. Applicants were recorded as being rejected or having their assessments deferred based on concerns over an applicant's education, criminal record, disability, race, history of child abuse or mental illness. Other applicants were denied based on concerns that they were "too fat;" their own child had died; they did not want to have biological children; and the brevity of their marriage. Do we develop a baseline of criteria or do we incorporate our own values? And, do we or can we share this with prospective adopters? Do we tell them what would exclude them from adopting or do we judge each applicant on a case by case basis?

Case Scenario

Rachel has been caring for her three year old niece, Laura, since Laura's parents - Rachel's sister and her brother in law -- died in a tragic car accident four months ago. Rachel is Laura's godmother and her only aunt and has had a close relationship with her. Rachel wishes to adopt Laura and is moving ahead with the necessary legal papers. Laura's paternal grandparents, who have always disapproved of Rachel because she is a lesbian, however, plan to contest the adoption because they believe that Rachel's lifestyle is detrimental to Laura. They want to adopt Laura. They believe that they can provide Laura with an opportunity to grow up in a normal two parent home with "family values." The court has to decide who should be Laura's adoptive parent(s).

- Who is the "better" adoptive parent for Laura? On what basis should this decision be made? Who should decide?

- To what extent is a "good" adoptive parent defined by sexual orientation? Single or two parent status? Age? Degree of relationship?

Case Discussion

Two states in the U.S. currently consider it illegal for gays and lesbians to adopt. The decision-making process regarding whether gay or lesbian prospective adopters are approved, however, is determined by state and county-based systems. In this working session, there was no consensus as to whether this results in a significant number of gay and lesbian applications being denied. In virtually all states of the U.S. and in Britain, gay couples are not allowed to adopt a child jointly - that is, only one person can adopt the child and be considered that child's legal parent in the eyes of the law.

Gay parents and single parents often end up being approved to parent children with the greatest needs. They are getting "damaged goods" because they are considered "damaged goods." Ironically, society is more accepting of a dysfunctional heterosexual couple with poor parenting skills and more willing to award them a "non-damaged" child than a gay individual or gay couple with good parenting abilities. While some people believe that it is unfair to burden children who are already carrying a lot of "emotional baggage" with the additional burden of explaining what gay families are like, others believe that the discrimination and pressures that gay and lesbians face may actually equip them with skills that enable them to be more flexible, creative and sensitive parents. It should be a question of the qualities of prospective adoptive parents, their parenting skills, and in cases where the prospective adopters already have a relationship with a child, the quality of that relationship. In Britain, where there are very few infants available for adoption, prospective adoptive parents must be under 35 or 36 to adopt an infant. To adopt children with special needs (children who are not infants; children with disabilities, learning difficulties, behavioral problems and/or emotional problems; sibling groups; ethnic minorities; and those who have been abused), however, there are no age restrictions. In the U.S. and Canada, there are federal laws which prohibit age discrimination.

In supporting an age limit to adopt (particularly infants), service providers may want to ask the questions, "Are you going to be able to support this child when he/she goes to college or when he/she is trying to establish him/herself in the world? What will happen to the child if you cannot support him/her or you are no longer alive?" On the other hand, if these questions are addressed, shouldn't we also ask such questions as "Do you wear your seatbelt?" and "What is your cholesterol level?" Self assessment, and not age, should be the method in which prospective adopters are judged.

Models of Adoptive Parent Assessment

The old model or accepted mode of assessment in Britain had the following elements:

1) Group preparation: educating families about child development, reasons why children are in the system, attachment and other related issues.

2) Homestudy: 6-8 visits, speaking with members of the families as a group and individually.

Families spoke about what it was like to be assessed under this model:

- It was a passive experience.

- It was threatening and produced a sense of having no control.

- Questions were impertinent, delving into extended family history and personal matters unrelated to the ability to parent: "Have any of your relatives ever been arrested?" "Do you have a healthy sex life?"

- The goal becomes getting the social worker to like you by being a good listener and empathizing with the difficulties he/she encounters in his/her work.

The model that is currently being utilized in the central region of Scotland focuses on empowering prospective adopters through self-assessment. A pilot study was conducted in which adoption workers used this new model. The model has the following elements:

Goals:

Interactive Learning
- sharing life experiences, knowledge and skills. The families, engaged in a group process facilitated by social workers, share their experiences and learn from each other - a method which could be particularly effective considering that in a study conducted in Britain a predominant number of prospective adopters had previous parenting experience - 46% of one or both adopters already had children and 34% had experience as foster parents.

Empowerment
- Dictionary definitions of empowerment include: to enable, to strengthen, to facilitate, to be un-obstructing, to be un-restraining, to provide support and resources. Empowerment in self-assessment is not about leaving prospective adopters on their own without guidance. This would essentially be setting them up to fail. Social workers, in a sense, give up some of their professional power, and use their experience to guide and support prospective adopters in assessing themselves.

Key elements:
- Participants write their own assessments, take part in group work and complete homework.

- Each participant is assigned a social worker (one of the two working with the group) to facilitate the writing of the assessment and provide feedback.

- Social workers conduct group sessions and private sessions in order to provide venues in which everyone feels comfortable discussing personal issues.

- Matching issues are examined from the outset of the process.

- Participants present their own assessments to the adoption panel.

- Preparation and assessment are linked in that prospective adopters integrate their responses to issues raised during group work into their own assessments.

- The social worker contributes 2-3 paragraphs to the assessment.

- The panel receives a transcript of all group sessions, the life story of prospective parents, and their self-assessments.

Adoption panels report that this method makes for livelier panels, sharpens the panel's practice, challenges the panel's role, shifts the power from social workers to prospective adopters (which they view as positive), helps the panels to grow, and gives the panel the opportunity to ask prospective adopters about questionable information. Direct contact with prospective adopters and their responses to panel concerns may actually cause panel members to change their opinions regarding applicants' suitability.

Concerns:

Some social workers fear that pedophiles will be approved to adopt under a self-assessment model.
Panel members are not sure whether working under the premise that applicants are truthfully assessing themselves might limit the panel to asking only general questions, precluding them from addressing sensitive issues and points of concern.

Results:

The model is largely successful.

Social workers still make the final decision but prospective adopters also have power.

Prospective adopters are surprisingly more particular about matching issues than expected. Part of the empowerment process seems to include adoptive parents expressing preferences regarding the type of children that they are willing or not willing to adopt.

Prospective adopters are able to tell their own story and express their anger.

Prospective adopters' motivation to adopt is tested.
The abilities of prospective adopters to see tasks to completion are tested.

Prospective adopters are given a sense of the strength and control they will need in order to meet future inevitable challenges, such as locating and receiving post-adoption services.

Conclusions:

Homestudies still have a valid place in the assessment.

Self-assessment is a method in which adopters can have a voice in the process.

Self-assessment enables applicants to correct any misinformation that may be inadvertently presented by social workers and to add another perspective to a report that is usually filtered through one person's (i.e. the assessing social worker's) experience and value system.

Being present at panel meetings enables applicants to be viewed by panel members as real people and not just names on paper.

Assessment and education should be integrated so that applicants can apply what is learned.

#4) For Lawyers and Facilitators: Does the Concept of "Client" Apply?
Facilitator: Monica Farris Linkner, J.D., Adoption Law Center, Berkley, MI

Definition of Facilitator :

In some states, it is a statutory term that can apply to those who professionally facilitate adoption such as attorneys and agencies.

In other states, it refers to an individual who has a business in which he/she finds prospective birthparents through advertising and then provides their names to prospective adoptive parents for a large fee.

There are some concerns as to what the second type of facilitators are doing. Do they have ethics? If so, where do their ethics lie? In California, there is a statute regarding facilitators, but only to the extent that it requires a facilitator to stipulate in all marketing and materials that he/she is not an attorney nor a part of an agency. The statute does not regulate facilitators' activities in any way.

In adoption, there are different ethical systems at work - for example, legal ethics and social work ethics. How do these systems impact the delivery of adoption services?

In Madelyn Freundlich's article on ethics and adoption which appeared in Adoptive Families, she talks about the framework underlying the principles of the best interests of the child in terms of key values at two levels.

1) Individual level

- How we view the needs, interests, rights and obligations of all members of the triad.

Respect

- recognizing the dignity and worth of each individual

Beneficence

- promotion of good to the individual who is served in the adoption

Autonomy

- individual ability to determine his/her life course to make decisions

Knowledge

- in order to make informed decisions and act autonomously

2) Systems level

- Inform the way in which we design and provide adoption services.

Fairness, Equity, Accountability

How do we run our practices when we run into conflicts between these values? How do we resolve these conflicts in a way that is consistent with both our professional obligations and our personal beliefs?

Case Scenario #1

Sam and Sue Jones had been working with attorney Jane Barrister in the hopes of expanding their family through adoption when a relative told Sue about Peggy -- a woman with an unplanned pregnancy who was considering placing her baby for adoption. Sue spoke with Peggy and asked her to contact attorney Barrister.

Barrister met with Peggy, spent 45 minutes obtaining medical and social history information, and in the process learned that Peggy had used cocaine fairly regularly up until the time that she learned she was pregnant. Because Peggy was embarrassed about her drug use, Barrister agreed not to share this information with Sam and Sue Jones. Barrister and Peggy also discussed Peggy's need for financial assistance in light of having left her job as a waitress in her fourth month. At the end of their meeting, Barrister referred Peggy to a colleague so that she would have her own her own legal representation. Barrister then told the Jones' that they would need to plan on paying $850/month for Peggy's living expenses.

As the pregnancy progressed and attorney Barrister sent itemized monthly statements to the Jones', they saw that a significant portion of each month's services was for telephone calls between Barrister and Peggy. They asked Barrister what, if anything, Peggy's lawyer was doing for her and Ms. Barrister replied that the other lawyer would be going to court with Peggy for her consent hearing, but that because he had not been returning Peggy's phone calls, Barrister was "holding Peggy's hand." The Jones' also expressed their concern that they still had not received a copy of Peggy's medical records, although Barrister had told them that Peggy had signed the authorization some weeks back. Barrister said that she hadn't had a chance to request the records yet, but that Peggy had told her that everything was fine with the pregnancy.

Who is Barrister's client in this scenario?

What is Barrister's obligation, if any, in regard to disclosing Peggy's cocaine use to the Jones'? Does she have any other obligations as a result of learning this information?

Did Barrister handle the issue of the birth mother's living expenses in an ethical manner?

Was Barrister doing anything wrong or unethical in providing "hand-holding" for Peggy?

Does the delay in obtaining Peggy's medical records raise any ethical questions?

Are the answers to the above questions different depending on whether the parties live in a "separate representation" or "dual representation" state?

If Peggy later claimed the court should set aside her consent to the adoption because she hadn't had independent representation and didn't understand her rights, what do you think the court would do? Should do?

Case Discussion

It is not clear who the attorney is representing. This appears to be a case of dual lawyering (which occurs often in adoption). Even when who the client is can be legally defined, cases such as this one may serve to blur the lines in people's minds, causing them to feel less confident about what is happening and whose interests are being taken care of.

Who is paying the bill and does that influence representation? Is there a rule of thumb that states that the person paying the bill is the client? It is possible for one person to pay for the representation of another. The starting point for attorneys should be to determine who the client is and this should govern and inform conduct from that point forward.

Can attorneys represent one person while being paid by another without it interfering with the attorney-client relationship? Cases involving birthparents are amorphous and ambiguous because, oftentimes, the birthparent does not know what her rights are beyond the basic right to legal representation. While the attorney-client relationship, in itself, involves an inequity due to differences in knowledge of the law, cases in which the client is a birthparent - who usually has significantly less money and education than the attorney - involve an even greater imbalance of power. When this birthparent is represented by an attorney who is paid by the prospective adoptive parents (who usually have more money, education and power than the birthparent as well), the situation is exploitive and unethical.

It is true that any time a lay person seeks the counsel of an attorney, there is an inequity due to differences in knowledge. It is this difference that causes people to seek a lawyer's guidance, just as doctors are consulted in medical matters. It is the responsibility of the professional - in this case the attorney - to offer their expertise. This type of inequity is not offensive.

But in the case scenario, in deciding to withhold the drug information from the adoptive parents, is Barrister not making a decision which requires the expertise of someone other than a lawyer? Is it appropriate for a lawyer to do the hand-holding of the birthmother or should someone else be doing it?

Are lawyers supposed to do the hand holding with their own clients? Attorney licenses and certificates state that they are both attorneys and counselors. There are times when lawyers have an obligation to do more than offer legal counseling. This is especially true in adoption because it is a social welfare issue. If an attorney makes the decision to offer only legal advice, it is critical that he/she make sure that the client receives the needed services. How do attorneys know when they are about to cross the line into someone else's area of expertise? How do they know when to politely decline to "hold the client's hand" and refer them to other professionals?

According to Michigan's rules of conduct for attorneys (presumably more or less the same as rules of other states), rule 2.1 states: In representing a client, a lawyer shall exercise independent professional judgment and shall render candid advice. In rendering advice, a lawyer may refer not only to law, but to other considerations such as moral, economic, social and political factors that may be relevant to the client's situation.

With regard to the case scenario:

Who should the medical information be disclosed to? Who is the attorney-client relationship with? To what extent should an attorney become involved in making medical decisions for other people by disclosing or not disclosing? In that context, does the adoption attorney's role involve raising issues in cases where a pregnant woman - who is planning on relinquishing her child to that attorney's client - is not receiving appropriate pre-natal care?

Is it unethical for Barrister to delay obtaining Peggy's medical records? California and almost all states now have official requirements of disclosing medical and background information to prospective adopters before placement. This also applies to interstate adoptions. Although the pregnant woman must sign a release in order for her medical history to be shared with the prospective adopters, this does not always guarantee full disclosure in the sense that she may be estranged from her family and have little or no knowledge of her family history.

The use of the term "birthmother" itself defines the situation in that it assumes that the mother is going to relinquish her child. During gestation, she is the "pregnant woman" and after the birth, she is the "mother" of the child until she surrenders her right to parent. The adoptive parents are not the "parents" but "prospective adoptive parents" until the mother decides to relinquish her child. This is an important distinction to make, especially in the case of failed adoptions, where the birthparent feels like she has let everyone down and fails to keep her promises if she changes her mind. Yet, she cannot give away something that is not hers. She must have her hand held, but not by "tainted" legal counseling that has been paid for by the adoptive parents because it blurs the line of who the client is.

In non-adoption situations, lawyers are permitted to represent clients with different interests if the clients consent, but applying this model in adoption is problematic. In some states such as Maryland, attorneys are prohibited from even offering clients the opportunity to waive a conflict and prospective adoptive parents must pay for counseling for the pregnant woman and for the attorney that represents her.

Is it possible for attorneys, facilitators and agencies to ethically handle an adoption and be involved in dual representation? There is always the potential for conflict in dual representation. It is dependent on the individual attorney (or facilitator or agency).

Who is advocating for the child's rights? Why is there not a third attorney in the scenario to look after the child's interests? The legal system is set up so that when an adoption is in its final stages, the judge is responsible for advocating for the child. While the child is the focus of attention throughout the adoption process, the reality is that the child does not have legal representation until the final stages. Should there be protection and representation for children?

How do adoption lawyers perceive their service? As a civil service, looking out for the legal requirements of an adoption? As a brokerage firm? How are the clients perceived by the lawyer? What is the overall good the lawyer is offering them?

One way for lawyers to alleviate negative stereotypes and provide clients with the services they need without "trespassing" into other areas of expertise is to form affiliations and work closely with social workers and agencies.

In Michigan, pregnant women who are considering placing their children for adoption are now given the opportunity to read the homestudy of the prospective adopters.

Case Scenario #2

Through a woman at church, Harriet Nelson learned of Dewey Cheatham, Esq., a lawyer in a neighboring state who specialized in adoptions. A few days after Harriet and her husband Ozzie had an initial telephone consultation with Cheatham, he called to say he had a birthmother whose baby was due in two weeks. If the Nelsons were interested, they would need to send $18,500 by over night mail, with an additional $7,500 to be paid within four weeks. They were told that the birthmother did not know who the birthfather was and that she had told Cheatham, "Even if I knew who he was I wouldn't tell him about this baby." The Nelsons felt everything was happening too fast but because they didn't want to lose the opportunity to adopt, they sent the money.

Little Ricky was born on his due date and all seemed well except for a problem with his left eye. Cheatham told the Nelsons it was just a "lazy eye" which could probably be corrected with exercises. Cheatham took the birthmother's consent the day Ricky was born. Ricky was discharged from the hospital to the Nelsons and they flew home with him the next day.

When the Nelsons didn't pay the remaining $7,500 of Cheatham's bill within four weeks, he began calling and writing to them about his fee. The Nelsons explained they were in a tight financial situation, particularly because Ricky would soon need delicate eye surgery and their insurance wouldn't provide coverage because they had nothing to document that Ricky had been placed with them for adoption. Cheatham said that he would send them the Placement Order, but only after he received his money. He told the Nelsons that if he didn't receive payment within ten days, he would take the child back and place him with another family.

Who is Cheatham representing in this scenario?

Does his fee arrangement present any ethical concerns? If so, what are they?

Does Cheatham's conduct from the time of Ricky's birth until the Nelsons returned home present any ethical problems? Jeopardize the adoptive placement?

Do Cheatham's efforts to collect the balance of his fee raise any ethical questions?

What is Cheatham's obligation, if any, to send the Placement Order to the Nelsons when they owed him money under the fee agreement?

If you were drafting a malpractice complaint against Cheatham, how many claims against him can you allege and what are they?

Case Discussion

What are the ethical violations in Cheatham's conduct? What is the fee for? Is there any method of recourse? Any regulatory system? 1) State bar organizations have grievance processes. If found guilty, lawyers may be reprimanded, suspended or disbarred. 2) AAAA has their own ethical disciplinary structure. 3) Individuals may file malpractice suits. 4) In Illinois and other states, the courts review the fees.

Should social workers practice dual representation? In Ottawa, Canada, since the government office which regulates private and intercountry adoption decided not to allow dual representation, the adoption process has improved for all concerned parties.

We have rationalized dual representation, claiming that it is acting in the best interest of the child but the concept of "best interests" is a social work fiction in that it is based on values - and we don't all share the same values.

What are the obligations of the attorney who is representing the prospective adoptive parents if the birthmother refuses to identify the birthfather? The attorney should not go any further with the process because it is potentially threatening to the child as well as to the adoptive parents. If the birthfather should later appear and claim that he did not consent to the adoption and wants custody of the child, the adoption could be viewed as a fraud and the security of the child could be jeopardized.

If a pregnant woman wishes to place her child for adoption but insists that it is within her constitutional right to privacy to not disclose the name of the child's father, does that mean that she cannot place her child?