THE U.S. SURGEON General, Richard H. Carmona, has embarked on an admirable quest. Citing the obvious fact that many diseases are inherited, he has created a national campaign that encourages all American families to learn more about their health histories.
To make this important task easier to accomplish, Dr. Carmona's office has created software that all of us can download at no cost to help track medical information about our parents, grandparents and other relatives. And to underscore how serious the surgeon general is about getting us all to act, he designated an annual National Family Health History Day to coincide with Thanksgiving.
For tens of millions of people, though, this well-intentioned initiative is nothing more than a mirage, an enticing glimpse of water in the desert that they know they cannot reach. Because all of the Americans to whom Dr. Carmona refers do not include the vast majority of those who were adopted, rather than born, into their families.
Adoption in the United States has made enormous strides in the last few decades, moving out of the shadows and becoming an increasingly conventional, normal way of forming a family; that's especially good news for children who need permanent, loving homes.
But progress has been uneven. One way in which adoption has not yet entered the 21st century is the anachronistic reality that most states still prohibit adoptees, even after they reach adulthood, from obtaining their birth certificates or other documents that would enable them to follow the surgeon general's sage advice.
Proponents of keeping these records sealed assert it's a necessary measure to maintain the anonymity that was guaranteed to birth mothers at the time their children were placed for adoption. That argument, unfortunately, is based on cultural myths and faulty stereotypes.
In fact, nearly every shred of research and experience over the last 20 years shows that none of these women was given legal assurance of anonymity; at least 90 percent of them want some level of contact with or knowledge about the lives they created, regardless of what they might or might not have been told verbally; and adopted people are not stalkers or ingrates but simply human beings who want the most basic information about themselves.
The good news is that we have learned an enormous amount about adoption and its participants as the institution has steadily moved into the mainstream, and many positive changes are occurring as a result. Among them are that parents adopting domestically and an increasing number who adopt from abroad routinely receive medical information about their sons and daughters at the outset and - because relationships with birth families are becoming increasingly commonplace - on an ongoing basis as their children grow up. Indeed, providing such information is now a widely accepted "best practice" for adoption practitioners.
Some states have changed their laws to permit adopted people, once they become adults, to gain access to their records. And there has been no hint, anywhere, that the recipients of those records are violating their birth mothers' privacy or otherwise disrupting their lives.
It is a wonderful coincidence that Dr. Carmona's potentially life-saving effort coincides with the recent unsealing of birth records in New Hampshire, the latest state to take such action. It's a propitious time for the surgeon general to use his influence to help break down the legal barriers across our country that for far too long have relegated adoptees to a special, less-privileged class of citizenship.
There's good reason to think he will do it. After all, he did say his medical advice applied to all Americans.
Adam Pertman is the executive director of the Evan B. Donaldson Adoption Institute and the author of Adoption Nation: How the Adoption Revolution is Transforming America.
Columnist Ellen Goodman is on vacation.
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