Doctors need to share a child's full family medical history with prospective adoptive parents, even when the birth parents have not given their consent, argue specialists in the Archives of Disease in Childhood.
UK adoption law encourages frank disclosure of the adoptive child's family health history to prospective adopters, but birth parents do not always consent to this.
AdvertisementDoctors are usually privy to most of this information, but professional guidelines and legislation prohibit disclosure without the express consent of the birth parents unless it is "in the public interest," often leaving doctors in a quandary.
The argument in favour of disclosure may be more clear-cut where there is a high risk of a treatable heritable condition, but greater clarity is needed for subtler risks such as fetal alcohol problems, say the authors, from the University of Southampton and the British Association for Adoption and Fostering.
They point out that many of the UK's 4000 children adopted every year will have experienced physical or emotional abuse or will have complex developmental and educational needs.
Their birth parents are likely to have experienced similar abuse and may also have had bouts of mental ill health and other problems, such as substance misuse, all of which "powerfully influence a child's future health," say the authors.
"If medical information is not shared at this point, the adopted child may experience a lifetime of ignorance about their family health history and possible future health risks," not only for them, but also for their children, they write.
Such information also enables prospective adopters to make an informed decision about whether to adopt a child and/or prepares them for the future health problems their adopted child might have, which arguably is likely to make them better parents, they say.
Nevertheless, current legislation is unhelpful, they suggest. "Article 8 of the European Convention on Human Rights, incorporated into the UK Human Rights Act 1998, recognises the need to respect family privacy, but does little to resolve the competing interests of birth and adoptive families," they write.
"Nor is it clear whether the rights and freedoms of the child to knowledge of their health risks outweigh the rights of the birth family to confidentiality of their medical information," they add.
Furthermore, recent controversies over the security of electronic records "risk an excessively cautious approach to the determination of a public interest threshold for sharing information in adoption," they say.
"Although cases will need to be judged on their individual details, we argue that in many cases it will be appropriate to share relevant medical information with prospective adopters, on the grounds that this benefits the current and future welfare of the child," they conclude.