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Access to Adoption-Related Records

One of the lingering controversies surrounding adoption is whether the process should be confidential. Irrespective of the physician's personal beliefs on the matter, the state law must be followed. A physician should not disclose information in violation of confidentiality provisions, but neither should persons be denied information that they are entitled to under state law. This question often arises when adopted children approach the physician who attended their delivery and request a copy of their birth record. (Most states leave the physician's and/or the hospital's name on the adoptee's birth certificate.) Unless the state has a specific provision in its access to medical records law, adult adoptees are entitled to read or copy any medical records that contain information about their birth or pediatric care.

As with all other medical records, the physician is advised not to alter or mutilate the records to disguise the birth mother's name. If the physician is concerned about the child's access to the records, the state agency regulating adoptions should be contacted for advice. It may be able to provide medical information to the child without violating anyone's privacy. Most states also have a registry system whereby former parents can express their wish to contact or provide medical information to the children they relinquished for adoption. If the parent has notified the state of such a wish, the registry can direct the child to the parent without violating the laws governing adoption. A physician treating a person who has given up a child for adoption should inform the patient of any information about genetic diseases or other conditions (such as DES exposure, birth injuries, and congenital infections) that might be necessary medical information for the child.

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