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 own 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.