Ethical Issues in America Infant Adoption

In “The Son My Sister Placed for Adoption Wants to Find Her. What Should I Do?”, NY Times, October 26, 2021, Ethicist Kwame Anthony Appiah questions the ethics of confidentiality versus a right to know one’s biological ancestry for those separated by adoption. The case at hand involves a woman contacted by the son her sister placed for adoption decades before who asks if she should tell her sister or respect her alleged wishes to maintain confidentiality imposed on her decades prior.

How can anyone opine on the ethics and rights of people seeking their truth while ignoring the ethics of the system that made them need to?

Adoption Secrets and Lies

Adoptees are legally grafted to their adopted family. Their true original birth certificate is sealed and the state issues a falsified “amended” birth certificate – a vital record – stating they were born to their adopters to officially seal the lie. What is ethical about legally codifying secrets and lies? This is governmental fraud committed by every state in the nation.  How can we discuss the ethics of adoption reunification without a mention of how and why the truth has been denied adoptees by laws that codify lies and pretense?  Adoptees lives are built on a fiction that violates truth and human rights and turns their lives upside down.

Appiah, with no expertise in adoption, does just that, entering into this ethical dilemma without a word about the ethics of adoption itself: a social construct which redistributes children, taking them from the poor and disenfranchised and moving them to those who can afford to pay tens of thousands of dollars per child depending on age, health and race with little to any way to distinguish between gray and black market adoptions that involve corruption and the international trafficking of children.

All of this, as well as the ethics of gaslighting someone’s entire life by expecting them to ignore reality and pretend total strangers are their mother and father, are ignored by Appiah, who posits an argument using outdated cliches, myths and misinformation about adoption, such as:

Almost all the facts about your biological family that shape your identity can be substituted for by an adoptive family” . . . The point of adoption, it seems to me, is that your family identity becomes that of your adoptive family.

The intended point of adoption, in fact, is to care for children in need – a goal which could be achieved without the façade of changing one’s identity. Changing one’s identity without their knowledge is identity theft, which is criminal. How is that ethical?  States allow the process of adoption, which changes one’s custody, to externally manipulate one’s identity by changing the adoptee’s name. But a legal change does not change one’s heredity, ethnicity, familial or genetic traits or temperaments. Thus, while adoption changes one’s name and caretakers, it does not and cannot change one’s identity – the essence of who you are.

Appiah, a “columnist on confidentiality and our claims to know our biological ancestry” with neither expertise nor any personal knowledge of adoption of the intense lifelong trauma and pain maternal/infant separation has on both parties as a result of relinquishment and adoption, creates an ethical dilemma of the simple human desire to know one’s truth, origins and kin substantiating his narrative with unlikely assumptions such as:

. . . your sister decided that she did not want him to be able to [know her]. This matters a lot . . .  Your sister’s decision was made in the light of prevailing attitudes of the day. Those may no longer be the attitudes prevailing in our day, but the decision was one she had the legal right to take.

The definition of a decision, by definition, is “a conclusion or resolution reached after consideration.” How can a so-called “decision” made by a teen – a minor – in crisis, pressured by her parents be considered legal and binding? How is that ethical?  What options did this mother, or any other, have?  Did the pressure rise to the level of coercion?  Was this mother given a choice of an open or closed adoption?

Appiah claims that she “signed the adoption papers with the proviso that her identity would “not be revealed to the child” – her child. Prior to the advent of open options this was not an option or a choice. Confidentiality was not asked for; it was standard procedure foisted upon mothers.  By choice or by mandate, should a parent have the right to deny their offspring his right to know his parents, a right Appiah admits is protected by the United Nations? How is that ethical?

Was she told how the trauma of mother-child separation affects both parties? Do mothers “voluntarily” relinquishing  – even today – have unbiased counseling or legal advice sufficient to make an informed decision?  Are they made aware of their legal rights?

Relinquishing mothers – even today – have no legal representation other than one who is recommended and paid for by the adoption agency or prospective adopters who have stake in the completion. Ethical rules dictate that “a lawyer shall not permit a person who recommends, employs, or pays the lawyer to render legal services for another to direct or regulate the lawyer’s professional judgment in rendering such legal services” (ABA Model Rules, 5.4 which have been adopted by most states).  Such dual representation in any other legal transaction would be a clear conflict of interest, but is allowable in adoption.   How is this ethical? 

Susan Smith, author of The Evan B. Donaldson Adoption Institute report “Safeguarding the Rights and Well-Being of Birthparents in The Adoption Process“ 2006 notes that the “practice of dual representation raises acute ethical and practical concerns.”

American Adoption History

Prior to the 1930s all adoptions were open.  Open adoption has slowly become more common since research in the 1970s. Adoptions became closed when social pressures mandated that families preserve the myth that they were formed biologically. Social workers tried their best to match physical characteristics of birth and adoptive parents and counseled those adopting not to tell the children they were adopted, lest they would feel awkward about their relationship to their parents.

Open adoption has slowly become more common since research in the 1970s when the number of white women relinquishing babies for adoption began to dwindle because of more accessible birth control and acceptance of single parenthood, even allowing pregnant teens to attend school.  It wasn’t until  the early 1990s that open adoptions were offered by a majority of American adoption agencies. Yet, no open adoption contracts are enforceable, a fact not revealed to mothers. How is that ethical?

Today, with the advent of many adoptees utilizing Ancestry websites and DNA to locate kin, it is impossible for anyone to assume that whatever confidentially they were told, agreed to, or thought was granted them decades ago is moot.

When it comes to the rights of fathers, the ethics are virtually non-existent.  In the past, mothers were routinely advised to say they didn’t know who the father was thus obliterating any requirement to obtain his consent to an adoption. Today, all states have enacted Putative Father Registries which require the father to know of the pregnancy and proactively assert his rights prior to the birth, while the expectant moms have no legal or ethical obligation to inform the father of the pregnancy, birth or her intention to have their child adopted. Thus, fathers are often unaware that a child of theirs exist until it is too late to challenge the loss of that child without an extensive and often futile legal battle. How is this ethical?

Adoption Reunification

Returning to the man in Appiah’s scenario who found and contacted his aunt seeking his mother, he, like all adoptees, did not ask to be born or relinquished shortly thereafter and then bound by antiquated sealed adoption records that deny adopted citizens the rights all others take for granted and leave them with a blank medical history, or if never told they are adopted – a false medical history. How is any of that ethical?

His mother, as is often the case, was a teenager who lacked agency and felt the need to hide her pregnancy from her parents. Like many women of her generation she was pressured by social stigma into signing away her constitutional rights to raise her child. Her parents encouraged adoption. The dilemma of such expectant mothers has been described by historian Ricki Solinger and author Ann Fessler, both of whom have documented experiences of women in the post WW II, pre Roe v. Wade era.  Studies as well as anecdotal reports indicate that such women are often plagued with guilt and shame for the rest of their lives. They do not forget, but rather long to know the well-being of the child they lacked the support to care for. Whatever she was convinced was “best” at that time was then. Times have changed. She changed. She is no longer a frightened teen and single parenthood is no longer a “sinful” act for women.

This mother and son are now two grown adult people locked into roles neither of them asked for or chose; they are imprisoned by the secrecy that shrouded adoption in past decades and keeps adoption records sealed in most states still. The movement for adoptee rights has succeeded in allowing adoptees access in some states, but most often with restrictions and obstacles that apply only to adoptees.  Adopted adults are infantilized by society and confined by restrictive laws created in bygone times. Few of their mothers’ need or want to be “protected.”  There is no other situation in which healthy adults are treated like they are emotionally fragile or cognitively incapacitated and unable to manage their lives, who they chose to meet, speak with, get to know, or not. Nor, is there any other situation in which a person’s desire to make contact with a relative is so fraught with apprehension.

Of course, it is true, as Appiah notes, that “[s]ome well-adjusted adopted children simply have no interest in their biological ancestors.” First, adopted children rarely actively initiate a search for their origins. In terms of adults like the man who initiated this inquiry, their desire to know their heritage  is no different than for those who are not adopted. Some people have a keen interest in exploring their genealogy and others less so or none. Neither is right or wrong. Neither has anything to do with how “well-adjusted” one is. Only adoptees are judged for their natural curiosity and accused of being ungrateful.

Appiah’s conclusion to let the mother make her own decision is half correct. The young man who precipitated this inquiry has – or should have – an equal if not more valid right to decision-making power regarding the truth of his existence.

How sad that this man’s request was met with such concerns instead of the simple joy of finding a long-lost nephew, her sister’s son. Those outside of the adoption constellation are not routinely subjected to warnings to be cautious what they might find when they peruse their genealogy or told they may be hurting their parents by seeking to know their ancestry.

He is a family member not an interloper. Both he and his mother deserve to be treated as the adults they are. They have a right to know one another and decide how to proceed. They need to be treated with respect, dignity and with the same rules that apply to all others. Their lives are not an ethical dilemma. They are just people navigating legal obstacles and a public that treats them like predators for trying to have a family reunion.

Why do we question the ethics of those seeking to retrieve the missing puzzle pieces of their lives in order to be whole but not the ethics of separating families to meet a demand and create a falsehood their lives are constrained by?

Other Ethical Issues in Adoption

The major issue and stumbling block to ethical adoption practices in the US is the privation of infant adoption and the money. Not-for-profit and non-profit are tax statuses. Every adoption business aka “agency” has payroll, overhead and other expenses including large PR and outreach budgets. And therein lies the problem. Indigent expectant mothers are eligible for food stamps and housing assistance which would eliminate the majority of such expenses and judges have to be more conservative in signing off on amounts that could constitute baby buying. Nor should any mother ever be told she is obligated to repay expenses if she finds she is able to parent her child.

The money’s the problem,” says Adam Pertman, author of Adoption Nation and president of the National Center on Adoption and Permanency. “Anytime you put dollar signs and human beings in the same sentence, you have a recipe for disaster.”

All of the money for adoption comes from prospective adopters creating an immediate and serious imbalance in what some inaccurately refer to as a “triad” consisting of adoptive and birth parents and adoptees.

Laws in every state allow expectant mothers’ “expenses” to be paid by prospective adopters.  These include counseling and legal fees creating an obvious bias toward their benefactor.. This creates an unhealthy enmeshment that causes mothers to feel obligated and sets up fail expectations for adopters. It also puts them at risk for adoption scammers.

Madelyn Freundlich, author of The Market Forces in Adoption, notes:

To what extent do prospective adoptive parents’ expenditures to cover a birth mother’s medical … or other living expenses create a sense of indebtedness that may affect her decision-making?  Does a birth mother ultimately ‘owe’ it to the prospective adoptive parents to follow through on an adoption because a good deal of money has been expended …?

L. Anne Babb, author of Ethics in American Adoption (1999) found that:

The research on ethics in adoption shows that adoption, more than any other human service, is rife with conflict of interest… Professionals have yet to develop uniform ethical standards in adoption or to make meaningful attempts to monitor their own profession.

Some ethical guidelines for adoption have been set by the American Bar Association (ABA), Child Welfare League of America (CWLA), and organizations such as the Evan B. Donaldson Adoption Institute (EBDAI).  But they are not enforced and are often ignored. For instance, the American Bar Association Standing Committee on Ethics and Professional Responsibility concluded in 1987 that lawyers might not ethically represent both adopting and relinquishing parties.  Dual representation violates the ABA Model Rules of Professional Conduct  [Rule 1.7(a)].

States allow such dual representation, as long as the client is given written knowing and informed consent of dual representation. Who explains such a consent and are they enforced?  Additionally, no state offers legal aid for relinquishing parents, as is required for indigent criminals.


It is disappointing that the New York Times published a piece on ethics in adoption written by someone with no expertise in the subject matter who thus ignored all that is unethical in domestic infant adoption in America, and myopically focused instead on two non-problems, adoptees seeking to reunite and an alleged right of anyone to remain anonymous.

Society needs to stop treating those separated by adoption as a special and suspicious class of people who need unique rules that apply only to them. Get out of the lives of adults seeking their genealogy and possible reunification and instead focus on the fact that infant adoption has become a multi-billion dollar industry, that has changed the focus from finding homes for children in need to filling a demand with approximately 40 couples competing for each newborn relinquished.

In order to make adoption ethical and safe, we need to:

  • refocus on the needs of children over any of the adults involved
  • end the falsification of birth certificates
  • certify and license all adoption facilitators and middle-men
  • reduce the pressure and coercion of mothers
  • end conflict of legal representation
  • curb unnecessary and overblown “expense allotments”
  • end the disregard of fathers’ rights and the commodification of children
  • end corruption and trafficking

In order to protect parents and children – including adopters who are victimized by scams – focus on the need to create oversight of domestic infant adoption at the federal level and the enforcement of a set of ethical standards.

Mirah is author of two internationally acclaimed books, more than 200 published articles, and cited in twenty professional journals having been researching, writing and speaking about American and global child adoption, restoration of adoptee rights, as well as contract anonymous conception and surrogacy since 1980. More at her website and Wikipedia. Read other articles by Mirah, or visit Mirah's website.