An Argument of the Morality for Pre-Adoption Genetic TestingAccording to raiseachild.org, in 2013 there were over 400,000 children in foster care waiting to be adopted. If you have watched TV recently, you have no doubt seen how easy (and relatively inexpensive) it is to have a personal genetic test done. With genetic testing being more readily available, there has been in increase in reports that prospective parents who want or are going through the adoption process are requesting that potential adoptees undergo genetic testing to find out if they have any preexisting health issues or are genetically pre-disposed to health issues and disease. While some would argue the morality of these tests, stating that it will do more harm than good, I will be arguing why we should allow pre-adoption genetic testing.The Childs Best InterestThe scope of parental authority in medical decision making over and against a child’s moral status as a person with autonomy is commonly defined by what is in a child’s best interests. Of course, the definition of ‘best interests’ could vary depending who is defining the interest. Even in the U.S., there is not one defining definition. Each state defines what it thinks the best interest of the child is and there are variations with each (Determining the Best Interest). Some states define best interest the “Health, safety, and/or protection of the child” while others state that the best interest in a child is not removing it from his or her home (Determining the Best Interest). The latter leaving a fairly vague and open-ended definition for adoption agencies and foster homes to interpret. For the sake of this discussion, we will use the definition of best interest written by Allen E. Buchanan and Dan W. Brock, which states that the best interest for an individual is “acting so as to promote maximally the good of the individual,” (10); and in this case the individual is the child. The party that is responsible for the maximum good of the child is the adoption agency or foster home. Aside from the health, safety, and security of the child the next largest sum of good will be derived from finding a permanent home – as this is the ultimate goal of an adoptable child. Since finding a home is not only good for the child, but also good for the caregivers, in this case foster home or agency, the greatest good comes as it relates to the best interest of the child is finding them proper and permanent home.The Agency’s Best InterestThe adoption agencies or foster home’s major and possibly biggest interest is in placing and ensuring the children stay placed with adoptive parents. The adopting parties also have an interest in ensuring the privacy of all parties involved in the adoption process, thus minimizing risk of liability. Since the privacy of information is imperative in the adoption process, these agencies need well defined guidelines on the information they are allowed to disclose and what must be kept in confidence to each party involved in addition to the child involved.Since multiple suits have already been brought against foster families and adoption agencies for not disclosing the adoptable child’s genetic or health history (Blair, 703), these agencies will look to minimize further risk. To reduce the potential for a lawsuit, these agencies may feel obligated to require pre-adoption genetic testing of the child. Not only is there a potential for liability for not disclosing the child’s genetic history, the adoption agency and other parties that are involved in the placement of the child may have suit brought against them for failure to test the adoptee for potential negative genetic markers that may indicate future health issues or the risk for disuse. While agencies are not mandated to conduct and provide genetic test results, they are required to provide potential adoptive parents with written reports, assessments, and other documents that disclose the health information of the child. (Background Checks). At the time of this writing, over 25 states have a form of law that requires the agency to disclose a child’s health and background information. (State Statutes Search), yet none have a mandate to require genetic testing though there are several states that require you disclose genetic information if available. Even if an agency was able to successfully defend themselves against a wrongful adoption suit, they would still have to account for the time and money lost for its defense. The mere risk of a lawsuit may force agencies to require genetic testing without fully understanding the impact it could have on the child. Furthermore, as the availability of genetic testing increases and costs decreases, agencies could be pressured to require testing out of fear of an increase of potential lawsuit. As the availability of genetic tests increases and the cost decreases, this pressure to require pre-adoption genetic testing will rise, as the cost/risk benefits of having the information will outweigh the potential cost/risk of a lawsuit for the agency. Since agencies are unable to operate without money, and lawsuits could potentially have a negative impact on them, the best interest of the agency is to provide as much data as possible to the adoptive parents to ensure a permanent placement for a child and to mitigate the risk of suit.The Adopter’s Best InterestIn the process of adoption, we must not forget the to include the interests of the adopting parents. In the adoption process, the best interest for the adopting parent is to adopt a child from an adoption agency or foster care. Most parents would contend that they are bound by right to make medical decisions, including genetic testing, for their minor children, and generally the law affords them this right. However, in the case of adoption, these potential parents would not yet be the legal guardian and would have no legal right to demand genetic testing. This does not mean they are not able to request such testing be performed, it merely means they are not able to legally authorize the test. There are many reason an adopting parent might seek pre-adoption genetic testing of a child. Some of these reasons could be financial or emotional based. Due to the potential of a large financial burden created by treating certain diseases, one argument could be made that adopting parents would need a full medical and genetic background so they can make a well informed financial decision on whether or not to adopt. A tie in to the financial argument is that parents might not have the ability to emotionally handle a child with particular needs. A similar argument could be made that pre-adoption genetic testing could ensure the parents are better prepared to monitor the child’s condition and are able to seek out the appropriate care if a health issue does come up.With this information in mind, we can conclude that the best interest of the adopting parents as it relates to the adoption process is to adopt a child that is within their emotional and financial means.The OppositionTo be able to see the validity of pre-adoption genetic testing, one must look at both sides of the argument. One argument against pre-adoption genetic testing could be that once an adopting parent is made aware of a potential negative gene trait resulting in the possibility of future health issues, the likelihood the family will go through with the adoption could decrease significantly. Most families would likely want to adopt a child with a healthy genetic background. If a child is deemed to have a negative genetic trait which indicates the possibility of future health issues or disease, the adopting parents could request to adopt a different child or choose to back out of the adoption process entirely. If the parents decide to go through with the adoption process with results they deemed negative, there could be risk that the child will be treated differently based on the genetic results and potential for health issues. Additionally, this could set the precedent to where potential parents are able to choose children based on specific genetic health traits. This would could end up having those with less than desirable traits left in the adoption or foster system, lessening their chances for further adoption. According to the U.S. Department of Health and Human Services, only 20% of children older than 6 find placement in homes. If you reduce the chances of older children being adopted by giving them a ‘stigma’ of bad genes, this figure could end up being lower.Like children who are brought up by their biological parents, the heath of a child is not guaranteed. It could be said that genetic testing only favors the adopting parents, or those children with stronger genetic backroads, leaving the remaining children with specific genetic characteristics or predispositions with little or no chance of adoption. A Rawlsian may state that pre-genetic testing should be removed from the adoption process to ensure that all children are treated equally, without genetic bias. Due to their lack of autonomy, most children are unable to make educated medical or health related decisions for themselves, which means it could be morally wrong for agencies or parents to request these tests on behalf of the child. These children could be told do not have a say in the process or convinced it could help them get adopted quicker, without being told or shown the facts. This is even more true on infants and toddlers who are generally incompetent and incapable of making a rational decision at all. Another argument could be that while it may seem to be the best interest of all parties involved in the adoption process that prospective parents have as much information about the adoptable children as possible, genetic history and predispositions should be accessible to those not deemed family or medical personnel. While, there are laws requiring agencies to release all health information, including already performed genetic tests, the argument could be that the family should not have access or the right to request any new genetic testing.The Best Interest for AllThough not limited to the three groups above, given what we know, we can now make a valid argument in favor of pre-genetic testing. While we did hear potential arguments against pre-adoption genetic testing, we can use the following arguments to show that the greater good comes from allowing adopting parents and agencies to request pre-adoption genetic testing. As stated the best interest for the child is finding them a proper and permanent home. The best interest in the adoption agency is to provide as much data as possible to the adoptive parents to ensure a permanent placement for a child and to mitigate the risk of suit. Finally, we concluded that the best interest of the adopting parent is to adopt a child that is within their emotional and financial means. Given these interests, we can state that it is morally valid to perform pre-adoption genetic tests on children. The fist inductive argument states that pre-adoption genetic testing reduces the risk of wrongful adoption and other lawsuits against the adoption agency. Since the agency does not want to be sued, we should allow pre-adoption genetic testing. The next argument is that adopting parents will not file suit if they have all necessary health and genetic information prior to adoption. Like previously mentioned, the agency does not want to risk suit, therefore we should allow the genetic tests. Following that argument, the genetic testing would allow the adopting parents to complete the adoption process without any unknown financial or emotional risks. Since the end result and best interest is to complete the adoption process, then we should allow the tests to be performed. And since the best interest for the child is to be adopted, and parents are now fully understand the risks financially and emotionally – therefore, completing the adoption process – we are able to assert that the pre-adoption genetic test is morally acceptable to all parties.
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