Intercountry Adoption: A Need for Mandatory Medical Screening

I. Introduction II. Principle Types of Adoption III. Adopting in a Foreign Country-Recognition IV. Intercountry Adoption Occurring in the United States V. Different Parties to the Intercountry Adoption VI. Health Problems Associated With Intercountry Adoption A. Parasitosis, Hepatitis B, and Other Infectious Diseases B. Problems Specific to China C. Problems Specific to Romania VII. Mandatory Screening VIII. INA & Adoption History IX. Conclusion I. INTRODUCTION Infertility has caused many couples to turn to other methods in order to create a family. Various options are available for families who have difficulties with conception.(1) The primary non-medical, non-invasive method is that of adoption. Adoption, although at times very expensive, can be less costly than fertility treatments.(2) Those seeking to adopt may still face substantial hurdles. Even if a couple is the `right' age, `right' race, earns a sufficient income, and is of the `right' sexual orientation, they may still have difficulties with adopting their preferred child, and at the very least they face sometimes unnecessarily long waits before a child becomes available.3 Couples often turn to intercountry adoption because of the "less restrictive eligibility requirements" and the short time period before the actual adoption.(4) This Note addresses some of the hurdles associated with domestic adoption, and further examines the choice to adopt internationally. Despite the numerous benefits of intercountry adoption, most families do not consider the possible health ramifications. Since adoptive parents are unsuspecting of ailments associated with foreign countries, a complete pediatric examination is a must after receiving the foreign adoptee. Such a pediatric examination will be effective when it is uniform and thorough, but without such an examination both parents and physicians remain in the dark about the child's health.(5) Congress ought to amend the Immigration and Nationality Act (INA) to require a standard pediatric examination for all foreign adoptees, regardless of the country of origin, as a condition to approval of granting immediate relative status to the adoptee. This Note proposes that Congress can effectuate mandatory screening of internationally adopted children through its power to regulate immigration and therefore, should use this power to ensure that all international adoptees receive all necessary screening and treatment. II. PRINCIPLE TYPES OF ADOPTION Numerous avenues exist through which a couple may adopt a child. Couples can adopt through an adoption agency or through an independent adoption.(6) An adoption agency can be either public or private.(7) When couples choose to adopt through an agency, they rarely deal with the natural mother.(8) Typically the agency, and not the birth mother, conducts the investigation to locate suitable adoptive parents.(9) Couples generally prefer private agencies because public agencies involve long waits10 and a lack of knowledge of the birth mother.(11) To shorten the adoption process, numerous couples elect to adopt through a private agency. Although adoption through a private agency may slightly shorten the adoption process, the couple must still satisfy the other desirable qualities of adoptive parents.(12) Aside from the shorter duration of the pre-adoption process, private agencies accomplish the same ends as the public agencies; however, private agencies are more costly to the prospective parents.(13) Frustrated with the long waits and lack of available infants, some couples have chosen to pursue independent adoptions domestically. Independent adoptions are more attractive than agency adoptions for numerous reasons, the most substantial being the shorter waiting period.(14) Another important aspect of independent adoptions which attracts prospective parents is fewer procedural requirements, which consequently allow for more privacy. …