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Problems of overseas adoption

BMJ 1995; 310 doi: (Published 04 March 1995) Cite this as: BMJ 1995;310:603
  1. Mary Mather
  1. Consultant community paediatrician Greenwich Healthcare Trust, London SE18 3RS

    EDITOR,—Rupert Robin proposes that general practitioners should advise infertile couples that adoption is a suitable “treatment.”1 He also suggests that adoption in such cases will save NHS resources and at the same time help the deserving orphans of Third World countries. If only life were this simple and solutions to complex problems so easy to find. Adoption is not simple, therapeutic, or cost effective. It is a totally child centred process in which decisions are made only in the best interests of a particular child. When being assessed as potential adopters, couples have no automatic rights to adopt and all that matters is their ability to parent and meet the needs of a very disadvantaged child. When this process is properly done it is far from cost effective. The average costs of a full assessment vary between £6000 and £10000.

    Adoption is not for everyone. Most adopted children in this country come from backgrounds of abuse and neglect, need to be placed in sibling groups, or are of mixed race. They require very special adopters to meet their needs and heal their emotional damage. It is to avoid these difficult children that couples often resort to adopting babies from other countries. These babies often have birth families who are alive and who in better circumstances would be capable of looking after them. The babies may have undiagnosed medical and developmental needs. They will grow up to be teenagers who will almost certainly ask hard questions about their birth families, their origins and culture, and why they have to travel thousands of miles to find the answers. I wonder how they will view this simple solution.


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