Public Health Law Map - Beta 5 - Medical and Public Health Law Site

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.
G. Surrogate Parenthood
These issues are addressed within the traditional context of adoption and parental
rights determinations. This leads to a conservative approach based on the stricter state
laws in each area. Although this provides a more generally applicable legal and ethical
approach to reproductive technologies, physicians in less restrictive states may choose
to be more aggressive in their use of these technologies, consistent with appropriate
legal and ethical guidelines. Since legitimacy determinations and adoption laws differ
dramatically from state to state, it is important for physicians to ensure that they
comply with applicable state laws. Procedures that are legal and acceptable in one state
may subject the physician to criminal prosecution and imprisonment in a different
state.
Most of the legal disputes involving reproductive technologies have centered on the
disputes over traditional parental rights to the resulting child or fertilized ova. Some
cases, usually denominated as baby selling, are criminal prosecutions for failing to
comply with the applicable adoptions laws. The most highly publicized cases have
been custody disputes such as the Baby M case in New Jersey and the Davis divorce
case in Tennessee. The Davis case, while involving more sophisticated technology, had
a simpler legal solution. The only technology involved in the Baby M case was
artificial insemination, but it had a much more complex legal result. In a thoughtful
and articulate opinion, the New Jersey court discussed the legal problems posed by socalled
surrogacy agreements and, implicitly, the general policy considerations in
heterogeneous parentage situations. The following discussion includes quotation from
the legal opinions themselves to convey the attitude of the courts as well as the
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