Adoption Advocacy and Requests for Medical Updates
Love Without Boundaries is so proud to be able to provide medical care, foster care, and education services to better the lives of children in China. This has been our mission from the start, and we work each day to always think of the child first and foremost. In turn, our hope is that the children in our programs will become increasingly more likely to be adopted or become self-sustaining members of their communities. However, there are often times we are limited in what we can do. We carefully follow the guidelines and regulations set by the Chinese government and work together in the best interest of the child.
The children in our programs, while we are involved in their care, fall under the guardianship of the orphanage and the CCCWA (The China Center for Children’s Welfare and Adoption). LWB is never the guardian of the child, and we make all of our decisions in coordination and with the agreement of the child’s guardians. Guardianship always remains with each orphanage until the day a child is officially adopted.
Often families reach out to us when they are reviewing the file of a child who might be in a LWB program or when they are matched with a child in a LWB program and waiting to travel. While it is always exciting to hear from these parents, we hope everyone understands that government regulations limit what we are able to provide in the way of information, medical testing, or photographs prior to the completion of the child’s adoption. We can confirm that a child is in our program or if we provided a surgery or other medical care, but it is not possible for us to order further tests, request exams, or arrange for surgery. It is also important to note that there are differences in what is considered “routine” medical care in China compared to the U.S. What is considered routine testing or procedures in a city in the the U.S. may not be routine in rural China.
Many times when adoptive parents are looking at a waiting child’s file or having a doctor review the file, they are confused that a child with a diagnosed heart condition has not had a heart catheterization or echocardiogram or that they cannot simply order the orphanage to obtain one so that they can make a decision on whether or not to adopt that child. Many adoptive parents expect that these tests would be easy to request and perform, but often in more rural areas they are not readily available. In addition, orphanages typically do not have the funds to send a child to a major city for exams. Since the orphanage retains custody of the children in our programs, this is something they have to decide to do and get approval for. This may be difficult for some agencies and parents to understand since LWB may already be providing medical care to these children.
LWB’s resources are limited and are utilized for the most ailing children, who are often brought to our attention by the orphanage themselves. Additionally, once a child is paperwork-ready and could soon have a family, the limited resources of the orphanage and LWB can then can be used to care for other children who are nowhere near having a family to provide their care. The reality is that we always have to triage children to decide which children have the most needs.
When a child for whom we have arranged pending surgery is matched with a family, families will sometimes contact us and say they don’t want the surgery to take place. Some families prefer that a doctor of their choice completes the surgery. However, in these situations it is important to realize that until a family gets to China and signs the official paperwork, the orphanage is still the legal guardian of the child; therefore, it is ultimately the orphanage’s decision as to whether or not the surgery takes place. There have been occasions in the past when we did stop a surgery at a parent’s request only to have the family back out of the adoption due to personal circumstances or back out once they were in China. In those situations, we realized that we did not put the child’s best interests first, as the child’s surgery was ultimately delayed — sometimes for quite some time. So now our official policy is that the legal guardian of the child gets to make the medical decisions, which means the orphanage and the CCCWA get to decide whether medical care takes place and when.
We know that once families are reviewing a file or matched with a child, they want to learn as much as they can about a child. The “parent” instincts kick in, and the waiting family wants to make sure the child about to be added to their family is well cared for and receiving proper medical care. Waiting parents understandably work to do all that they can to ensure this. Many of us at LWB have been waiting parents, and all of us empathize with the feelings the waiting parent is experiencing. We all have to work within our limitations, however, to best provide for the child.
Through advocacy we are able to take our mission one step further to increase the likelihood of a child’s adoption. With all of the new changes in the waiting child program (the institution of both the shared list and the individual special focus children), we want to make sure everyone understands our limitations. We have been receiving more and more requests by agencies and families to order additional tests on children so that families can decide whether they wish to move forward with an adoption. While we are 100% committed to helping every child find a home, we are not in the position to order tests for adoption purposes. Our medical program’s main mission is still to save lives and to help children get quality health care. There are never enough resources to match the need, but we all work each day to help as many children as possible. When adopting through the waiting child program, we believe education is key, and so we understand fully a family’s desire to have all medical information possible. We hope everyone appreciates, however, that in many cases adoption is truly a “leap of faith” – and exact medical information may not be possible.
Maureen Gealy and Meg Montgomery, Adoption Advocacy