Should We Photolist Waiting Children?, Page 4

Privacy Concerns

Limits on sharing information based on privacy may be either ethical or legal. Ethically, officials must consider the child's age, her understanding of the photolisting process, and her grasp of the possible implications of being photolisted. Birthfamily, friends, and community members may be able to access the child's personal information. Officials must acknowledge the child's understanding of the process and such possibilities as school friends seeing her on the Internet and reading about her background.

Decisions about posting specific health and mental health information should be based on several considerations-the seriousness of the condition; how recent the occurrence; the relationship, if any, between the problem and the child's current environment; and how the condition would affect the child and the prospective family.

Listings that include diagnostic labels without any context for such information is of particular concern. Pediatrician Lisa Albers, with the Developmental Medicine Center and Adoption Program at Children's Hospital in Boston, emphasizes that childhood emotional and behavioral disorders are diagnosed through observations and reports of behaviors and tend to be less definitive than a medical diagnosis based on an x-ray or blood test:

Sometimes the diagnosis is well described by an alphabet soup (RAD, PTSD, ODD, ADHD, etc.), but in my experience, those letters only shed light on one facet of any given child. In addition, children with any one of these diagnoses may present very differently from another child with the exact same diagnosis or diagnoses.2

Legal constraints also limit publicly sharing certain information. Privacy laws in most states prohibit sharing information about adult members of the birthfamily. Some states require a court order to photolist a child. By law, a child's HIV status may not be disclosed publicly. Finally, privacy regulations under the Health Insurance Portability and Accountability Act (HIPAA) could significantly limit the types of information posted in photolistings. HIPAA sets rigorous standards to protect individuals' health information from disclosure. States thus far have varied in their interpretation of how or whether this law applies to child welfare issues.

Can Practice Support Appropriate Information Sharing?

Because the Internet makes possible the transmission of information to millions of people, it raises unique practice issues. Internet photolistings allow families who may be in the early stages of considering adoption to view children anonymously, bring significantly greater attention to the needs of waiting children, and alert families to waiting children in other states.

Child welfare's capacity to meet the response that Internet photolistings can generate, however, remains undeveloped. In many communities, social workers are overwhelmed with the number of inquiries generated by newer, more effective transmissions of information. In some communities, photolistings provide extensive negative information about children to dissuade families whom officials may view as inappropriate
resources from contacting the agency. If they are to use the Internet to recruit families, child welfare agencies must be able to respond to inquiries, provide information, and engage families in the adoption process.

Strengthening Photolistings

Photolisting websites can be strengthened to more effectively alert families to the needs of waiting children and educate them about adopting. These websites should contain information-or links to sites with accurate information-that helps potential adoptive families understand such complexities as

* the definition of the term special needs-from a physical or mental health disability to the child being placed for adoption as a member of a sibling group-and how states define special needs differently;

* general qualifications to adopt, such as marital status, age, and other requirements;

* the availability of adoption subsidies and tax credits for special needs adoption;

* a basic explanation of foster care, termination of parental rights, and the adoption process;

* interstate adoptions, transracial adoptions, and adopting older children; and

* perhaps most importantly, information about the number of families who adopt successfully each year from the foster care system, including profiles of families who have done so and links to foster and adoptive support groups nationwide.

We need to understand much more about the effectiveness of Internet photolistings as a recruitment tool, especially compared with other recruitment methods. Do users of photolisting websites obtain the information they need? How does the quality or uniqueness of children's biographies influence adoptive families' decisionmaking? How do caseworkers' responses to calls resulting from photolistings affect families' decisions to go forward?

Sarah Gerstenzang is Policy Analyst, and Madelyn Freundlich is Director of Policy, for Children's Rights, New York, New York. They invite comments on the issues raised in this article: E-mail sgerstenzang@childrenrights.org. Standards for Internet photolistings are available from AdoptUSKids (www.adoptuskids.org) and the Adoption Exchange Association (www.adoptea.org).

1. Children's names throughout this article have been changed.
2. Lisa Albers. (Summer 2001). Medical Matters: PST, RAD, OCD, ADHD...An Alphabet of Childhood Psychiatric Diagnoses. Fostering Families Today 1 (2). Available online at www.adopting.org/fosteringfamilies/medicalmatters.html or www.adoptinfo.net/fft/medicalmatters.htm.

Credits: Children's Voice