Accepting adoption's uncertainty: the limited ethics of pre-adoption genetic testing

J Bioeth Inq. 2014 Jun;11(2):245-60. doi: 10.1007/s11673-014-9519-2. Epub 2014 Jun 10.


An increasing number of children are adopted in the United States from countries where both medical care and environmental conditions are extremely poor. In response to worries about the accuracy of medical histories, prospective adoptive parents increasingly request genetic testing of children prior to adoption. Though a general consensus on the ethics of pre-adoption genetic testing (PAGT) argues against permitting genetic testing on children available for adoption that is not also permitted for children in general, a view gaining traction argues for expanding the tests permitted. The reasoning behind this view is that the State has a duty to provide a child with parents who are the best "match," and thus all information that advances this end should be obtained. While the matching argument aims to promote the best interests of children, I show how it rests on the claim that what is in the best interests of children available for adoption is for prospective adoptive parents to have their genetic preferences satisfied such that the "genetics" of the children they end up adopting accurately reflects those preferences. Instead of protecting a vulnerable population, I conclude, PAGT contributes to the risks of harm such children face as it encourages people with strong genetic preferences to adopt children whose genetic backgrounds will always be uncertain.

MeSH terms

  • Adoption*
  • Child
  • Child Welfare*
  • Developing Countries
  • Genetic Testing / ethics*
  • Humans
  • Parents*
  • Risk
  • Uncertainty*
  • United States