Baby feet in hands

Striving Towards Ethical Adoption Practice

By Susan Dusza Guerra Leksander

In the United States, the practices of adoption are rarely oriented towards the goals of anti-racism, child-centeredness, and reproductive justice.

In this article, I present a model that strives to fulfill these goals. At Pact, an Adoption Alliance, the non-profit organization where I work as agency and clinical director, our mission is to serve adopted youth of color, and our approach to domestic infant adoption emerges from 30 years of serving Black, Latinx, Asian, and multiracial infants and their families. Based on our work with adopted children and adults of color, first/birth1 and adoptive parents, and adoption professionals, I will share our tenets of ethical adoption practice.

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Monarch Butterfly, pupae and cocoons are suspended. Concept transformation of Butterfly.

Understanding Transracial Adoption: Life-long Transformations, Not Frictionless Transactions 

By April Dinwoodie

I took a long, slow, deep breath when I heard Amy Coney Barrett, the adoptive mother of Black children, describe adoption as a “frictionless alternative to abortion.” As a Black/bi-racial transracially adopted person in mid-life, adoption has been and continues to be many things, but “frictionless” isn’t one of them.  

On the contrary, being adopted into a white family and raised in a majority white community has been filled with the tension between the realities of what I was experiencing and feeling, and what others thought I should be. For me, Amy Coney Barrett ridiculously over-simplified the most intricate experience of identity one can have, being born into one family and raised by another. This is especially complex when the separation includes differences of race, ethnicity, and culture. 

What I have learned over time is that Amy Coney Barrett is not alone in her desire to categorize adoption as uncomplicated and a good solution for everyone connected to the experience. What I have also learned is that this kind of thinking more broadly is unrealistic and often results in gaps in services and support for all parents (expectant, birth, and adoptive) and leaves adopted persons without the tools they need to navigate this lifelong, transformational journey.  

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Nurse weighs baby in the nursery of the Cairns General Hospital at the FSA (Farm Security Administration) farm workers' community. Eleven Mile Corner, Arizona.

The Racialized History of Adoption Practice

By Rickie Solinger

The racial and gender coercions at the heart of adoption clarify the violence inherent in Justice Amy Coney Barrett’s wish to revitalize adoption in America as a substitute for abortion.  

The mass practice of adoption, which started in the U.S. in the post-World War II era, pressed white unwed mothers to surrender their babies to a four-faceted cause: preserving the face of white chastity in the era of emergent feminism; bolstering the fraying institutions of white male authority; reinscribing the hegemony of the white family (as this institution, itself, began to weaken); and crucially, underscoring the difference between Black and white.

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Lexington, Kentucky / United States - 06 28 2020: Fire Station 22 in Lexington, Kentucky in the early morning idle hours.

Safe Haven Laws and Anti-Abortion Politics

By Laury Oaks

During the Supreme Court oral arguments for Dobbs v. Jackson Women’s Health, Justice Amy Coney Barrett acknowledged that previous cases addressing abortion rights relied on a consideration of the burden of parenting and forced motherhood. For Justice Coney Barrett, this consideration was a non sequitur: “Why don’t safe haven laws take care of that problem?”

The so-called “safe haven” laws to which Justice Coney Barrett was referring were passed in every state from 1999 to 2009, to designate places where or people to whom an unharmed baby may be legally and anonymously relinquished and then adopted. A Florida safe haven advocacy group argues, “Safe Haven babies are given a chance for a future. A Safe Haven baby might become the President of the United States, a Supreme Court Justice, a scientist finding a cure for cancer or most important, a great mom or dad to their children.”

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Judge's gavel, handcuffs and scales on grey background, flat lay with space for text. Criminal law concept.

The Reproductive Violence of Family Policing & Separation

By Dorothy E. Roberts

In the Dobbs v. Jackson Women’s Health Organization oral arguments, Justice Amy Coney Barrett presented parental relinquishment as an alternative to abortion access. In the leaked Supreme Court opinion in Dobbs, which overturned Roe v. Wade, Justice Alito referred to this idea approvingly.

We asked Professor Dorothy E. Roberts, George A. Weiss University Professor of Law and Sociology and the Raymond Pace and Sadie Tanner Mossell Alexander Professor of Civil Rights at the University of Pennsylvania, to highlight some of the problems with that claim. 

Drawing on her recently published book, Torn Apart: How the Child Welfare System Destroys Black Families – and How Abolition Can Build a Safer World (Basic Books, 2022), Roberts explains in the conversation below how the child welfare system uses family separation (or the threat thereof) as a means of policing Black families (as well as Native families, other non-white families, and poor families). This, she adds, is a result of the state’s failure to invest in families in fundamental ways, and is a clear manifestation of reproductive violence.

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United States Capitol Building - Washington, DC.

Psychedelic Policy on the Federal Level: Key Takeaways from a Petrie-Flom Center Panel

By James R. Jolin

To navigate the myriad interests and stakes involved in creating federal psychedelic policy, the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School convened a virtual panel discussion with three leading psychedelic policy advocates.

The conversation was situated against the backdrop of the “psychedelics renaissance” in the United States, which has been fueled by a wave of local and state legislation reducing or eliminating the criminal penalties associated with these substances.

Though many localities have made significant strides in addressing the legal questions surrounding psychedelic substances such as psilocybin and dimethyltryptamine (DMT), federal policymakers have not pursued similar initiatives.

Suggestions and considerations for federal psychedelic policy thus formed the substance of the discussion among the panelists:

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Female hand writing signature on the paper document.

How to Construct Better Organ Donation Policy and Achieve Health Equity

By James R. Jolin

The United States is facing an organ donation crisis, with massive gaps between supply and demand.

Per estimates from the Department of Health and Human Services (HHS), over 106,000 Americans are currently awaiting this life-saving medical treatment. Further, the burden of this shortage falls unequally:  in 2020, while approximately 48% of white patients in need of transplants received an organ, only 27% of Black patients secured one.

The stakes are too high to allow the organ donation crisis to proceed in the U.S. without bold intervention. But with many policy options on the table, unresolved ethical concerns, and a patchwork of organ donation laws across the country, the proper path forward is not immediately clear.

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Waiting area in a doctor's office

Churntables: A Look at the Record on Medicaid Redetermination Plans

By Cathy Zhang

The COVID-19 Public Health Emergency (PHE) expires at the end of this week, with Department of Health and Human Services (HHS) Secretary Xavier Becerra expected to renew the PHE once more to extend through mid-July.

When the PHE ultimately expires, this will also trigger the end of the Medicaid continuous enrollment requirement, under which states must provide continuous Medicaid coverage for enrollees through the end of the last month of the PHE in order to receive enhanced federal funding. This policy improves coverage and helps reduce churn, which is associated with poor health outcomes.

After the PHE, states can facilitate smooth transitions for those no longer eligible for Medicaid by taking advantage of the full 12- to 14- month period that the Centers for Medicare & Medicaid Services (CMS) has established for redetermining eligibility.

In August 2021, CMS released guidance giving states up to 12 months following the end of the PHE to redetermine whether Medicaid enrollees were still eligible and renew coverage. Last month, CMS released new guidance specifying that states must initiate redeterminations and renewals within 12 months of the PHE ending, but have up to 14 months to complete them. The agency is encouraging states to spread its renewals over the course of the full 12-month unwinding period, processing no more than 1/9th of their caseloads in a month, in order to reduce the risk of inappropriate terminations.

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GHRP affiliated researchers.

Introducing the Global Health and Rights Project’s New Affiliated Researchers

(Clockwise from top left: Alma Beltrán y Puga, Luciano Bottini Filho, Ana Lorena Ruano, María Natalia Echegoyemberry)

By Alicia Ely Yamin and Chloe Reichel

Leer en español.

In the years before the pandemic, and especially since the pandemic began, there have been increasing calls to decolonize global health. Setting aside what Ṣẹ̀yẹ Abímbọ́lá rightly characterizes as the slipperiness of both the terms “decolonizing” and “global health,” these calls speak to the need to reimagine governance structures, knowledge discourses, and legal frameworks — from intellectual property to international financial regulation.

Global health law itself, anchored in the International Health Regulations (2005), purports to present a universal perspective, but arguably rigidifies colonialist assumptions about the sources of disease, national security imperatives, priorities in monitoring “emergencies,” and governance at a distance. The diverse tapestry of international human rights scholarship related to health is often not reflected in analyses of the field from the economic North. In turn, that narrow vision of human rights has also increasingly faced critiques from TWAIL, Law & Political Economy, and other scholars, for blinkered analyses that fail to challenge the structural violence in our global institutional order — which the pandemic both laid bare and exacerbated.

In an attempt to enlarge discussion of these important topics and amplify diverse voices, the Petrie-Flom Center is welcoming four new affiliated researchers to the Global Health and Rights Project (GHRP).

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