Should you adopt?
The moral questions surrounding adoption after cancer are similar to the concerns about having more biological children after a cancer diagnosis. When you adopt or carry a pregnancy to term, you are assuming a responsibility to raise the child to adulthood. A key consideration is whether you (and your spouse) will be alive and physically able to raise the child. Other important questions include:
- Is the cancer in remission? If so, what is the likelihood of a recurrence? If the five-year survival rate does not exceed 85%, it is clearly irresponsible to take on responsibility for another person. Your oncologist must be willing to write a letter stating that he or she considers you to be cured.
- Are there other family members who could provide support and take over responsibility for the child if you die? For example, is your spouse healthy?
- The age of the child also matters. If you are adopting a newborn baby, you should have a life expectancy of at least 20 years, to ensure that your child can graduate college.
- Do you have a will and does this will provide instructions regarding the placement of your children upon your death?
Clearly, even a healthy person could be hit by a truck crossing the street. The ethical issue with adoption after cancer is the extent to which you can predict an unfortunate event. To put it in black and white, what are the odds of your dying before the child reaches adulthood?
The following types of cancer have 5-year survival rates of 90% or more:
- Prostate Cancer
- Thyroid Cancer
- Testicular Cancer
- Skin Cancer (especially Melanoma)
- Lip
- Breast Cancer
- Hodgkin's Lymphoma
- Colorectal Cancer
There are no hard and fast rules, but generally cancer survivors who had other types of cancer should not consider adoption unless there is a clear indication for long-term survival without a recurrence.
It is also important to consider the stage of the cancer. A stage 1 survivor is often a better candidate for adoption than a stage 3 or 4 patient since cure rates are higher.
In addition, the more time that has passed since the initial therapy without a relapse, the lower the likelihood of a recurrence. Many cancer survivors consider the 5-year-mark as a benchmark for survival.
Can you adopt?
Each country has its own policies concerning whether cancer survivors can adopt. These policies can change. For example, China previously allowed cancer survivors who had passed the five-year-mark to adopt, but changed the rules in 2007 to not allow cancer survivors to adopt. Even countries that allow cancer survivors to adopt may place a temporary hold on all adoptions as they adopt the Hague Convention or other rules.
Most countries require a letter from the prospective adoptive parents' physicians that indicates that they are in general good health. Sometimes these letters are not included in the dossier, but rather are reviewed by the social worker who prepares the home study. (The contents of the doctor's letter will vary from country to country and even adoption agency to adoption agency. It is not uncommon for the letter to indicate that the prospective parent is free of cancer and other diseases and impairments without specifically mentioning a prior history of cancer.) The social worker will sometimes omit any mention of a history of cancer if the country does not specifically ask about cancer. If there is a mention of a history of cancer, the mention should be brief and clearly indicate that the doctor believes the cancer to be cured and that the prospective parents are currently healthy and have a normal life expectancy.
Some countries require cancer survivors to have past the five-year mark before they will let them adopt. Others require two or three years. Some adoption agencies impose their own requirements, so it may be worthwhile to shop around for an adoption agency that is more flexible.
Countries from which cancer survivors have adopted children include: Colombia, Ethiopia, Guatemala, Kazakhstan, Nepal, Russia, South Korea (5 years), Ukraine, United States of America and Vietnam.
Standards may be more relaxed for cancer survivors who are interested in adopting a special needs or older child.
Other Resources
The Yahoo Group Adoption After Cancer is a discussion group for cancer survivors who are thinking about adopting.
Copyright © 2008-2018 by Mark Kantrowitz. All rights reserved.
www.cancerpoints.com
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