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David Vaughan has a medical condition -- "I get the shakes," he says -- and the doctors would like to make a better diagnosis: They want to know his family's medical history.
Vaughan, 36, can't provide it.
Adopted as an infant in the early 1970s and reared in Raleigh, he knows nothing of his birth parents or his biological background.
Under North Carolina law, the state keeps secret the original birth certificates of adoptees, including Vaughan's, sealing off the names of birth parents and the locations of the births. New certificates are printed to show only adoptive parents and where they lived at the time of adoption.
Vaughan and other advocates want the legislature to change that, but their effort pits them against long-held beliefs about secrecy surrounding adoptions.
Bills have been introduced in the state House and Senate to undo North Carolina's law sealing birth certificates, which dates to the 1940s, a time when society cast more shame on out-of-wedlock births.
Opponents of the change worry about the effect of providing adoptees the information, particularly on birth mothers who could be contacted against their wishes. Some also argue that more openness will discourage adoptions.
Advocates of more openness say current law makes it difficult for many adoptees to trace their genealogy, learn about their biological and medical history or search for their birth parents.
Last year, there were about 3,500 adoptions in North Carolina, most through a public agency.
Balance is tricky
"This is a very tough thing to balance -- the privacy of a birth parent against the search by an adoptee for their own personal information," said Brinton Wright, a Greensboro adoption lawyer and board member of a children's home. "It's easy to sympathize with everybody in this."
A hearing is expected in a House committee in the next two weeks.
Vaughan, who graduated from Sanderson High School in Raleigh and now lives in Rocky Mount, said he's probably like a lot of adoptees. He said he already knows his parents -- they're the couple who adopted him.
"They made me mentally," he said. "But you do look in the mirror and wonder: What physically made me?"
His recent onset of benign essential tremor is why he began his search for family medical information, he said. A family history might help doctors zero in on areas of concern or lead them to a possible explanation.
He also fears being asked in an emergency -- a heart attack, for example -- for a family history.
"Put yourself in my shoes, where you can't answer those questions that could really matter," he said.
Lori P. George, 38, of Greensboro also wants access to her original birth certificate, a search that started after she gave birth to a daughter 10 years ago. George looked at her daughter and realized she was the first blood relative she ever met.
The certificate would tell George her birth mother's name, which George might use to trace her genealogy.
"I'm not looking for a reunion," she said. "But you do start to want to know where did I come from and what are my origins?"
Lawmakers have periodically considered giving more access to birth certificates since the late 1980s but always decided to keep them sealed.
The case for secrecy
Previous efforts at change in North Carolina and in other states were fought on a range of arguments, at times in emotional, searing debate.
Some adoptive parents fear "losing" their child to the birth parent after a reunion. Opponents of change say birth mothers worry about being contacted against their wishes. Supporters of adoptions worry that a change might discourage mothers from choosing adoption over abortion.
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