Until the court started voiding legal adoptions
.... and returning children to their biological parents/parent, and one or the other parent could change their mind years later and win, Family medical histories were not known.
Medical histories now include family history. However, there is no guarantee that the information provided is accurate. (Some are not prone to admit to mental illness there.)
Now the advances in genetic testing for familial conditions can provide information if a couple wants to have the potential adoptee checked out beforehand.
However, I think that the couples who opt for adoption do not think along those lines. They want a child, and are willing to take their chances as we all do with our progeny.
There are inherited conditions that require that both parents have the gene. One can only be a carrier. Example, inherited iron overload.
Do we start requiring that genetic testing be a part of the marriage license issuance? Or by the obstetrician at the first office visit? Or mandated for everyone at a certain age? (I started to say before becoming sexually active, but that gets younger and younger.) Or, horror of horrors, we sterilize the carriers?
The issue of inherited medical problems is complicated.
Conventional parents roll the dice. (There is always the chance that one that jumps generations can show up.)
I see nothing to be gained by destroying a family just because the technology now exists that blows the whstle.
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