Families in the United States experience child abuse investigations, the removal of children from their homes, and the termination of parental rights at higher rates than peer countries. Yet this does not make them safer and comes at a cost. As a historian and practicing doctor, Mical Raz asks how American society came to accept punitive interventionist policies that prioritize termination of parental rights. These practices “free” children for adoption, which leads to the devastation of families and communities and the creation of “legal orphans”—children who have no legal ties to their families of origin.

Drawing on original archival sources, legislative documents, and oral histories, Raz argues that adoption is not the inevitable solution to a child welfare system in crisis, maps the political history of this shift in child welfare policymaking—exemplified in the passage of the 1997 Adoption and Safe Families Act—and proposes future reforms.

Mical Raz is professor of history and health policy at the University of Rochester and works as a hospitalist at Strong Memorial Hospital.