"I get the shakes," he said. The doctors would like to make a better diagnosis: They want to know his family's medical history. Vaughan, 36, can't provide it.
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 the 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 N.C. 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 about birth mothers who could be called against their wishes. Some also argue that more openness will discourage adoptions.
that 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.
"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."
Vaughan, who graduated from Sanderson High School in Raleigh and now lives in Rocky Mount, said he is probably like a lot of adoptees. He said he already knows his parents - they're the couple who adopted him.
Lori P. George, 38, of Greensboro also wants access to her original birth certificate, a search that started after she gave birth to her daughter 10 years ago.
In a statement, the nonprofit National Council for Adoption opposed the North Carolina legislation because it requires the birth parent to opt out of being contacted. The organization said that the law should presume that the birth parents desire privacy, and allow those who don't object to being contacted to sign a registry.
It's unsettling, he said, to think of violating the expectations of privacy for birth mothers who gave up a child for adoption at what was certainly a difficult moment.
North Carolina and New Jersey rank as the states with the least openness in the area of adoption and access to information, according to The White Oak Foundation, an Illinois nonprofit group that tracks adoption laws nationally.
Seven states, including Tennessee and Alabama, allow adoptees to obtain their true birth certificate. At least six others are considering changes.
Robert Tuke is a lawyer in Nashville, Tenn., who was on a state adoption commission there and litigated the case on behalf of adoptees. He said in an interview that at first he assumed that more openness could be problematic.
But he said the commission's research showed no increase in abortions and few, if any, unwanted contacts with birth mothers. Birth mothers can "veto" any contact from an adoptee by signing a form.
Oregon opened birth certificates to adoptees after voters approved a statewide measure in 1998. The vote produced a long, turbulent court fight, but courts upheld the change toward openness. About 8,200 adoptees have obtained their certificate since that time.
In five years, about 500 Oregon birth parents filled in forms spelling out their contact preferences. Of those, about 80 birth parents said they wanted no contact at all, according to the Oregon Department of Human Services.
Rep. Margaret Dickson, D-Cumberland, is a main sponsor of the changes. She said that Internet searches and other tools are making it harder to keep information about birth parents from adoptees, anyway.
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