Obama Issues Directive on Hospital Visitation and Medical Decisions
April 15th, 2010
When then-candidate Barack Obama accepted the Democratic Party’s nomination, he only made one LGBT-related commitment in his acceptance speech:
I know there are differences on same-sex marriage, but surely we can agree that our gay and lesbian brothers and sisters deserve to visit the person they love in the hospital and to live lives free of discrimination.
Today, President Barack Obama followed through on that commitment. Today he issued a Presidential Memorandum ordering ordered the Secretary of Health and Human Services (HHS) to issue new rules requiring hospitals who receive Medicare and Medicaid payments to provide visitation rights to same-sex partners, and to make it easier for gays and lesbians to make medical decisions on behalf of their partners.
The President’s memorandum makes a compelling case for the new rules:
[E]very day, all across America, patients are denied the kindnesses and caring of a loved one at their sides — whether in a sudden medical emergency or a prolonged hospital stay. Often, a widow or widower with no children is denied the support and comfort of a good friend. Members of religious orders are sometimes unable to choose someone other than an immediate family member to visit them and make medical decisions on their behalf. Also uniquely affected are gay and lesbian Americans who are often barred from the bedsides of the partners with whom they may have spent decades of their lives — unable to be there for the person they love, and unable to act as a legal surrogate if their partner is incapacitated.
For all of these Americans, the failure to have their wishes respected concerning who may visit them or make medical decisions on their behalf has real consequences. It means that doctors and nurses do not always have the best information about patients’ medications and medical histories and that friends and certain family members are unable to serve as intermediaries to help communicate patients’ needs. It means that a stressful and at times terrifying experience for patients is senselessly compounded by indignity and unfairness. And it means that all too often, people are made to suffer or even to pass away alone, denied the comfort of companionship in their final moments while a loved one is left worrying and pacing down the hall.
This has been a very real problem and persistent problem. In February 2007, Miami’s Jackson Memorial Hospital denied Janice Langbehn access to her partner of eighteen years, Lisa Marie Pond, who had collapsed due to a brain aneurysm while preparing to board a cruise ship. For hours, hospital staff refused to allow Janice access even after a legal power of attorney was faxed to the hospital. It was finally a priest who had been called to give last rites who made sure Janice could say her final goodbyes. A social worker at the hospital defended the hospital’s actions, saying that Florida was an “anti-gay state.”
This evening, President Obama called Janice from Air Force One to say he had been moved by her case:
“I was so humbled that he would know Lisa’s name and know our story,” Ms. Langbehn said in a telephone interview. “He apologized for how we were treated. For the last three years, that’s what I’ve been asking the hospital to do. Even now, three years later, they still refuse to apologize to the children and I for the fact that Lisa died alone.”
The memorandum directs HHS to begin the process to issue new rules for hospitals to comply to or risk being denied Medicare and Medicaid payments. The rule-making process could be a lengthy one, requiring the creation and publication of new proposals, a period for public comment and additional approvals. The weakness of this process is that it could be overturned by a future administration, but that overturning would also have to undergo the same lengthy process — creation and publication of a new set of regulations, public comment period, etc. While it is not as immediate as an Executive Order, it is much more robust and durable. And because this proposed rule would provide that any patient — gay or straight — could designate anyone — a partner, trusted friend, a relative who is not necessarily the next of kin — to have access for hospital visitation and make medical decisions on their behalf, it’s hard to see that there would be a significant impetus to overturn this rule.