Hospital visitations and
critical health-care decisions
Background. Description of the problem
Hospitals often have strict rules limiting patient visitors to spouses and close relatives when their patients are very ill. Hospitals have also sometimes refused to recognize written authorization that allow individuals to make critical health-care decisions for their patients. In some of these instances, hospitals do not recognize loving, committed, long-term, same-sex relationships; they people are viewed only as roommates.
On 2010-APR-15, President Obama signed an executive order that instructs almost all U.S. hospitals to give patients the right to designate which people can visit them, consult with them at critical times, and -- in the event that the patient is unable to communicate -- act according to written directives. 1
The executive order said in part:
""Every 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. ..."
"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."
"Without the expanded visitor-designation rights, 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." 2
This executive order will affect lesbians, gays, bisexuals, transgender people (LGBT) in addition to heterosexuals and people of all races, colors, genders, national origins, religions, and disabilities. It has caused major reactions among LGBT persons, their support groups, religious conservatives, and others.
This is the latest step in the slow march towards equality for LGBT persons since President Obama's inauguration in 2009-JAN. Previous steps by his administration have included:
A bill to expand the existing hate-crimes legislation became law. Four additional protected groups were added. All Americans are now also covered against violent hate crimes based on the victim's gender, disability, sexual orientation and gender identity. More info.
A bill passed by Congress allowed the repeal of the "Don't Ask, Don't Tell" policy of the Armed Forces. This allows gays and lesbians to serve openly.
The U.S. Forces became the last major armed forces in the West to allow persons of all sexual orientations to join and remain in the military.
Also before Congress is the "Student non-discrimination act" which would discourage harrassment, bullying, violence, and discrimination against students in public schools on the basis of their sexual orientation or gender identity.
President Obama held the first Gay Pride Day celebration in the White House.
In addition, same-sex marriages have been legalized in some areas of the country as a result of actions within individual states.
Some conservative faith groups expressed alarm at the President's exective order. Some feel that separating lesbians and gays from their spouses, partners and children is extremely rare; thus, there is no significant problem to be addressed. Others suggest that it is simply one more way in which same-sex couples are given additional rights -- thus indicating a political agenda to promote equality for persons of all sexua orientations.
Many LGBT individuals and their support groups expressed anger that this march towards equality for people of all sexual orientations and gender identities is proceeding so slowly.
The hospital problem impacts in particular couples who deviate from the common opposite-sex marriage. These include:
Elderly couples who have never married because it would negatively impact their finances.
Other couples who have decided to live together without marrying.
Same-sex couples who may be married, registered in a civil union, or simply living together.
The scope of the problem is unknown. It tends to impact individual couples and is difficult to measure. One indication is seen in New Jersey where only civil unions have been made available to same-sex couples so far:
The Dallas Voice, a news source for LGBT individuals and couples in Texas reported that:
"Of the first 1,000 people who were civilly united, half filed complaints of unequal treatment."
The Newark, NJ Star Ledger reported:
"Civil union couples still have trouble being recognized as next-of-kin by employers when they seek benefits and by hospital officials when one partner is ill. Not surprisingly, this separate institution turns out to be unequal." 3
Hospitals often restrict access to patients who are seriously ill. Many only allow immediate family members and spouses access to their loved ones while excluding friends, roommates, etc. Some hospitals recognize loving, committed same-sex couples -- even those who have been married or registered in a civil union or domestic partnership -- only as roommates and refuse to allow them access to their partners. A patient's aunt may have been acting as their parent for decades and yet be excluded because she is not the patients actual mother. A widow might want to have a friend by her side in the hospital only to have that friend excluded.
In the case of same-sex couples, two well known cases indicate the seriousness of the situation:
The first case ocurred many years ago, when a lesbian in a long-term partnership became disabled and was taken to the hospital. Her family believed that their daughter was a heterosexual who had been seduced into a lesbian relationship.They gained access to their daughter and transferred her to a nursing home many hundreds of miles away, where she was kept under dreadful conditions. Her partner was prevented from visiting. For many years, many gay pride marches were led by a woman pushing an empty wheelchair to symbolize this injustice. [We are recalling the details from memory and will attempt to track the details on this event.]
The second case ocurred in 2007-FEB. An article in the New York Times4 was the trigger that motivated President Obama to issue the executive order.
Janice Langbehn and Lisa Marie Pond, 39, were a lesbian couple who had been together for 17 years. They were on vacation with their three adopted children, 9. 11 & 13 in Miami, FL, and were boarding a cruise ship when Pond suddenly collapsed. She was rushed to Ryder Trauma Center of Jackson Memorial Hospital. Medical personnel refused to let Langbehn visit her partner, even after she supplied Power of Attorney documents.
According to Now Public:
"Langbehn begged and pleaded for hours to be given access to the room, but was denied. Langbehn said she was allowed in to see her partner for only five minutes as a priest gave Pond the last rites."
"Pond died from a brain aneurysm while Langbehn was forced to stay in the waiting room. It wasn't until Pond's sister arrived at the Miami's Jackson Memorial Hospital that Langbehn got any information. ..."
"President Obama personally called Langbehn to apologize for the way she was treated. Langbehn, who said she tried for years to get an apology from the Miami hospital without success, says she was humbled by the phone call and believes that the new rule would mean that her partner didn't die in vain." 5
Langbehn never actually got to speak with her partner; Pond was in a coma by the time that the hospital allowed them to be together.
The following information sources were used to prepare and update the above
essay. The hyperlinks are not necessarily still active today.
Michael D. Shear, "Obama extends hospital visitation rights to same-sex partners of gays," Washington Post, 2010-APR-16, at: http://www.washingtonpost.com/