In a groundbreaking move that will greatly enhance the ability of gays and lesbians to designate caregivers and medical decision makers, President Obama has ordered the U.S. Dept. of Health and Human Services to “respect the rights of patients to designate visitors.”

In a memo released April 15 by the White House, the president said, “There are few moments in our lives that call for greater compassion and companionship than when a loved one is admitted to the hospital. In these hours of need and moments of pain and anxiety, all of us would hope to have a hand to hold, a shoulder on which to lean — a loved one to be there for us, as we would be there for them.”

The memo went on to state that often individuals are denied that comfort because of policies that decree visitation to be limited to immediate family only even if, as is often the case, the visitor has holds a durable healthcare power of attorney or other legal document giving them decision-making authority.

“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.”

To rectify the problem, the Obama memo highlights efforts made in North Carolina, Delaware, Nebraska and Minnesota in this regard, and orders DHHS to “ensure that hospitals that participate in Medicare or Medicaid respect the rights of patients to designate visitors. It should be made clear that designated visitors, including individuals designated by legally valid advance directives (such as durable powers of attorney and health care proxies), should enjoy visitation privileges that are no more restrictive than those that immediate family members enjoy. You should also provide that participating hospitals may not deny visitation privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity, or disability. The rulemaking should take into account the need for hospitals to restrict visitation in medically appropriate circumstances as well as the clinical decisions that medical professionals make about a patient's care or treatment.”

All hospitals participating in Medicare or Medicaid must be in full compliance with these regulations, and a report “on actions the Department of Health and Human Services can take to address hospital visitation, medical decision-making, or other healthcare issues that affect LGBT patients and their families” is due back to the president within 180 days.

Local GLBT reaction to the memo was swift and positive.

“I find this monumental,” said H.G. Stovall, president of the Tennessee Equality Project. “In states such as Tennessee where gays and lesbians can still be fired from their jobs on the basis of who they love, equality in hospital visitation is a landmark and symbolic victory. On tax day, to say that the gay community — which does pay taxes — is deserving of just one more of the hundreds of rights that are denied with the inability to marry at the federal level is just monumental.”

TEP has been working to advocate this and similar protections, and has gained more than 1,000 supporters through Facebook and other social media for its efforts.

“When a partner is in need of medical care, whether due to an emergency or for a longstanding illness, it is a time of increased stress and emotional discomfort,” Stovall said. “This is exactly the time that the community deserves these kinds of protections, and we applaud President Obama in securing these rights for us.”

Local hospitals have also been quick to respond to the president’s directive.

“We respect the rights of all of our patients including those in the gay, lesbian, bisexual and transgender community that are specifically addressed in the presidential memorandum on hospital visitation,” said Terrell Smith, R.N., director of Patient/Family Centered Care at Vanderbilt University Medical Center. “But our visitation policy is quite broad-based on principles for patient-and family-centered care because we know how important it is to have those loved ones close and able to help communicate our patient needs, as well as help relay their medical history.”

VUMC policy already allows for designated visitors, including individuals designated by legally valid advance directives such as durable powers of attorney and healthcare proxies, according to the hospital, which added in a statement that “These visitation privileges are no more restrictive than those that immediate family members enjoy … VUMC supports the rights of any patient, including those in the gay, lesbian, bisexual and transgender community, involving those decisions that address hospital visitation, medical decision making, or other health care issues that affect patients and their families.”

For the complete text of the presidential memo, click here.

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