The first rule of hospitals is to try to stay out of them. Unfortunately, that rule must sometimes be broken. So let me suggest a second rule: no one should be alone in a hospital.
Hospitals can work miracles, saving lives and improving quality of life. But they can still be dangerous and (ironically) inhospitable places. Patients need someone by their side not just to provide comfort, but often to monitor their care and act as their advocate.
A natural corollary is that patients should be free to choose as their companions and advocates whomever they most trust in those roles.
I thus find it astounding that, at least until last night, hospitals could refuse to honor advance directives in which a patient had specified who they wanted to have visitation rights and the power to make decisions on their behalf. As President Obama wrote in a memo to HHS Secretary Sebelius:
Yet 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. 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.
The President’s executive order forbids this conduct for any hospitals that receive Medicare or Medicaid money:
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.
Sounds right to me.