President Obama and Visiting the Sick

…which is, in case you didn’t know, a mitzvah for Jews and a corporal work of mercy for Catholics. Dunno about the rest of you guys. Anyway, the President has issued an executive order requiring all health care facilities that receive Medicare or Medicaid money to honor the express wishes of all patients with regard to visitation and surrogate decision-making, without discrimination by reason of, among other things, sexual orientation.

My experience and understanding is that hospitals have typically dealt with these issues on a fairly informal basis. For instance, they have exercised a lot of leeway in deciding who is “next of kin” for purposes of information and decision-making. If anybody in the patient’s family is a medical or legal professional, that person is likely to get a lot of deference from the hospital, as a way of neutralizing a possible source of litigation and legal hassle, regardless of genealogical or geographical closeness or the patient’s expressed wishes. Aside from that, any relative who turns up and asks a lot of questions is probably going to get answers, unless there is some other relative already on the scene with better credentials. I don’t know that hospitals make any written rules about this (docs please correct me if necessary.) And ordinarily, if the patient is really aggressive about introducing a person as “my medical power of attorney,” regardless of genealogy, the hospital goes along with this. Unless, that is, there are other more “official” relatives already on the scene who disagree with this arrangement.

But same-sex partners have on occasion been shut out of visitation and decision-making (sometimes even with a properly signed and witnessed health care power of attorney) by antagonistic family members. The news this week contains lots of instances of such gratuitous meanness. If this involves violation of a power of attorney, it was probably already illegal, but stuff like this usually happens when nobody has the time or the energy to go to court about it.

So the president’s order has solved what has sometimes been a heartbreaking problem for same-sex couples, and probably puts him in the Big Leagues of doers of mitzvot and corporal works of mercy. Good on him.


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