The American Gazette

Commonsense political and social commentary from "Flyover Country"

Location: Rural Michigan, United States

Friday, October 15, 2004

Patient Rights-Gay and Lesbian Couples

Let me quote something Edwards said in the Vice Presidental debate concerning homosexuality, this is only a small part of what was said in the exchange that included Edwards bringing up Ms. Cheney. This quote does not focus on that, but on something that I am much more intimately familiar with.

Quoting Edwards-
For example, a gay couple now has a very difficult time, one, visiting the other when they're in the hospital, or, for example, if, heaven forbid, one of them were to pass away, they have trouble even arranging the funeral.

Let me explain something, when someone visits a person in the hospital you do not have a nurse patrol out there making sure a gay or lesbian partner is kept out of the room. In fact the nurse may not keep any visitors out of the room unless it is deemed medically necessary and even then there are times it is very difficult to deal with. We often see gay or lesbian couples in the hospital, the partner is simply termed the significant other just like we do for couples who heterosexual who are not married.

A hospitalized patient has rights, as long as they are awake and alert they make the decision as to who may visit and who may not. The only time this is not in force is when the patient is unable to speak for themselves, in that case the person who has been deemed the Durable Power of Attorney makes that choice. This is how it works regardless of the sexual orientation of the patient. In the case that the patient does not have a DPOA, then the decision making falls to the next of kin. For married couples that is the partner not hospitalized, for children that is their parent and if that child is an adult but not married it is still the parent or parents who make decisions. If it is an adult child who is gay and who did not put a DPOA in place to ensure that their partner is legally able to speak for them and the parent that is now making decisions decides they don't want that partner involved then it is the choice of that parent not to allow that to happen. In some cases this means that a guardian will be sought by the hospital through the social worker, or the partner can go through legal means to have access or anything else they feel their partner wanted. However medical personnal or the medical facility does not get involved unless and only if what is happening is deemed harmful to the patients condition.

This situation is not any different than the patient who did not do a DPOA and has a wife or husband who is now making decisions when the patient is unable to, but there are children who are involved and who feel the person making decisions are felt by other's in the family to be making inappropriate decisions. In that case the children can ask for a guardian to be put in place, they can do this by working with the social worker in order to have someone who can explain the process to them or by hiring an attorney themselves. Generally in this type of situation a hospital social worker becomes involved when a referrel is given by medical staff because the staff feel that what is happening is detrimental to the patient or if the family members specifically request for assistance in dealing with their particular situation. When a situation develops when parties do not someone to visit, REGARDLESS OF THE SEXUAL ORIENTATION OF THE PATIENT, it is actually necessary for the family to get a court order to disallow visitation. I have seen this only three times in my 13 and a half year career as a nurse. In all three cases it involved heterosexual couples who had not married. Not once in my career have I ever seen homosexual couples be disallowed to see their partner.

It is very simple to ensure this situation does not occur for anyone, again regardless of sexual orientation,all it takes is for any person to fill out a DPOA form. All hospitals are legally bond to ask every single patient when they are admitted if they have a DPOA form and if they do not to offer it to them and to also offer a social worker to go over the paperwork with the patient so they can fill it out appropriately. The filled out form must be witnessed by two people, nurses are not allowed to be witnesses, but social workers and/or Pastors are or any other competant persons the patient deems. The DPOA form does not cost a dime, it does not require an attorney. Nursing homes are bond by the same law. I know I do this probably 20 times a week. If you wish to have DPOA papers and are not an admitted patient, you can still go to any hospital and get the appropriate paperwork, a brochure that explains it and any other assistance from the appropriate hospital personnel that you require. This simple form can save a great deal of heartbreak and upset/anger though it is important to point out that if you wish to have someone deal with your finances when you are incapable of doing so something more has to be done, again however it is a simple process that should be done prior to a problem.

I encourage all of my patients to do this and also encourage their family members that are not hospitalized to do this prior to being ill. If this is taken care of than it isvirtually impossible for anyone to take away the right of someone to be the speaker for the person who requested them to do this service without the dissenting party going to court and if they go to court they need to be very prepared to be able to prove why the patients wishes should not be followed. Every single patient who does not already have a DPOA recieves the appropriate paperwork to do so, again this is fully required by law. I am required to fully explain it, offer a social worker or pastor to speak to the patient and then I am required to chart the whole thing. This is not simply something that a medical facility does as a nice service, it is something that has grown out of patient rights issues and the fear of many people of having medical procedures such as being placed on a ventilator at end of life when they do not want this.

Any couple or any person for that matter, who wants to ensure that they have their wishes adhered to should ensure their future as well as the future of those they care for doing a DPOA and they should do it as soon as they have someone who is willing to be a DPOA no matter how young they are or how healthy they are because one never knows when an accident will happen.

I am not allowed nor is any other nurse in this country allowed to not give this information to someone simply because they are gay or lesbian. However, all medical personnal are fully bond by the privacy act of HIPPA which limits what information we are allowed to give without the express permission of the patient, that covers all patients regardless of sexual orientation, regardless of whatever situation the patient or their family members are in.

If there are homosexual couples who have not been able to visit their partner then it is because the patient is not able to speak for themselves and they have not taken the extremely easy step of making a DPOA and therefore someone else is calling the shots that, for whatever reason, have decided that the significant other cannot visit. It is not the hospital who does that, it is not the nurses who make that choice. We simply follow the legal guidelines that are in place. With DPOA the person holding that piece of paper has the right to make any and all decisions, it is that person who has the legal right to speak for the patient. The only time the hospital gets involved is if in the judgement of the physicians or nurses the DPOA is making poor choices and that discomfort is taken to the social worker or the ethics committee, then the hospital gets involved, but only because the medical personnal feel it is in the best interest of the patient, not because someone is gay and gasp! Visiting the sick patient.

DPOA is designed to protect patient rights by allowing any person who is of legal age to have someone they trust to make decisions the patient is no longer able to make for themselves. Again it is important to realize that all one has to do is to take personal responsiblity for their live and what they want. It is not necessary to involve the government in the decision making process, all it takes is a simple form and two witnesses.

Yet if you are not familiar with these simple guidelines than it is easy to believe the bunk that Edwards mouthed.



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