Friday, April 16, 2010

President Obama's memorandum on increased patient rights to designate hospital visitators and medical powers of attorney

In a memorandum, President Obama has directed the Department of Health and Human Services to draft rules allowing hospital patents to designate visitors, and to afford the visitors at least the same level of access as immediate family members. The rules would apply to all hospitals that participate in Medicare or Medicaid. Members of LGBT families would be among designated visitors guaranteed equal protection of visitation privileges. The rules would also require the hospitals to have policies for honoring patient designation of medical powers of attorney when patients are, or become, incapacitated. (NY Times / LA Times / Washington Post / LGBT POV)

Law professor John Culhane has a predictably perceptive insight on what President Obama has accomplished. Having argued over a decade for marriage equality, he understands that marriage equality would do much more to remedy problems of discrimination against same-sex couples. But "read the Memorandum closely," he urges, "and you’ll see that the requested change goes far beyond marriage equality: The idea is to allow people to designate the person of their choice (either “on the spot” or through advance directives) to visit them in the hospital ... That respect for individual autonomy and decision-making in the most challenging circumstances is the great accomplishment of this Memorandum, and it shouldn’t go unacknowledged." (WordinEdgewise)

Mainstream media have represented the LGBT community as divided on the importance of Obama's memorandum. (Washington Post) The news has had a welcome reception among several advocacy organizations, including GLAAD, Lamda Legal, the National Gay and Lesbian Task Force, and the Human Rights Campaign. HRC Vice President David Smith called the development "a huge deal." (NY Times) This view has support in the tragic circumstances of an LGBT family that led to a lawsuit filed by Lamda Legal and an apology by President Obama. (The Miami Herald reports on what happened to that family and the subsequent lawsuit.)

While praising the decision, other advocates of marriage equality reserve criticism about what it falls short of. "[T]he dynamic leaves" Andrew Sullivan "queasy." (Daily Dish) Marriage Equality New York asks its supporters to share their appreciation with the President, but to also let him know "that we expect more from the White House on marriage equality." (MENY Marriage News) "It's not full equality, but it's something," says Maia Spotts of "[D]oes HRC really think this is a huge deal," asks blogger John Aravosis, "or are they simply, yet again, working for the President rather than working for the community?"

The memorandum already has opponents. Peter Sprigg, a senior fellow for policy studies at Family Research Council, questions the President's political motivations, even though he does not reject the proposed benefits for LGBT families. (Washington Post) Pretending to separate intent from outcome, Sprigg said that the memorandum must be taken in its "political context." In that context, he claims, it "clearly constitutes pandering to a radical special interest group. The memorandum undermines the definition of marriage, and furthers a big-government federal takeover of even the smallest details of the nation's healthcare system." (LA Times)

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