Further Thoughts on the Hospital Visitation Issue
Perhaps, the greatest irony about blogging is that it’s very often the posts to which we bloggers devote the least amount of attention that elicit the greatest amount of controversy. I had posted on the president’s hospital visitation order, in large measure, because my take nearly perfectly paralleled that of a the left-leaning lesbian friend who alerted me to the story. We both liked the result, but were concerned about the means.
I put together that post in a matter of minutes, eager to get it done so I could get on with my weekend. And it generated a relatively long thread in a very short amount of time, with solid arguments and intense acrimony.
Later, when I read some of the comments, it was amazing to see how many people, deliberately or not, misrepresented my view on the issue or used the space we offer to make juvenile and/or inaccurate accusations.
That said, amidst the bile, there was some very solid criticism of my free market approach. Darkeyedresolve addressed an issue I should have considered in my initial post:
I’m not sure how of a customer you are when you got into a hospital, most people get rushed to the nearest hospital in the event of emergency. You may not get the same treatment at that hospital as a opposed to the one you frequent, especially in an out of the state situation.
While normally a libertarian, opposed to government mandates, I’ve never had a problem with a government mandate that private hospitals treat people rushed there for emergency treatment. So, in that situation, I would certainly favor requiring hospitals to accede to the patient’s request to have the visitor of his choosing.
And thanks to reader Jason, we learn that hospitals were already required to recognize directives that individuals crafted giving others the right to make medical decisions.
And the directive allowing visitation appears only to be a reiteration of existing federal policy. Indeed, in those cases, where the same-sex partners of hospitalized patients are denied visitation rights, it appears that either the patient declined to craft said directive or “rogue” personnel at the hospital declined to enforce it. As David Link observes in his post on the Independent Gay Forum:
. . . there have been cases where hospitals have ignored the legally binding documents that same-sex couples have entered into. I don’t imagine this happens a lot any more, but every time it does, it is the most sickening, tangible kind of bigotry.
The problem is not the law then, but the hospital.
I recently read about a horrifying tale where a Washington State lesbian couple ad had gotten their ducks in a row, so to speak, only have to a nurse ignore their efforts. JoAnn Ritchie and Sharon Reed “had prepared for a medical emergency, creating living wills, advanced directives and power-of-attorney documents.” After JoAnn Ritchie, was hospitalized, dying of liver failure, she was moved to ICU at the University of Washington Medical Center. There, the nurse on duty
. . . refused Sharon access to JoAnn’s room and bedside, continually evicting her from the room. By the time Sharon regained access to her partner the next morning, JoAnn’s condition had deteriorated, and she was heavily drugged. She died within a matter of hours.
Reed has sued and the case is scheduled for trial this month, naming both the nurse and “her employer” as defendants. (From my research, it’s possible that that employer was not the hospital, but an employment agency as it appears the nurse was not a full-time staffer at the hospital.)
The issue here is not the absence of a directive requiring a hospital to follow a directive crafted by one of its patients, but the failure of a staffer at the hospital to recognize that legally binding agreement.
Contrary to what some of my critics might contend, I do hope Reed prevails.
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Yea, some people’s comments made it seem like a hospital set up is like going in to purchase goods from any business. I don’t see that as a case, its not like many cities have more than one major hospital. You usually also can’t just up and leave if you feel like your wishes are not being honored or your partner is being denied access to you.
The Washington Story is really sad, and its a worthwhile action to ensure that it doesn’t happen again.
Comment by darkeyedresolve — April 19, 2010 @ 9:06 am - April 19, 2010
Again: The implicit assumption is that some hospital would refuse a patient’s request to have a visitor of his choosing. Come on. What hospital? There is no issue there.
There may be cases where an incapacitated patient’s *legal agent* refuses certain visitors. But that comes later. And it’s legal. And usually, even that is a good thing – for example, the patient may have written an advance directive not to be visited by certain hateful relatives, people who normally would be admitted because, again, *hospitals are in the business of admitting visitors, among other things, and not excluding them.
Exactly. There was no need for it. It doesn’t accomplish anything – except for Obama to throw his weight around, i.e. to further extend the (supposed) authority of the Federal government.
What’s next – a directive from Obama that families be nice to each other and serve apple pie, if they in any way receive a Federal tax break or other (supposed) benefit? Then the Dear Leader’s fascist acolytes can say worshipfully, “Thank you, Dear Leader – because apple pie and family harmony did not exist, before you.”
Comment by ILoveCapitalism — April 19, 2010 @ 10:04 am - April 19, 2010
Really? Whose?
Obviously, a hospital provides services, not goods. Difference #1. Having said that, hospitals ought to be allowed to function as businesses. As opposed to the reality, that they have been burdened with decades of government mandates that prevent them from functioning efficiently. That also makes them very different from a goods business. Difference #2. So DER, who made it sound like a hospital is a goods business? I know I didn’t.
Back to Dan. Dan, you quote David Link:
And as you hint, Link refutes his own point in the very next sentence:
So again: Why have a special Federal order to solve a non-existent (or nearly so) “problem”?
Note that refusing to honor legally binding documents is itself illegal. In the rare cases where some rogue hospital administrator is determined to violate the law to begin with, why would Link believe an extra order from Obama will stop him? What evidence does Link, or any Obama acolyte, have for the power of Obama’s orders to inspire good in the hearts of criminals?
And guess what else? People who happen to be straight, also get their hospital visitation wishes illegally / criminally denied on certain rare, tragic occasions. It’s why we have a justice system, including State courts. Not everything is anti-gay bigotry, not everything needs Obama to solve it, and not everything should be made into a Federal case – unless you are, in fact, a fascist at heart.
Comment by ILoveCapitalism — April 19, 2010 @ 10:20 am - April 19, 2010
ILC: I find it ironic that you point out that we have a justice system and state courts. Oh really? These same courts that are called “activist courts trying to shove SSM down peoples’ throats”? Now your advocating running to the courts? Too rich.
Comment by Jim Michaud — April 19, 2010 @ 11:51 am - April 19, 2010
@IloveCapitalism
“Why don’t we allow the consumers (remember them — they’re the people who used to be able to afford to pay hospital bills themselves) to dictate who gets to visit whom in the hospital?
I know not every hospital allows same-sex partner visitation rights, and this is very wrong. But unless the hospital is run by idiots, or the decision is taken away from the management (by, say, the government), most of them can be brought around to understanding it isn’t very smart to piss off the consumer.
Remember when the customer was always right? Whatever happened to that guideline?
With every new layer of bureaucracy that is added to the system, consumer choice becomes less and less a factor.
Comment by Lori Heine — April 16, 2010 @ 10:05 pm – April 16, 2010″
I never said you did but that comment was to what I was referring to.
Comment by darkeyedresolve — April 19, 2010 @ 12:07 pm - April 19, 2010
Jim, not at all. I’ve never said it is wrong to go to the courts for redress of grievances. Such a position would be ridiculous.
What might be “rich” here, then, is your (apparently) getting off on ascribing positions to me that aren’t mine.
Comment by ILoveCapitalism — April 19, 2010 @ 12:07 pm - April 19, 2010
DER, thanks for taking the trouble to cite.
Having said that, I still don’t see how you interpreted from Lori’s comment that she thinks hospitals (what ought to be allowed to function as a service business, a business dedicated to serving the consumer) is like a store selling goods. I guess I will have to leave the matter between you and her.
Comment by ILoveCapitalism — April 19, 2010 @ 12:12 pm - April 19, 2010
Also Jim, while I’m still here… Perhaps you are confused about the difference between the legislative, executive and judicial functions. They are different things. If you really want to know, my position on court “activism” is that courts should do their job, i.e., they should do the judicial function… and *not* the legislative or executive functions. Simple. But if it strikes you as ironic or hypocritical or whatever, hey, go have fun with yourself.
Comment by ILoveCapitalism — April 19, 2010 @ 12:15 pm - April 19, 2010
(And as to legislating SSM or not, that is… the legislative function.)
Comment by ILoveCapitalism — April 19, 2010 @ 12:28 pm - April 19, 2010
“Having said that, I still don’t see how you interpreted from Lori’s comment that she thinks hospitals (what ought to be allowed to function as a service business, a business dedicated to serving the consumer) is like a store selling goods…”
Thanks, ILC. Darkeyed simply isn’t very smart.
Darkeyed, I will now introduce you to the difference between THINGS THAT ARE SIMILAR and THINGS THAT ARE EXACTLY ALIKE.
I believe they have exercises like that as part of most I.Q. tests. Obviously, you’ve never taken one.
There are likenesses in the way ALL private ventures operate, because the profit motive spurs them (unless it is an NPO, such as a charity, a fund supporting a symphony orchestra or something like that).
They are different, of course, in that the goods or services they provide may vary widely. We do not seem to have a problem, in this country, with gay people being turned away from emergency rooms and left to die. If that happens, of course it becomes a public safety issue and government would have to get involved.
No one has, as of yet, been able to explain to me why the profit motive would create less of a reason than the government can for hospitals to allow visitation by same-sex partners.
I’m not saying that such a visitation had never been denied, so don’t try to claim that I said that. I’m saying that THIS IS LESS LIKELY TO HAPPEN when the hospital is given an incentive to care whether its patrons are happy than it would when government is in charge and it’s all under the control of whoever currently has the most powerful political pull.
As gays are in the minority, and are never likely to get power that way, it would not seem to me that that way of seeking advantage would be particularly, well, advantageous for us.
Plese, Darkeyed, tell us again how Lori Heine has confused Banner Samaritan Medical Center with Uncle Joe’s General Store. It seems you really are trying to prove that liberals are stupid. We should let you continue where you left off.
Comment by Lori Heine — April 19, 2010 @ 12:34 pm - April 19, 2010
Do hospitals ask for proof of relationships? In my experience, your word is the proof. No ID is required. The legal documents are meaningless in the sense that no one looks at them and knows how to read them. This is a cultural and social issue. The law will never be enough. People have to accept the idea that there are valid alternative lifestyles.
Comment by anon2273892 — April 19, 2010 @ 12:42 pm - April 19, 2010
#11 No, they never checked in my case, even when I introduced myself as her ‘Partner’ and gave them the POA. I was still the primary contact all the way to the end.
Though it does make me think, “Social Networking: Because there is no patch for human stupidity.”
Comment by The_Livewire — April 19, 2010 @ 12:45 pm - April 19, 2010
Exactly. Contrary to all the social-fascist propaganda floating around, the profit motive, or having to compete for customers, makes businesses more consumer-friendly as well as more efficient.
In free markets, that is. Show me an instance where you think the profit motive worked makes businesses less consumer-friendly, and I will show you a market that the government (with all its directives, taxes, subsidies, rules, programs and mandates that effectively lessen competition for consumers) that is not free; a market that government has messed up and prevented from working.
Comment by ILoveCapitalism — April 19, 2010 @ 12:47 pm - April 19, 2010
Ugh, sorry for the crazy edit. Please let me try again. “Show me an instance where you think the profit motive has made businesses less consumer-friendly, and I will show you a market that almost certainly isn’t free; a market where the government (with all its directives, taxes, subsidies, rules, programs and mandates) has stepped in and prevented consumer competition from working.”
Someone suggested that consumer competition can’t apply to hospital emergency rooms because you go to the nearest one. Not true. There is a funny bit in The Simpsons, where Marge needs to go. The ambulance sign says it’s going to the Catholic hospital. Homer says no, he wants her to have the best care money can buy. The driver flips the sign to the Jewish hospital. Homer says “Ugh, not that good!” The driver flips the sign to the Presbyterian hospital. Now, that is fiction, but it illustrates my point: even in emergencies, people often have a choice of 2 or 3 hospitals to go to – often enough to bring consumer competition to bear.
Comment by ILoveCapitalism — April 19, 2010 @ 12:55 pm - April 19, 2010
I’m sorry ILC if I attributed some opinions to you. My bad. Is there anyone here who thinks we shouldn’t go to the courts at all? That said, what hospital in their right minds would refuse visitation by a partner? Not if they want to remain in business.
Comment by Jim Michaud — April 19, 2010 @ 1:39 pm - April 19, 2010
First part: Thank you. Last part: To my point; guess we agree on something.
Comment by ILoveCapitalism — April 19, 2010 @ 1:45 pm - April 19, 2010
Yes almost every time I went to the ER I was able to choose, you can always ask an ambulance to take you somewhere else. The only difference would be if you are unconscious.
Severe trauma, however, mandates going to hospitals equpped with certain trauma centers. Not every hospital will accept gunshot victims, they can’t handle them. if you walk in yourself of course they will treat you, but if you are in an ambulance, even if you ask for a different hospital they’ll take you to the one with the trauma center, NOT the nearest one, which in that case would be the correct way to service the customer.
That said, I don’t think anyone has asked me for proof, just took my word I was family. I can only think of the reason for not letting people in is if the patient requests it, or if too many people are in and out and the nurses think the patient isn’t getting enough rest, and so cracks down.
Comment by plutosdad — April 19, 2010 @ 2:10 pm - April 19, 2010
Also I don’t think it was “visitation” but making decisions for an unconscious loved one that is the real issue?
Comment by plutosdad — April 19, 2010 @ 2:11 pm - April 19, 2010
A review of the Reed case at http://caselaw.findlaw.com/wa-court-of-appeals/1510225.html; it appears that Reed and family were provided access to the Ritchie (the partner) while in the hospital. After being admitted, Ritchie was moved to ICU and was Reed and family were provided access for a bit.
When the nurse denied access it was for presumably medical reasons. And she denied access to everyone.
The characterization here is that she was denied access because they were same-sex partners. Nothing in the brief seems to indicate that is actually the case.
Comment by duane — April 19, 2010 @ 2:13 pm - April 19, 2010
[...] needing a little good PR after the health care “reform” debacle. It turns out that hospitals were already required to recognize directives that individuals crafted giving others the right to make medical [...]
Pingback by Solving a problem that wasn’t. — Pursuing Holiness — April 19, 2010 @ 2:13 pm - April 19, 2010
Likely so.
There again: The law establishes who the hospital is supposed to listen to. If you’ve made the right arrangements – marriage if you can get it, civil union if you can get that, or power of attorney for health care + Advance health care directive (probably best to do both of those together), then it is illegal for the hospital to not listen to your partner. I mean, already illegal. Without Obama’s order. No Obama needed.
Comment by ILoveCapitalism — April 19, 2010 @ 2:31 pm - April 19, 2010
A few years back, my other half suffered a perforated appendix and was in considerable distress. On a Sunday afternoon, we went to the ER at a 7th Day Adventist hospital in Kansas.
He was admitted and scheduled for surgery that evening. The staff kept me fully informed and I was allowed to stay with him in the ER and in pre-op while they got him ready for surgery. The staff were wonderful all the way through discharge.
I suspect most visitation issues originate with relatives, not hospital staff. The hospital is going to want documentation when the visitor claims to be a decision maker (rightly so).
I’m not sure Obama has actually solved an issue that actually exists these days.
As far as hospitals and “market forces”: When someone needs immediate care, they’re usually not in a position to shop around. If you’re having a heart attack or bleeding out, odds are you’re not going to be asking for a price sheet or a look at hospital policy.
Comment by SoCalRobert — April 19, 2010 @ 4:00 pm - April 19, 2010
SCR, try this on:
Is the point made, or should I say more? Oh, what the heck. It’s an invalid argument. Both theory and experience teach that the 10% or 20% or 50% or more who *can* shop around, make the necessary market forces for the benefit of those who can’t.
Comment by ILoveCapitalism — April 19, 2010 @ 4:11 pm - April 19, 2010
(that is: If government gets out of the way, allowing market forces to work)
Comment by ILoveCapitalism — April 19, 2010 @ 4:13 pm - April 19, 2010
“If you’re having a heart attack or bleeding out, odds are you’re not going to be asking for a price sheet or a look at hospital policy.”
No, but if you’re a hospital employee responsible for deciding whether to let a same-sex partner have access to a patient, and you know that indulging in your own, personal bigotry (let’s play along and call it “religious conviction”) will likely result in the hospital being pilloried in the media and yourself being fired (after being publicly identified, thereby hindered in your search for another job in the healthcare field), you might think twice about that.
Still no explanation as to why the government could do better…
Comment by Lori Heine — April 19, 2010 @ 4:17 pm - April 19, 2010
We all know how bad doctor-patient bedside manners are. This is no different. They are getting better with it, but not perfect. I think a new approach is necessary that appeases those who diagree with accommodating queer relationships. (Let’s play along and call it a same-sex accommodation.) However, lets look at the broad picture.
Every patient should be free to enjoy their own guests without restrictions from the hospital staff within reason. Afterall, there are many other home-life situations as well that are not exactly ideal. There are plenty of people who have shack-up honeys and bastard children.
The hospital should agree that patient happiness will help in recovery. If the situation is terminal, the patient should see loved ones as much as possible. However, it should be made clear that all such accommodation isn’t possible. Hospitals are places where there are working professionals keeping people alive. The goal is patient care.
Comment by anon2273892 — April 19, 2010 @ 6:59 pm - April 19, 2010
I’m really surprised how much substantive debate the hospital visitation issue has elicited here. In my view, the bigger picture is that Obama has once again “bravely” taken on a problem head-on that is obscenely inconsequential in context. Once the full weight of Obamacare is unleashed on the US healthcare insurance industry and the US healthcare system, and the reality of a 40,000 shortage of primary care physicians is finally acknowledged by the state-run media, we are all going to look back on this time and think how ADORABLE it was that just a few years before we had the luxury of debating the controversial issue of how quickly our boyfriends could be ushered to our bedsides (STAT!) if we were ever, God forbid, hospitalized.
Yeah, the VIP list of who gets past the nurses station to see us in the hospital is the BIGGEST issue our nation is facing when it comes to healthcare. Just like reducing nuclear proliferation between ourselves and Russia is the most IMPERATIVE issue that Obama should be taking by the horns, right?
How is it possible that Obama is getting away with this charade of governance? Next week, the media will probably be licking his balls for signing a new law that protects only UNEMPLOYED gay people from discrimination in the workplace. It would be perfectly consistent with how Obama approaches every other issue–our partners will be legally authorized to bring us a “get well soon” mylar baloon in the hospital, but there won’t be any beds or doctors available to treat us. The US and Russia will dramatically decrease their nuclear capabilities just as Iran gets fully locked and loaded against Israel and those who would defend her. Why shouldn’t unemployed gay people be protected from discrimination in the workplace? I’m sure the lefty blogs will at least praise it as “a step in the right direction toward protecting gays in the workplace who are actually still working in the workplace.” I guess the only issue is whether Obama TELLS US that what he’s doing is remedying a horrible, festering problem. That’s all that matters.
Comment by Sean A — April 19, 2010 @ 9:22 pm - April 19, 2010
The overall point here is that Il Douche is throwing yet another bone to gays so they’ll STFU and love him again. End of story.
Comment by ThatGayConservative — April 20, 2010 @ 5:11 am - April 20, 2010
Here in Australia, and I am talking close to 30 years ago, I had an experience where two lesbians had given birth to baby boys. The hospital was Mercy Maternity in East Melbourne. Now the point of this story is that one of the women had already given birth some time before the one who was in the ward with me. As I remember the situation the partner was actually quite obnoxious. She was not prevented from visiting her partner, and it was not an issue with the other women on the ward, it was simply the obnoxious behaviour involved. In the end the woman who had just given birth was discharged. To be honest it was a relief when she was sent home.
There is a post-script to the story: both boys were kept in the same cot. It turned out that one of the babies died as a result of cot death a few months later.
Comment by StraightAussie — April 20, 2010 @ 6:17 am - April 20, 2010
As a nurse I would just like to point out that in the example used -the nurse not allowing in or chasing a partner out of ICU-many ICU’s only allow 5 minute visitation every 2 hours and some restrict the hours further with no visitation during the night. However, many ICU’s are lax in enforcing the hours they have posted (with nods from the administration)-an agency nurse might (again might) have only been enforcing the posted visitation policy. It is not possible to tell from the linked report.
Comment by Skye — April 20, 2010 @ 8:32 am - April 20, 2010
Except it’s a bone that is already theirs.
Hey TGC, guess what, I just issued a decree granting you your underwear and guaranteeing your conservative viewpoint. Donate to my campaign?
Comment by ILoveCapitalism — April 20, 2010 @ 10:33 am - April 20, 2010
I know, but the Gay Inc. has convinced the stupid drones that they DON’T have it already. Ergo, it’s easy to toss the bone to them.
Can you decree my truck fixed? So far, Levi hasn’t coughed up the cash to take care of it.
Comment by ThatGayConservative — April 20, 2010 @ 3:43 pm - April 20, 2010