[Federal Register: April 20, 2010 (Volume 75, Number 75)]
[Presidential Documents]
[Page 20511-20512]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr20ap10-106]
Presidential Documents
___________________________________________________________________
Title 3--
The President
[[Page 20511]]
Memorandum of April 15, 2010
Respecting the Rights of Hospital Patients to
Receive Visitors and to Designate Surrogate Decision
Makers for Medical Emergencies
Memorandum for the Secretary of Health and Human
Services
There are few moments in our lives that call for
greater compassion and companionship than when a loved
one is admitted to the hospital. In these hours of need
and moments of pain and anxiety, all of us would hope
to have a hand to hold, a shoulder on which to lean--a
loved one to be there for us, as we would be there for
them.
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.
For all of these Americans, the failure to have their
wishes respected concerning who may visit them or make
medical decisions on their behalf has real
consequences. It means that doctors and nurses do not
always have the best information about patients'
medications and medical histories and that friends and
certain family members are unable to serve as
intermediaries to help communicate patients' needs. It
means that a stressful and at times terrifying
experience for patients is senselessly compounded by
indignity and unfairness. And it means that all too
often, people are made to suffer or even to pass away
alone, denied the comfort of companionship in their
final moments while a loved one is left worrying and
pacing down the hall.
Many States have taken steps to try to put an end to
these problems. North Carolina recently amended its
Patients' Bill of Rights to give each patient ``the
right to designate visitors who shall receive the same
visitation privileges as the patient's immediate family
members, regardless of whether the visitors are legally
related to the patient''--a right that applies in every
hospital in the State. Delaware, Nebraska, and
Minnesota have adopted similar laws.
My Administration can expand on these important steps
to ensure that patients can receive compassionate care
and equal treatment during their hospital stays. By
this memorandum, I request that you take the following
steps:
1. Initiate appropriate rulemaking, pursuant to your
authority under 42 U.S.C. 1395x and other relevant
provisions of law, to ensure that hospitals that
participate in Medicare or Medicaid respect the rights
of patients to designate visitors. 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
[[Page 20512]]
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.
2. Ensure that all hospitals participating in Medicare
or Medicaid are in full compliance with regulations,
codified at 42 CFR 482.13 and 42 CFR 489.102(a),
promulgated to guarantee that all patients' advance
directives, such as durable powers of attorney and
health care proxies, are respected, and that patients'
representatives otherwise have the right to make
informed decisions regarding patients' care.
Additionally, I request that you issue new guidelines,
pursuant to your authority under 42 U.S.C. 1395cc and
other relevant provisions of law, and provide technical
assistance on how hospitals participating in Medicare
or Medicaid can best comply with the regulations and
take any additional appropriate measures to fully
enforce the regulations.
3. Provide additional recommendations to me, within 180
days of the date of this memorandum, on actions the
Department of Health and Human Services can take to
address hospital visitation, medical decisionmaking, or
other health care issues that affect LGBT patients and
their families.
This memorandum is not intended to, and does not,
create any right or benefit, substantive or procedural,
enforceable at law or in equity by any party against
the United States, its departments, agencies, or
entities, its officers, employees, or agents, or any
other person.
You are hereby authorized and directed to publish this
memorandum in the Federal Register.
(Presidential Sig.)
THE WHITE HOUSE,
WASHINGTON, April 15, 2010
[FR Doc. 2010-9211
Filed 4-19-10; 8:45 am]
Billing code 4110-60-P