歐巴馬對於同志伴侶探病權簽署的備忘錄

 

在美國，對於病人的探視權有極嚴格的規定，除親屬外，其他人不大被允許探病，

然而，該項規定對於擁有親密關係的同志伴侶卻是一大阻礙，

為此，總統歐巴馬於 2010 年 4 月 15 日簽署了一篇備忘錄，

要求任何接受聯邦醫療保險與醫療補助資助的醫院，讓病患的同志伴侶有權探視。

以下是備忘錄的中譯（感謝虎虎虎先生提供）以及英文原文：

 

白宮

發言人辦公室

請即發布

2010  年 4 月 15 日

總統備忘錄──醫院探視


給衛生及公共服務部部長的備忘錄

主旨：關於醫院病人接受訪客及指定醫療緊急代理決定權人之權利

 

在我們的生命中有些時刻，當我們所愛的人住進了醫院，需要更大的同情和陪伴。在這需要的幾小時，

 

痛苦和焦慮的時刻，我們都希望有一個手可以握住，一個肩膀可以依靠－心愛的人為了我們在旁邊，就

 

如同我們將陪在他們身邊一般。

然而每一天，在全美國，都有患者被剝奪親人在身旁的好意和關懷－無論是突發緊急醫療或長期住院。

 

通常，無子女的寡婦或鰥夫被剝奪了來自好友的支持與安慰。宗教修會的成員們，有時只能選擇由直系

 

家庭成員而不能選擇其他人探訪，並代表他們作出醫療決定。此外特別受影響的是同性戀者，他們往往

 

被禁止到與他們可能以幾十年生命陪伴的伴侶病床邊，無法在他們的愛人身邊，如果他們的伴侶無行為

 

能力，也不能作為他們的法律代理人。

 

 

這意味著，醫生和護士也無法總是擁有關於病人的藥物和病歷的最佳資訊，也同樣代表朋友和特定家庭

 

成員不能作為協助傳達病人需求的中間人。這意味著，具有壓力甚至有時候令人感到恐怖的經驗無謂使

 

病人加劇失去尊嚴、並且不公平。它意味著往往是由人民孤單承受痛苦，甚至孤單地去世，被剝奪了最

 

後時刻陪伴的安慰，而同時他們所愛的人被留下、擔憂並且離開醫院。

許多州已採取措施以盡量杜絕這些問題。北卡羅萊納州最近修改了其病人的人權法案，使每個病人「有

 

權指定哪些訪客應得到與病人的直系親屬同等的探視特權，不論該名訪客與該病人是否有法律親屬關

 

係」－此一權利適用於該州的每一個醫院。德拉威州，內布拉斯加州和明尼蘇達州也採取了類似的法

 

律。


我的政府可以擴大這些重要步驟，以確保病人在他們住院期間能得到關愛和平等的對待。通過這一備忘

 

錄，我要求您採取以下步驟：

 

 

1.根據 42 U.S.C. 1395x 和其他有關法律規定賦予您的權力，開始制定適當的規則，以確保參加醫療保

 

險或醫療補助的醫院，尊重病人指定訪客的權利。應當明確指出被指定的訪客，包括具法律效力預先指

 

令所指定的個人（例如擁有授權書和保健的代理人），應享有探視特權，相較於直系家庭成員所享有的

 

探視權，不得有更多限制。您還應該規定，參加醫療保險或醫療補助之醫院不得基於種族，膚色，民

 

族，血統，宗教，性別，性取向，性別認同，或殘疾的原因而拒絕探視特權。該規則制定並應兼顧醫院

 

限制探視的需求以提供醫學上的適當環境，以及臨床醫務人員對病人的護理或治療所作出的決定。

2.確保所有參加了醫療保險或醫療補助的醫院是完全遵守法規，編纂於 42 CFR 482.13 and 42 CFR

 

489.102(a) 項，頒布以保證所有病人的預先指示得到尊重，例如擁有授權書和保健的代理人，並且病

 

人的代表有權作出有關病人護理的知情決定。此外，我要求你依照 42 U.S.C. 1395cc  和其他有關法律

 

規定所賦予你的權力，發出新規則，提供技術援助，如何使參加醫療保險或醫療補助的醫院最能符合法

 

規，並採取任何其他適當措施，以充分執行該等規定。


3. 影響到同志病人及其家屬的醫院探視、醫療決策，或其他醫療問題上，衛生和人群服務部可以採行的

 

各種行動，請在這份備忘錄發布的 180 天之內，提供其他額外的建議給我。

 

本備忘錄無意也並未創建任何一方可以針對美國，它的部門，機構或實體，其職員，僱員或代理人，主

 

張任何實體上或程序上，可依法執行或同等之權利或利益。

 

您被授權及指示發表這份備忘錄在聯邦登記冊。


巴拉克　歐巴馬

 

 

The White House　

 

Office of the Press Secretary　

 

For Immediate Release　

 

April 15, 2010　

 

Presidential Memorandum - Hospital Visitation　

 

MEMORANDUM FOR THE SECRETARY OF HEALTH AND HUMAN SERVICES

 

SUBJECT: Respecting the Rights of Hospital Patients to Receive Visitors and to Designate

 

Surrogate Decision Makers for Medical Emergencies

 

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 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.

BARACK OBAMA