What you don’t know is enough to make you sick
by Stella Fitzgibbons, MD
I know, you thought doctors didn’t even like lawyers. But after 20-plus years of seeing the legal problems my LGBT patients have, the question “Do you have a family lawyer?” generally finds its way into my first visit with them.
Nobody likes to think that they might become unable to make decisions for themselves. But a sudden illness or injury, while it may not affect your thinking, can require pain or anxiety medicines that make you too sleepy to handle complex questions, and, at least temporarily, somebody else will have to speak for you.
President Obama signed an order last year that forbids hospitals to discriminate against patients’ visitors on the basis of race, sexual orientation or similar grounds—but it’s still essential to have your preferences on this and other issues spelled out in writing ahead of time.
In Texas, a person’s spouse—the hetero kind—gets top priority as a proxy decision-maker, followed by adult children. If you don’t have either of those, your parents get the job—even if they tossed you out when you were a teenager or only contact you by mailing you ads for “gay cures.” They can and sometimes do control hospital visiting privileges, leaving the person closest to you unable to do anything to help, as a Florida lesbian couple found out several months ago when one lay dying.
During the dark years of the AIDS epidemic, healthcare workers saw a lot of painful situations: parents refusing treatment “because his sin caused the illness,” nurses sneaking non-approved visitors into patients’ rooms, a family who left town as their son was dying and told me not to call them until it was time to make burial arrangements. Nowadays, even though HIV is just another chronic illness, albeit an expensive one, there are plenty
of other health problems out there.
If heteros live together in Texas without a formal ceremony, the laws on common-law marriage help a fair bit; the domestic partner usually need only call him/herself a spouse and—badda bing—they’re married. If any Texan dies without a will, the legislature has solutions that at least settle the question of what to do with his or her property, though you may not like them much.
As a doctor, the first thing I beg you to get is a durable power of attorney for healthcare. This lets you specify who will speak for you if you can’t. This can be anybody: not just a partner, but your favorite cousin or somebody who is a good friend and knows something about the healthcare system. One of my AIDS patients designated his ex-sister-in-law, and she did a wonderful job. (The patient’s family . . . well, let’s not go there.) I even met a nurse once who did this for a fee and provided additional help by explaining medical issues in a way the patient could understand.
Now look at other things that can go wrong: is the house only in one person’s name? What about raising your children? Do you want half your belongings to go to AIDS Foundation Houston on your demise? And there’s other stuff that I don’t pretend to understand involving taxes—I just nod my head and smile when our family lawyer tells me what we need.
In spite of everything that we doctors tell you about preventing problems, something always gets away from us. You can avoid many painful situations by having the right legal documents stored in a safe place. You need a lawyer for that just as surely as you need a doctor when you’re sick enough for a hospital stay.
Stella Fitzgibbons, MD, has practiced medicine in Houston since 1981, both in primary care and in hospitals. Her interest in LGBT issues started with a gay brother and continued through the years since HIV appeared.