An Open Letter to Governor Robert L. Ehrlich, Jr.
May 18, 2005

EQUALITY MARYLAND
Contact: Dan Furmansky, Executive Director
Phone:    Office 301-587-7500
Cell    301-461-4900
Email:  dan@equalitymaryland.org

Governor Robert L. Ehrlich, Jr.
State House
100 State Circle
Annapolis, MD 21401-1925

May 18, 2005

Dear Governor Ehrlich,

As you consider the merits of the Medical Decision Making Act (Senate Bill 796 - Sen. Joan Carter Conway) from a policy perspective, a small but vocal group of individuals seek to turn this bill into a political wedge issue. Unfortunately, the rhetoric of these individuals is obscuring the compelling need for this legislation.

Picture the agony of knowing that your spouse is in her last moments of life after a long, debilitating illness. You have pledged to make sure she is not alone when she slips out of this world. But in those final, crucial moments, you are barred from seeing her, told you are a stranger. Your wife dies alone and you have broken your promise.

I am sure you will agree that it is our loved one's hand that we want holding ours when we are in the intensive care unit awaiting treatment. It is their voice we want speaking on our behalf when we our unconscious and unable to speak for ourselves. It is their reassuring smile we need to see when we are being transported to a hospital. And it is that person's knowledge of our wishes that we hope will guide the crucial decisions about how our bodies will be treated when we pass away.

The Medical Decision Making Act is about ensuring that those Marylanders without a legal spouse, but nonetheless in committed, loving relationships, are not left alone and afraid, enduring the pain and heartache of being told "you have no right to be here" or "but you're simply not family," or "I'm sorry those documents aren't on you, but without them, I can't let you in to see her."

Attached to this letter are real stories about Maryland couples that have come to my attention over the past year. These families have faced humiliating and frightening obstacles at the most critical times of their lives that could have been avoided had the Medical Decision Making Act been law. Many of these individuals traveled to Annapolis to recount their experiences to legislators and to testify in favor of this bill. These Senators and Delegates recognized the problem and found a solution.

I urge you to take a moment to review these stories before you make your final decision about the Medical Decision Making Act. It is these Marylanders I hope you keep in mind when you are making your decision as to whether or not you will sign this bill into law. These citizens, your constituents, deserve the peace of mind and basic protections that are found in this legislation.

Thank you for taking the time to consider this issue seriously.

Sincerely,

Dan Furmansky
Executive Director
Equality Maryland
www.EqualityMaryland.org

WHY IS THE MEDICAL DECISION MAKING ACT NEEDED?

Takia Foskey and Jo Rabb experienced first-hand how arbitrary hospital treatment of unmarried couples can be. Jo was overcome with pain while working as a Baltimore City bus driver and was taken to St. Agnes Hospital. She was given painkillers that made her unable to understand much of what the medical staff was telling her. Takia was denied access to Jo, information about Jo's condition, and a place in the family waiting room. Other family members who couldn't be present, including Jo and Takia's children and Jo's elderly mother, asked Takia for information she couldn't give them because the hospital staff didn't regard Takia as a "family member." Takia had to leave Jo alone to go home to their children and when she returned the next day, Jo was being prepped for surgery. The surgeon, not the same physician who had handled Jo's admission and diagnosis, allowed Takia to stay with Jo until she was taken into the operating room. He also called Takia at home with updates on Jo's condition. The follow-up visit, however, brought Takia and Jo back to the original admitting physician. He didn't remember Takia, so she told him she was Jo's sister. Unmarried couples should not have to lie about their relationships in order to get vital information about their loved ones' condition and care.

Like many people in our state, Russell "Rusty" Carbaugh came to live and work in Maryland as an adult, leaving his parents and extended family thousands of miles away in another state. Two years after Rusty and his partner, Bryan, moved to Baltimore, Rusty was diagnosed with a heart condition. His testing and diagnosis required hospitalization. The process was stressful-frightening, in fact. Rusty asked that Bryan be included in the discussions about his condition, treatment, and prognosis. As his partner, Bryan knew him better than any other person; he knew his medical history, his religious beliefs, and his wish to be an organ donor. Bryan is Rusty's closest relative geographically and emotionally; his biological family in his home state recognizes this. The medical facility where Rusty was being tested informed him that "partners are not family." As Rusty was being told that his treatment might cause cardiac arrest, he was also told that the one person who would be with him to care for him could not be a part of the information and decision-making process.

Clayton Spivey and her partner were careful people, spending hours with their attorney to create advanced directives and powers of attorney so that they would be able to be together and make necessary decisions for each other if either of them was incapacitated. In 2004, when Clayton was admitted to Union Memorial Hospital in Baltimore for her knee replacement surgery, she gave her advance directive to the hospital clerk when she checked in, asking that it be added to her file. She also informed the hospital that her partner held her medical power of attorney and requested that the hospital keep her partner informed of her condition. None of these requests were honored. Following her surgery, Clayton was alone in recovery for seven hours, waking periodically only to see other patients with their spouses. She asked for her partner, but personnel never accommodated in her request. She later learned that her partner had been requesting information and had been asking to be brought to her, but her requests were denied on the grounds that "the recovery area was too crowded."

Eduardo is a widower, though not legally recognized as such. When his partner of several years was dying in the hospital, his partner's parents, who were estranged from their son because of his sexual orientation, barred Eduardo from visiting. Hospital personnel complied with the parents request because Eduardo was not recognized as family, and his dying partner was not conscious enough to request Eduardo's presence. Eduardo was only able to visit his partner in the hospital during the shift of one compassionate nurse whose shift began at 2:00 a.m.

Donald Johnson met with hurdle after hurdle in executing his late partner's will because, even though they had been together for years and had raised two children together, he was not Kenneth Tennison's blood relative or spouse. He was not able to have Kenneth's body cremated as directed in Kenneth's will without a letter from Kenneth's elderly mother. He was not allowed to deduct from his taxes the medical expenses he paid because he was not a blood relative. He was not allowed the Social Security stipend intended to help with the costs of funerals because he was not a blood relative. Spouses are not forced to navigate these barriers. While the Medical Decision-Making Act currently under consideration would not remedy all of these barriers that stand in the way of partners, Donald would not have legal problems in executing his partner's posthumous wishes for disposition of remains had this bill been law.

Mary Beth Dyer and her partner Fran have been together for more than fifteen years. That didn't matter to the doctor who was assigned to Mary Beth's case when she was hospitalized with unexplained blood-loss in 2000. Mary Beth's father had to come from another city to speak with the physician and relay the information to Fran. Even though Fran was clearly the person who would take over caring for Mary Beth after her release, the doctor refused to talk to her. Mary Beth's father had to relay information from the doctor to Fran throughout Mary Beth's hospital stay. Mary Beth and Fran would gladly register as domestic partners to protect their right to care for each other in future illnesses.

John Lestitian was widowed after thirteen years when his partner James (Jim) Bradley passed away. Jim's family lives in Indiana and had not been close to him. Jim had made arrangements for the disposition of his body, but John was not allowed to carry out Jim's written directives without the consent of Jim's parents. John was only allowed to carry out Jim's wishes for cremation and placement of his ashes after negotiating with Jim's father and agreeing to send a portion of the remains to Indiana for burial. Jim had taken trouble to make arrangements in accordance with Maryland law, but because his relationship with his partner was not recognized, his arrangements for his own body were not honored in Maryland until an estranged parent in another state could be convinced to comply.

Jodi Kelber-Kaye and Stacey Kargman-Kaye have repeatedly had to rely on the assistance of sympathetic hospital staff in advocating for their rights as partners and parents. When Stacey was hospitalized for surgery, Jodi waited for her in her room. One of the nurses was so adamant about Jodi's leaving the room because she was not "a family member," that she tried to physically push Jodi out. The nurse who brought Stacey into the room intervened and spoke on Jodi and Stacey's behalf. Stacey faced the same kinds of attempts at eviction when Jodi gave birth to their son and he needed to be taken to the neonatal nursery before Jodi was ready to accompany him. One nurse repeatedly asked her, "Just who are you?" The situation was only resolved when Jodi was able to come to the nursery from her delivery. Partners in Maryland need laws that clarify their rights in emergency medical situations.

Lisa Polyak and her partner, Gita Deane, have been in a committed, loving relationship for 24 years, and have 2 daughters. Lisa and Gita experienced shame and separation at a time when they should have had no other focus than the new life they were about to bring into the world. They were in the labor and delivery ward at Union Memorial Hospital in Baltimore, and Gita was pregnant with their 2nd child. Gita's labor contractions became too intense and Gita asked for an epidural. The couple had gone to considerable effort to inform the labor nurses, the obstetrician and attending staff that they were together as partners and wanted to be treated that way for the duration of their hospital stay. They filed a Birth Plan, brought along copies of Power of Attorney, and did all the planning they thought was necessary. When the the anesthesiologist arrived to administer the epidural and prepared to thread the catheter into Gita's spine, Lisa was sitting with her - holding her hand and rubbing her back as the labor pains peaked and receded. The anesthesiologist forced Lisa to leave upon finding out she was not "family." Lisa left the room in the interest of expediting the procedure.

In 2003, Tom Ellwanger's partner of 37 years suffered a grand mal seizure and was taken to a Catonsville hospital. During the admission process, hospital personnel took a decidedly "who are you" approach to Tom, and his partner was incoherent and incapacitated. During the night, his partner went into shock and was moved to Adult Intensive Care Unit (AICU). Tom was not notified, and found out only after a phone call to the hospital later. Tom repeatedly had to call his partner's "real" family in Louisville, KY, to whom he is not particularly close, to get permission for procedures.

Bill Flanigan had to live through everyone's worst nightmare when his partner, Robert Daniel, became critically ill while they were traveling together. Alone in a strange city, they were separated during Robert's precious last hours. Bill and Robert were registered domestic partners in their home city of San Francisco. When they traveled to the east coast, they brought their durable and medical powers of attorney with them, knowing that Robert's health was fragile. In Havre de Grace, the staff at Harford Memorial Hospital made them both as comfortable as possible and allowed Bill to remain with Robert through the night. When Robert was transferred to the Shock Trauma facility in Baltimore, their nightmare truly began. Bill waited for information and access to Robert, but was not called up from the waiting area. He asked for information and was told that partners were not accepted in Shock Trauma. Bill knew that Robert's medical power of attorney was in his file, and asked that a supervisor be sent so that he could explain his need to be with Robert. No supervisor ever responded to his request. Four hours after Bill and Robert arrived at the Shock Trauma unit, Robert's sister arrived from another state. She was immediately brought to Robert's side, and she demanded that Bill also be brought in to Robert. When Bill and Robert were finally reunited, Robert had lost consciousness, and never regained it. Bill and Robert were denied their right to be together as Robert lay dying. Robert's own wishes about his medical care were ignored when Bill was not allowed to advocate for him. Bill is haunted by the promises he made and was not able to keep. He promised his partner that he would not be forced to undergo unwanted life-extending interventions. He promised his partner that he would not be alone. He promised that they would say goodbye to each other.

Bonnie faced a difficult situation when her partner, Cassie, was hospitalized for depression. As a nurse, Bonnie understand the importance behind medical power of attorneys and advanced directives and had all the documents in place so she would be the decision maker regarding any medical changes or treatment plan for Cassie. Despite advising the hospital staff in the ER and in the unit where Cassie was admitted that there should be NO medication changes or treatment plan changes without prior consent from Bonnie, a social worker and doctor at Carroll Hospital Center did not pay any attention to these expressed directions. They continued to bypass Bonnie and inform Cassie of decisions about medication changes or discharge dates. Cassie was in no position to be making yes and no decisions, and wanted Bonnie to advocate on her behalf. When Bonnie pointed this out to staff repeated times, they replied that they did not understand why it was that way; they wanted to know "who are you?" The staff did not understand their relationship, so they ignored the paperwork.

Mark F. Scurti, Esq. went to visit his partner at Sinai Hospital in Baltimore a few years ago, after his partner's surgery. When entering the area, he was approached by hospital staff inquiring as to his relationship to the patient and unless he was "immediate family" he was not allowed to visit. He told the hospital staff he was his partner and that he had a health care directive providing him specifically with visitation and medical power of attorney. Unfortunately he did not have the document at that time and had to return home to retrieve the form before returning to the hospital for a visit. The document was then scrutinized by the hospital staff and only an hour later was he allowed access for visitation. The next morning he arrived and again was approached with the same question by different hospital employees. Responding quickly, he stated that he was his attorney (which he is) and the hospital allowed him immediate access, no questions asked. Had the registry been in place and a state issued certificate, there would be no questions as to his rights to visit with his partner during hospitalization. Each health care directive is different and may have some nuisances that are modified from the unofficial suggested forms on the attorney general's website.

For a copy of any of these individual's complete testimony, please contact Equality Maryland at 301/587-7500.