Medical Decisions

After a lively debate that included alternate charges of "promoting the radical homosexual agenda" and being "homophobic," the Senate passed a bill yesterday to give medical decision-making rights to all unmarried couples who sign onto a domestic registry. The 31-16 vote came after two days of heated debate and marks a significant step toward the bill becoming law. The House of Delegates overwhelmingly passed a similar bill last year and passage is expected again in that chamber. The Senate's wide margin of approval yesterday was seen as a victory for the gay and lesbian rights community, which was championing the bill as a top priority this year.

Jodi Kelber-Kaye was thrown out of a hospital room when her long-time partner was emerging from heart surgery. Lisa Polyak was refused access as her partner received an anaesthetic before giving birth to their second child. And John Lestitian was left to haggle with the estranged parents of his late partner over their son's death wishes. All say they would have been helped by a bill up for a vote by the state Senate today that would create a registry of domestic partners and give unmarried couples such benefits as the right to make medical decisions for one another and visit each other in the hospital.

The Maryland House of Delegates overwhelmingly approved yesterday a proposal that would open the way for adults in committed relationships to share life-or-death decisions by registering on a state database. Also yesterday, the House approved a bill to encourage the use of renewable energy. And a Senate committee approved an amended version of Gov. Robert L. Ehrlich Jr.'s environmental cleanup measure known as the "flush tax," and a key senator predicted the legislature would abandon plans to require paper receipts on the state's new electronic voting machines in time for this fall's election.

ON ONE POINT, supporters and opponents of legalized abortion can agree: Any late-term abortion procedure is difficult, both physically and morally.In Maryland, as in many other states, abortions are already illegal past the point at which a fetus can survive outside the womb -- a point reached late in the second trimester of pregnancy. The power to make such decisions was reserved to the states in Roe vs. Wade, the Supreme Court decision legalizing abortion in the early stages of pregnancy.

YOUR MARCH 20 editorial, "Curbing the power of HMOs," contained a number of factual errors. The most blatant one was your assertion that "medical decisions are made not by physicians . . . but by bean-counters. . . ."I have been a sole practitioner for 25 years in Columbia. My specialty is family practice and I belong to several HMOs (over two-thirds of my patients are members of HMOs).I have never been told how to practice medicine by any HMO.I have been given practice guidelines on selected diseases (like asthma and heart failure)

Emissions test crucial to environmentAs people who have had cars tested on the new dynomometer and who would like Maryland's children to be able to breathe clean air, we were dismayed by recent legislative actions to delay the important Vehicle Emissions Inspection Program.We have pushed utilities, industries and auto manufacturers to clean up the air pollution that their companies create; we will continue to do so. But we must also make sure car owners are doing their part to maintain their cars properly.

HMO regulations raise many more questionsIn a March 12 letter, "HMOs seen in need of more regulations," Steve Shearer supports legislation making physician administrators in health maintenance organizations accountable for their medical policy decisions.He references a March 5 article, "Stronger oversight of HMOs sought," that detailed current legislative efforts to micromanage health care in this state. I say such efforts are Band-Aids. We need a tourniquet.State and federal legislation created the problem.

A BILL that would require health insurers to give patients the right to appeal unfavorable decisions on coverage would not entirely correct the imbalance of power that characterizes many of these situations. But it would be an important step in the right direction, and we urge its passage -- provided that insurers bear some of the costs.Health insurers, especially health maintenance organizations and other managed care groups, have profited handsomely on their ability to control spiraling costs for medical care.

WHEN IS LIFE no longer worth living? That ancient question has long received a standard response: That is not for men and women to decide.What about the 94-year-old woman who is "ready to go" but finds a new lease on life after a cataract is removed? Or the cancer patient who says he "can't take it anymore" -- until he gets proper pain medication? And what about the uninsured father who faces the agonizing choice of using his meager savings for treatment or finding a way to "go quickly" and leave something for his family to live on?

A former chief of Howard County General Hospital's medical staff is suing the hospital and three doctors for at least $80 million, alleging that "bad blood" and racism -- rather than questionable medical decisions -- led to the suspension last year of his privileges at the facility.In a federal lawsuit filed Monday, Dr. Kline A. Price Jr. -- a black gynecologist who claims to be Columbia's first private doctor and is the brother of National Urban League President Hugh B. Price -- lists a host of alleged medical miscues performed at the Columbia hospital by white physicians that were not punished.