All Australians should have equal rights in health. However, partners in same sex relationships do not have the same legal rights as those in heterosexual relationships. Also, not everyone is respectful of GLBT people and discrimination still occurs. Anxiety about decision-making and planning for the future can cause distress. When a person has a life-limiting illness, part of their care is affirming their individual identity and story, their relationships and needs. If sexuality is an important part of someone’s identity, then it should also be an important part of their care.
Health professionals
Health professionals may not be aware that someone is Gay, Lesbian, Bisexual or Transgender. Not all GLBT individuals will come out to someone they don’t know or feel comfortable with. Some may not feel the need. Some health professionals may also not be comfortable with this information.
A GLBT individual places trust in a health professional by disclosing theirsexuality to them. Health professionals should be aware of what support should be provided. It is important though, for each individual to discuss their needs. There is an Australian Charter of Health Care Rights which describes the rights of patients using the Australian Health system.
Patients may become unfairly stigmatized by health professionals. For example if a medical diagnosis, such as HIV/AIDS is assumed to have been contracted through male same-sex contact, in trading sex for money or as a consequence of needle sharing and IV drug use. Health professionals have a duty of care to educate and advise patients of how to reduce the risk of their disease to themselves and others. They don’t have the right to criticize a patient’s choices however.
Family
Family may not always be aware or accept GLBT status. Some GLBT individuals are not in close contact with their family of origin, and this can impact at the end of life. People who do not have their own practical support networks may find it impossible to stay at home once they need a lot of help. However, for some people this may also be a time for reconciliation with family, old friends or with children.
Not all GLBT individuals are open about their sexuality. Family and friends may not be aware of their relationships. Long-term friendships may not be recognised for what they are. This may mean the person who is ill or their partner may not be openly acknowledged. They may be unknowingly, and even knowingly, excluded. Health professionals should recognise a partner’s rights in end-of-life decision making in the face of family opposition or ignorance.
When someone is very ill
In end-of-life decision making, the preferences of the person who is ill to have a partner advocate for them may not be recognised by their family. This can be difficult and distressing.
Same sex partners may not be recognised either socially or legally. This could be in respect to carers leave, as next of kin in decision making, or in rights to benefits after a partner has died. Having a power of attorney will help make sure a partner can participate in decision making. A will is essential for GLBT individuals as same sex partners may not have rights without one. Estranged family members may have next of kin rights over and above a loved partner. This is particularly true where the partner does not live with the patient as is sometimes the case.
Bereavement
When the person who is seriously ill has died the partner left behind will be bereaved. This is difficult if the relationship was not acknowledged. They may not be able to openly grieve. It is important that same-sex partners are offered the same support that heterosexual partners would receive. They should not have to ask for it when they are already distressed.
Resources that can be accessed
This page was created on 03 November 2009 and will be reviewed in November 2011.