Not Dying Alone: the Need to Democratize Hospital Visitation Policies During Covid-19

Of the many adverse outcomes that may result from the spread of the severe acute respiratory syndrome coronavirus 2, known as COVID-19, one stands out as particularly vile: the experience of dying alone. Many healthcare facilities in the US and elsewhere adopted ‘No-Visitor Rules’ in an effort to contain the virus, but these rules mean that the countless people in nursing homes and hospital wards were isolated during their final hours of life. There is no epidemiological or US federal or state requirement to prohibit visitation to (and thereby isolate) dying patients—even those with COVID-19. Instead, constructing pandemic-specific visitation policies is usually left to the discretion of hospitals and healthcare providers. Such policies aim to limit the risk of exposure but fail to account for the individual and social costs associated with dying alone for patients, families, and frontline healthcare workers. As a result, the policies may be overly restrictive and actively cause harm. This article argues that US hospital visitation policies need to be democratised to include the perspectives of community members and patients. By drawing on existing patient rights frameworks, this article outlines several legal strategies to reconceptualise hospital visitation policies as a civil rights issue.