By Emily McTernan
Under Covid-era restrictions in hospitals, some died unable to see loved ones a last time, and some were unable to say goodbye to those they loved. Some women gave birth, some having stillbirths, without any companion present. Many women had to care for their babies shortly after birth on the post-natal ward, some with traumatic birth injuries or following c-sections, without partners or companions there. Patients endured treatment for serious illness and life-changing accidents without loved ones by their side much, or at all. Some received terminal or life-changing diagnoses without anyone they knew able to be present.
Hearing the stories of those who’ve experienced healthcare during and in the aftermath of Covid-19, one striking feature is the serious shortfalls in emotional and physical care: shortfalls which would usually have been made up for by the visitors who’d ordinarily have been by their side. The absence of visitors has resulted in cruelties and indignities. In the UK, visitors to overstretched hospital wards often help patients do basic but essential things such as eat food, get clean and get dressed in fresh clothing, pick up new babies and change them, or appeal for better pain relief from doctors. In their absence, some of these things were not done at all, or not done in a timely way.
Many restrictions on hospital visitors lingered, while the rest of society returned to normal. But my paper, “Against visitor bans: Freedom of association, Covid-19, and the hospital ward”, argues against extensive visitor restrictions in any but disaster scenarios, and disaster scenarios where there is no other way to mitigate the infection risk. It is easy to think of visitor bans and restrictions as a simple way to reduce the risk of infection. However, that both underplays the costs of visitor restrictions, suggested at above, and mistakes the significance of what is denied when we impose these limits.
Hospitals are places where many deeply significant moments in our intimate lives play out: our births, deaths and illnesses. Not being present when your child is born or in the hours immediately after birth, to be unable to hold the hand of a loved one when facing serious illness, to be forced to be absent when an intimate’s life draws to its end, are serious intrusions on our associational lives. To extensively restrict or ban visitors, then, infringes upon one of our fundamental rights, to freedom of association. People have a right to sustain their valuable and significant intimate associations, even when they are in hospital. Perhaps even especially when we are in hospital, given the significance of the events that happen in hospitals.
Restoring full access for visitors, then, must be a priority: it is deeply troubling that some restrictions on visitors have lingered on in certain places. And at many points during the pandemic, the wide-ranging visitor restrictions imposed in particular hospitals were likely unjustifiable. The reframing of hospital visitors in terms of a right, as my paper defends, also has implications for practice beyond the pandemic.
First, given the importance of permitting visitors, hospitals must ensure that each and every visitor restriction is well-justified: every single potential infringement on patient’s rights needs to be defended. That should to lead to more permissive visitation rules even than those found pre-pandemic.
Second, since we are looking at possible infringements on people’s rights, hospitals and hospital trusts ought to have very little lee-way to impose their own restrictions on visitors. That threatens to create a postcode lottery in how secure people find their exercise of their rights to be. I might be unfortunate and have to be treated in a hospital where I will have to be alone at crucial moments, where someone who lives the next trust over constantly has someone by their side. And when in the business of imposing restrictions that might infringe upon our fundamental rights, better that a democratic state do this directly, rather than leaving it in the hands of unelected hospital administrators who cannot easily be held to account by the public.
Author: Emily McTernan
Affiliations: University College London
Competing interests: None