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Disrespectful and inadequate palliative care to lesbian, gay, and bisexual patients

Published online by Cambridge University Press:  12 July 2023

Cathy Berkman*
Graduate School of Social Service, Fordham University, New York, NY, USA
Gary L. Stein
Wurzweiler School of Social Work, Yeshiva University, New York, NY, USA
David Godfrey
Commission on Law and Aging, American Bar Association, Washington, DC, USA
Noelle Marie Javier
Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Shail Maingi
Medical Oncology, Dana-Farber Cancer Institute, South Weymouth, MA, USA
Sean O’Mahony
Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
Corresponding author: Cathy Berkman; Email:



The study aims to describe inadequate, disrespectful, and abusive palliative and hospice care received by lesbian, gay, and bisexual (LGB) patients and their spouses/partners due to their sexual orientation or gender identity.


A national sample of 865 healthcare professionals recruited from palliative and hospice care professional organizations completed an online survey. Respondents were asked to describe their observations of inadequate, disrespectful, or abusive care to LGB patients and their spouses/partners.


There were 15.6% who reported observing disrespectful care to LGB patients, 7.3% observed inadequate care, and 1.6% observed abusive care; 43% reported discriminatory care toward the spouses/partners. Disrespectful care to LGB patients included insensitive and judgmental attitudes and behaviors, gossip and ridicule, and disrespect of the spouse/partner. Inadequate care included denial of care; care that was delayed incomplete, or rushed; dismissive or antagonistic treatment; privacy and confidentiality violations; and dismissive treatment of the spouse/partner.

Significance of results

These findings provide evidence of discrimination faced by LGB patients and partners while receiving care for serious illness. Hospice and palliative care programs should promote respectful, inclusive, and affirming care for the lesbian, gay, bisexual, transgender, and queer (LGBTQ) community, including policies and practices that are welcoming and supportive to both employees and patients. Staff at all levels should be trained to create safe and respectful environments for LGBTQ patients and their families.

Original Article
© The Author(s), 2023. Published by Cambridge University Press.

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