Last week on April 15 President Obama sent a memorandum to the secretary of his Health and Human Services agency, Kathleen Sebelius, ordering that she ensure that all hospitals getting Medicaid or Medicare funding (which is most hospitals in the United States) honor all patients' advance care directives. This includes directives designating who gets visitation privileges and who is able to make medical decisions, among others.

 The thing is, hospitals should already be doing this when advance directives are in place.

 However, until this memo was issued, hospital staff have apparently used their own discretion in determining which directives to validate and honor, and which they would overlook or ignore, without facing any kind of legal recourse.

 This is troubling, and obviously defeats the purpose of advance care directives altogether, since the whole point of their design is to ensure that the person of your choosing is the person who will be there for you when you need them most, which is a particularly significant issue for LGBT people and relationships.

 So, in other words, Obama's memo is reinforcing that hospitals must now do what has been expected of them all along: to honor ALL advance care directives, including those of same-sex partners.

 A current (and particularly devastating) example of why, unfortunately, we need this additional protection at the federal level, is the story of Clay and Harold. Together for 20 years, and with all of their important paperwork (advance care directives, power of attorneys) in place, they still faced heartless discrimination during an end-of-life situation that kept them apart for the last three months of Harold's life. When Harold got sick and was admitted to a hospital in Sanoma County, California, he was treated as if he had no family. Then, the county removed Clay from their home and confined him to a nursing home against his will, and auctioned off all of their belongings that they spent 20 years collecting together. Read more of the story, it is truly horrifying and inhumane.

 With Obama's new memo, most hospitals around the country are mandated to honor all advance care directives, and have 180 days from the time the memo was sent out (April 15) to make any necessary changes that would interfere with compliance.

 For our community, now more than ever, it is critically important that we have these legal protections in place for ourselves, our partners and our families. Have you started thinking about appointing a health care proxy or completing other protective legal documents? Do you already have a health care proxy in place? Do you have any stories or experiences related to this issue that you'd like to share?

 If you have any questions or concerns about health care proxies, such as where to find them, or how to fill them out, contact us!