Patients at nearly every hospital in the country will now be allowed to decide who has visitation rights and who can make medical decisions on their behalf -- regardless of sexual orientation, gender identity or family makeup -- under new federal regulations that took effect Tuesday.
The rules, which apply to hospitals participating in the Medicare and Medicaid programs, were first proposed by President Obama in an April memorandum and later implemented by the Department of Health and Human Services after a period of public review.
They represent a landmark advance in the rights of same-sex couples and domestic partners who heretofore had no legal authority to be with a hospitalized partner because they were either not a blood relative or spouse.
Hospitals must now inform patients, or an attending friend or family member, of their rights to visitors of their choosing. The policy also prohibits discrimination against visitors based on race, ethnicity, religion, sex, gender identity, sexual orientation or disability.
Janice Langbehn, who was barred from her partner Lisa Pond's bedside at Jackson Memorial Hospital in Miami for eight hours after she suffered an aneurysm in 2007, hailed the development as bittersweet justice.
"Other couples, no matter how they define themselves as families, won't have to go through what we went through, and I am grateful," she said. "But the fact that the hospital didn't let our children say goodbye to their mom... That's just something that will haunt me forever."
Langbehn, 41, had raised three adopted teenage children with Pond, her partner of nearly 18 years. At the start of a cruise vacation to the Bahamas, Pond collapsed suddenly and unexpectedly and later died at the hospital.
The couple's story, and forced separation during Pond's dying hours, inspired Obama to pursue a change to government regulations.
"The president saw an injustice and felt very strongly about correcting this and has spoken about it often over the years," White House deputy director of public engagement Brian Bond wrote on the White House blog.
Obama noted in April that hospitalization of a loved one is a time when compassion and companionship are perhaps needed most. "In these hours of need and moments of pain and anxiety, all of us would hope to have a hand to hold, a shoulder on which to lean -- a loved one to be there for us, as we would be there for them," Obama said in his memo.
Officials said the new visitation regulations would also benefit, for example, childless widows or widowers who may seek the care and companionship of an unmarried partner or friend. They will also apply to members of religious orders.
Hospitals must put their visitation policies in writing, including any "clinically necessary or reasonable restrictions" to visitation that may be appropriate.
Four states -- North Carolina, Delaware, Nebraska and Minnesota -- had already taken steps to allow patients to designate certain individuals the same rights and privileges of family members.
"LGBT people experience discrimination in many aspects of their lives, but it is perhaps at its worst during times of crisis," said Joe Solmonese, president of Human Rights Campaign, a gay rights group. "We thank President Obama and HHS Secretary [Kathleen] Sebelius for recognizing the hardships LGBT people face and taking this important step toward ensuring that no one will be turned away from a partner's hospital bedside again."
Langbehn said anti-gay animus at Jackson Memorial was behind her being kept in the dark on Pond's condition and denied access to her bedside.
"I was told by the social worker, 'You're in an anti-gay city and state. You won't get to see her without paperwork,'" she said. "I said I have that paperwork, I have the durable power of attorney. But I never saw the gentleman again in the eight hours of waiting."
She immediately called a friend to fax health care proxies and documentation of durable power of attorney but the hospital disregarded the documents.
The hospital has denied that one of its social workers made any such comment and that saving Pond's life was the doctors' top priority. Officials have also denied any double standard for Langbehn based on her sexual orientation.
While Langbehn was ultimately granted a brief visit with her dying wife, accompanied by a priest who was performing last rites, she was not allowed to stay. "No one should die alone," she said.
Now, nearly four years later, Langbehn said she finds some consolation in knowing that Pond's donated organs saved four lives that still live on.
"Her heart went to a Florida man. He was an anti-gay, right-wing guy. Former military service member. I was afraid to tell him," she said of her sexual orientation. "But, he said, 'You're my family now.' He's a wonderful man. I call him the keeper of Lisa's heart."