In a move to strike a balance between patient privacy and recognizing the interests of same-sex partners and other close friends in the care of their loved ones, on April 15 President Obama issued a Presidential Memorandum to the Secretary of HHS, directing the Secretary to review and develop regulations that recognize and expand hospital visitation and medical decision-making privileges to include certain non-relatives and friends, including same-sex partners. The memorandum notes that widows and widowers, members of religious orders, and gay and lesbian patients, often are restricted as to whom they can designate as visitors with whom to share companionship or critical medical information, or to appoint as surrogate decision-makers.

The President requested that HHS promulgate rules under the Medicare and Medicaid programs that would require providers to respect a patient's right to designate visitors and surrogate decision-makers, particularly those designated by advance directives recognized under state law. Hospital visitation privileges should be "no more restrictive than those that immediate family members enjoy," the memorandum stated. The memorandum stated further that, consistent with existing obligations for providing care, hospitals should not discriminate in the granting of visitation or decision-making privileges on the basis of race, color, national origin, religion, sex, sexual orientation, gender identity or disability. The directive to HHS requests that existing regulations regarding advance directives be enforced and that technical assistance be provided to aid hospitals in their compliance efforts.