As you're likely well aware, there have been several recent developments in the marriage equality arena. Iowa's supreme court unanimously legalized same sex marriage, Vermont's legislature overturned the governor's veto to legalize same sex marriage, and New York's governor revived a same sex marriage bill in his state.
Still, with the spectre of Proposition 8 in California and the state's supreme court unlikely to overturn it, not to mention the federal Defense of Marriage Act, same sex marriage in the U.S. seems to be years from widespread acceptance.
Where does that leave currently married or civily united same sex couples? Apparently in dire straights with no rights. For example, Janice Langbehn was denied access to her partner of 17 years despite having a legal advance directive that was provided to the hospital. I find this unconsciounable and, frankly, heartless. Yes, it's important to ensure only those the patient would want to have access and make medical decisions should be allowed to do so, but clearly the intent of the directive was that Janice should have access and not just make the medical decisions.