For the hospital / daycare, are you actually concerned with them checking your state-issued certificate though? It would seem that part of your personal agreeme

For the hospital / daycare, are you actually concerned with them checking your state-issued certificate though? It would seem that part of your personal agreement could be an agreement to call each other spouses, despite the state not being involved [0]. I understand that for the hospital end of life thing, you really wouldn't want to do anything that merely might make that more stressful. But from what I've seen of hospitals this just doesn't feel like a concern. If you're there for long periods of time, they understand. I do remember this subject being focused on back with the discussion around state-sanctioned same sex marriage, but I don't remember how much of that was abstract versus concrete. Also if there were concrete incidents, it's hard to rule out hospital staff choosing to cruelly enforcing the letter of a policy because it was a same sex couple, whereas they likely wouldn't have for a heteronormative couple. [0] this obviously wouldn't work in a place with common law marriage, but that isn't everywhere