Today is the National Vietnam War Veterans Day, honoring 50 years since the war's end 
U.S. Department of Veterans Affairs - The United States of America Vietnam War Commemoration 
Join us on 29 March, National Vietnam War Veterans Day, as Americans unite to thank and honor Vietnam veterans and their families for their service and sacrifice. ... The United States of America Vietnam War Commemoration honors all veterans who served on active duty in the U.S. Armed Forces at any time from November 1, 1955 to May 15, 1975, regardless of location, and their families. 
Editor's note: Several hospice "We Honor Veterans" programs have been using this commemoration to thank their community's Vietnam veterans, especially in light of differences between their returns home from those of WWII veterans. Within your networks of colleagues, friends and families, whom can you informally honor, today?

• National Vietnam War Veterans Day, March 29, 2025
• Local veterans to be honored at pinning ceremonies
• Hospice of Redmond presents a Welcome Home Vietnam Veterans Day Ceremony
• Residential Hospice to Honor Vietnam Veterans

Quality of life in heart failure. The heart of the matter. A scientific statement of the Heart Failure Association and the European Association of Preventive Cardiology of the European Society of Cardiology
European Journal of Heart Failure; Maurizio Volterrani, Geza Halasz, Stamatis Adamopoulos, Pier Giuseppe Agostoni, Javed Butler, Andrew J.S. Coats, Alan Cohen-Solal, Wolfram Doehner, Gerasimos Filippatos, Ewa Jankowska, Carolyn S.P. Lam, Ekaterini Lambrinou, Lars H. Lund, Giuseppe Rosano, Marco Metra, Stefania Paolillo, Pasquale Perrone Filardi, Amina Rakisheva, Gianluigi Savarese, Petar Seferovic, Carlo Gabriele Tocchetti, Massimo Piepoli; 3/25
Patients with heart failure (HF) experience much worse QoL [quality of life] and effort intolerance than both the general population and people with other chronic conditions, since they present a range of physical and psychological symptoms, including shortness of breath, chest discomfort, fatigue, fluid congestion, trouble with sleeping, and depression. The importance of QoL for patients with HF is highlighted in a survey showing that 61% attached more weight to QoL over longevity, with 9% and 14% willing to trade 6 and 12 months, respectively, for perfect health and better QoL. It is for these reasons that the Heart Failure Association is developing a new score for QoL in HF, sensitive to mechanism-specific interventions and tailored to be sensitive to changes within individual patients. 

Population-based payments to deliver health care to unhoused individuals
JAMA Health Forum; Sudhakar V. Nuti, Amanda K. Johnson, Theodore Long; 3/25
The 770,000 people experiencing homelessness in the US have a high prevalence of disease and high health care utilization. Compared to the general population, unhoused individuals in the US have a 3.5 times higher mortality rate and 27-year reduced life expectancy. To this end, we propose population-based payment models (PBPs) as a novel mechanism to provide increased, stable, and predictable funding for health care for unhoused individuals. PBPs are the most advanced category of value-based alternative payment models, where health care organizations are given a prospective payment to care for a population of patients, with the flexibility to tailor care without incentivizes to optimize billable encounters, while being held accountable for improved outcomes and costs. The flexibility in how to invest and earn funding is essential for focused investment in these models, as increased reimbursement alone is insufficient.
Publisher's note: Bolding in post above is ours.

Racial disparities in ALS progression: Time to clinical events observed in a single center 
Wiley Online Library; by Shanshan Chen, Demetrius Carter, Jillian Prier, JoBeth Bingham, Shital Patel, Manisha Kotay, Paula Burke Brockenbrough, Kelly Gwathmey; 3/25 
Studies examining racial differences in ALS have previously focused on diagnostic delay and disease severity. Time to critical clinical events has rarely been investigated, despite its importance in revealing differences in ALS patients' disease courses. This study explores racial disparities in time to specific clinical events in Black and non-Hispanic White ALS patients at a single center. ... Our single-center findings demonstrate a large racial difference in time to clinical events for Black versus White ALS patients referred for NIV, AAC, hospice, and wheelchair, suggesting more advanced disease at the time of presentation or more rapid progression.

Children as living solid organ donors: Ethical discussion and model hospital policy statement
The Journal of Clinical Ethics; Gyan C. Moorthy, Aidan P. Crowley, Sandra Amaral; Spring 2025
In recent years, more attention has been paid to living donation as a means to reduce the suffering of individuals with end-stage kidney or liver disease. Implicated ethical issues include medical risk and risk of coercion, counterbalanced by improved medical outcomes and the benefits of saving a life. Living donation becomes particularly ethically complicated with the prospect of child donation, given the child’s developing autonomy and uniquely dependent status. We outline four broad ethical considerations pertinent to living child organ donation: (1) beneficence, (2) respect for the family as a moral unit, (3) respect for the child as a person, and (4) justice. We conclude that it can be ethical for a healthy child to donate a kidney or liver lobe to a close relative who has exhausted other options provided that certain protections are put into place.

Ethics in patient preferences for artificial intelligence–drafted responses to electronic messages
JAMA Network Open; Joanna S. Cavalier, Benjamin A. Goldstein, Vardit Ravitsky, Jean-Christophe Bélisle-Pipon, Armando Bedoya, Jennifer Maddocks, Sam Klotman, Matthew Roman, Jessica Sperling, Chun Xu, Eric G. Poon, Anand Chowdhury; 3/25
The rise of electronic communication sent to clinicians via the patient portal has directly led to clinician burnout and dissatisfaction. With patients increasingly messaging their clinicians, replying to in-basket messages (akin to email) has become a burdensome task consisting of medical questions, refill requests, and administrative and scheduling requests. This survey study of 1,455 respondents showed that while overall satisfaction was high (>75%) regardless of author, respondents preferred responses written by AI [artificial intelligence] over those written by a human ... However, when an AI author was disclosed, satisfaction was lower for AI compared with a human author ... Meaning: Reduced satisfaction due to AI disclosure should be balanced with the importance of patient autonomy and empowerment.

Bioethics Artificial Intelligence Advisory (BAIA): An Agentic Artificial Intelligence (AI) framework for bioethical clinical decision support 
Cureus; by Taposh P. Dutta Roy; 3/12/25 
Healthcare professionals face complex ethical dilemmas in clinical settings in cases involving end-of-life care, informed consent, and surrogate decision-making. These nuanced situations often lead to moral distress among care providers. This paper introduces the Bioethics Artificial Intelligence Advisory (BAIA) framework, a novel and innovative approach that leverages artificial intelligence (AI) to support clinical ethical decision-making. The BAIA framework integrates multiple bioethical approaches, including principlism, casuistry, and narrative ethics, with advanced AI capabilities to provide comprehensive decision support. 

Multidisciplinary clinician perceptions on utility of a machine learning tool (ALERT) to predict 6-month mortality and improve end-of-life outcomes for advanced cancer patients
Cancer Medicine; Nithya Krishnamurthy, Melanie Besculides, Ksenia Gorbenko, Melissa Mazor, Marsha Augustin, Jose Morillo, Marcos Vargas, Cardinale B. Smith; 3/25
There are significant disparities in outcomes at the end-of-life (EOL) for minoritized patients with advanced cancer, with most dying without a documented serious illness conversation (SIC). This study aims to assess clinician perceptions of the utility and challenges of implementing a machine learning [ML] model (ALERT) to predict 6-month mortality among patients with advanced solid cancers to prompt timely SIC. Our study found that clinicians expressed widespread acceptability of ALERT and identified clear benefits, particularly in triggering earlier SIC and standardizing prognosis discussions across care teams. [Additionally,] a recent study found that ML prognostic models decreased use of aggressive chemotherapy at EOL and increased SIC frequency fourfold.

[Switzerland] The use of artificial nutrition at the end-of-life: a cross-sectional survey exploring the beliefs and decision-making among physicians and nurses
Support Care Cancer; by Christophe Pala, Claudia Gamond, Steffen Eychmuller, Francois Herrmann, Sophie Pautex; 3/17/25
The use of artificial nutrition in the last month of life raises many concerns for patients, relatives, and healthcare professionals... Whereas decisions on artificial nutrition at the end of life are common they may be mostly guided by physicians and nurses' beliefs, and patients' requests more than by robust evidence. Fostering palliative care education is pivotal. Our results emphasize the need to improve physicians and nurses' awareness of the complex interplay between values and evidence when decisions concerning artificial nutrition are taken.

[Canada] Death doulas’ experiences with and perspectives on unusual end-of-life phenomena
Omega-Journal of Death and Dying; Stephen Claxton-Oldfield, Madeleine de Ste-Croix Killoran; 2/25
In this article, the term ‘unusual end-of-life phenomena’ (EOLP) is used to refer to extraordinary experiences that can happen when someone is approaching death, at the time of death, and after death. Consistent with the results of previous studies involving people who work with the dying (i.e., doctors, nurses, hospice palliative care volunteers, nursing home staff) death doulas had commonly observed or been told about various EOLP in their work supporting people through the dying process. Deathbed visions were the most witnessed and reported EOLP. Death doulas indicated that they were comfortable talking about EOLP with their clients and clients’ families and most or almost all endorsed spiritual or transpersonal explanations for EOLP over scientific or medical ones. Death doulas have an important role to play in normalizing, validating, and educating their clients and clients’ families about EOLP.

Bitterness is like a cancer that enters the soul. ~ Sir Terry Waite