Literature Review

What does moral agency mean for nurses in the era of artificial intelligence?Hastings Center Report; by Connie M Ulrich, Oonjee Oh, Sang Bin You, Maxim Topaz, Zahra Rahemi, Liz Stokes, Lisiane Pruinelli, George Demiris, Patricia Flatley Brennan; 2/26Being a moral agent was once thought to be an irreplaceable, uniquely human role for nurses and other health care professionals who care for patients and their families during illness and hospitalization. Today, however, artificial intelligence systems are often referred to as “artificial moral agents,” “agentic,” and “autonomous agents.” As these systems begin to function in various capacities within health care organizations and to perform specialized duties, the question arises as to whether the next step will be to replace nurses and other health care professionals as moral agents. Focusing primarily on nurses, this essay explores the concept of moral agency, asking whether it remains exclusive to humans or can be conferred on AI systems. We argue that AI systems should not supplant nurses’ moral agency, as patients come to hospitals or any other health care setting to be heard, seen, and valued by skilled professionals, not to seek care from machines.Editor's Note: Pair this with yesterday's article, ""Black box" artificial intelligence for mortality prediction: a mixed-methods study of palliative care team, patient, and caregiver perspectives."

Dignity in motion: How hospice care and wheelchair transportation shape senior comfort in Tacoma US Culture & Style Today, Tacoma, WA; Press RElease; 3/11/26 For seniors approaching the most sensitive stages of life, the quality of care is defined not only by what happens inside a home or medical facility but also by how individuals move between places. Transportation during hospice care and assisted living transitions must protect dignity, emotional calm, and physical safety. When medical transportation is handled with respect and patience, the entire care experience becomes gentler for both seniors and their families. ... 

Pediatric Resource GuideThe HAP Foundation press release; 3/16/26Our team with the Lynda P. Bollman’s Pediatric Program collected as many resources as we could find to assist patients, families, and practitioners. Our goal is for this Resource Guide to be an efficient and effective tool to aid in caring for children with a serious illness and their families navigating their journey... The Pediatric Resource Guide is divided into several categories (i.e., financial support, transportation support, emotional wellness support, etc.) to ease navigation. You will also be able to break some sections into subcategories (i.e., Midwest, East, West, etc.)...

Will Scotland be the first [in the UK] to legalise assisted dying? BBC News; by James Cook, Scotland editor; 3/16/26 For more than a year, Scottish politicians have been grappling with matters of life and death as they debated one of the most contested bills in the history of devolution. Tuesday's (3/10) final Scottish Parliament vote on the Assisted Dying for Terminally Ill Adults (Scotland) Bill is seen as too close to call. But, if it passes, Scotland could become the first nation in the UK to legalise assisted dying. ... Critics of the bill have called it dangerous and say MSPs should focus instead on improving end-of-life care. ... [Supporters of the bill have] said the result was a "bulletproof" bill which amounted to "the toughest and most comprehensively-safeguarded" such legislation in the world.

Hospice fraud explodes in California after state ‘crackdown’: 742 flagged providers, $105 million overbilled, and ghost offices California Globe; by Megan Barth; 3/11/26 California investigative reporter Christian Hartsock, in collaboration with California State Assembly woman Alexandra Macedo for the California Courier, released a breaking undercover investigation just days ago, exposing dozens of suspicious hospice and home healthcare agencies in Los Angeles. Their on-site visits revealed hundreds of companies registered to crumbling buildings with no ramps, no handicap parking, disconnected phones, and signs reading “Out to Lunch.” Hartsock’s footage highlights how over $3.5 billion in Medi-Cal fraud has been identified in Los Angeles County alone, with 31% of all U.S. hospices registered there despite only 2% of the nation’s aging seniors residing in the area. 

Alliance concerned by MedPAC’s misguided 2026 home health and hospice payment recommendations National Alliance for Care at Home, Alexandira, VA and Washington, DC; Press Release; 3/13/26The National Alliance for Care at Home (the Alliance) is deeply concerned by the Medicare Payment Advisory Commission’s (MedPAC) March 2026 Report to Congress: Medicare Payment Policy. MedPAC’s congressionally mandated report provides analysis and recommendations on various Medicare programs, including home health and hospice. The Commission’s findings focus on payment adequacy, access to care, quality, financial performance, and projections for 2026 and beyond. The Alliance previously expressed concern in response to MedPAC’s vote in January 2026.

MedPAC: March 2026 Report to CongressMedPAC Reports; 3/12/26Medicare Benefit: National health care spending grew rapidly in 2023 and 2024, by 7 percent in each of these years. By 2024, national health care spending totaled $5.3 trillion. Health care spending has made up an increasing share of the country’s gross domestic product (GDP) over time, rising from about 13 percent of GDP in 2000 to 18 percent in 2024. Medicare spending grew more rapidly than national health care spending in 2023 and 2024 (by 9 percent and 8 percent, respectively), in part due to changes in Part D financing that shifted more of the cost of prescription drug coverage from beneficiaries to the federal government. By 2024, Medicare spending totaled $1.1 trillion—equivalent to 21 percent of national health care spending and 3.8 percent of GDP. (Please see the full report here for additional detail.)

* CEO, Hildegard House, nonprofit, Louisville, KY

Identifying key components of neuropalliative care fellowship using nominal group techniqueJournal of Pain & Symptom Management; by Sachi Y Gianchandani, Jocelyn M Jiao, Kwame O Adjepong, Yaowaree L Leavell, Jessica M Besbris, Neha M Kramer, Joel N Phillips, Paul M Vermilion; 2/26There is no standardized curriculum for neurology-focused palliative care training. An adapted nominal group technique (NGT) was used to collect and rank responses to 2 key questions: "In designing the ideal dedicated neuropalliative care clinician training experience, what core components should be included?" and "When a general palliative care fellowship has a neurologist in their program, how could the program/program director potentially tailor the year to their unique needs?" For both key questions, the top-ranked responses included: dedicated outpatient neuropalliative care experience, mentorship from faculty with expertise in neuropalliative care, and a core didactic curriculum that includes neurology-specific content. Additionally, appropriateness for certification in hospice and palliative medicine was identified as crucial.

Effects of psychoeducation on burden, depression, and anxiety in informal caregivers of patients with dementia: A systematic review of randomized controlled trialsWestern Journal of Nursing Research; by Hyeyeon Shin, Chanchanok Wandee, Kathy D. Wright, Dónal P. O’Mathúna; 2/26As dementia rises globally, caregivers face prolonged and demanding responsibilities, increasing their risk of burden, depression, and anxiety. We aimed to identify the effectiveness of psychoeducation on burden, depression, and anxiety among informal dementia caregivers. This review clarifies the benefits of psychoeducation to inform the development of effective, targeted interventions. Psychoeducation offers dementia-related information, behavior management strategies, and caregiver support to improve mental health and caregiving effectiveness.

The business case for family caregiver skills training: Results from a multisite trial in the Veterans health care systemJournal of the American Medical Directors Association; Brystana G Kaufman, Michael A Lourie, Kasey Decosimo, Cynthia J Coffman, Joshua Dadolf, Matthew Tucker, Leah Christensen, Virginia Wang, Kelli D Allen, Susan N Hastings, Courtney H Van Houtven; 2/26Increasing caregiver training programs is valuable; however, even minimal health insurance cost-sharing can reduce access for those who need it most. We evaluated costs from the VA perspective, in which veterans and caregivers do not face high out of-pocket costs. Outside the VA, Medicare beneficiaries with care needs and caregivers do face these costs, potentially exacerbating health disparities. Integration and documentation of all caregivers in need of training is needed to support the systematic implementation of programs. Policies like the RAISE Family Caregivers Act encourage health systems to identify and provide necessary skills to family caregivers of hospitalized patients; yet, few health systems include a caregiver field in their EHR. As the need for caregiver training increases, health systems may leverage new reimbursement mechanisms to support the financial feasibility of delivering evidence-based caregiver training programs.

Hospice and palliative care during COVID-19 in New York City: Clinician-reported patient and family experiences and lessons for future crisesAmerican Journal of Hospice and Palliative Care; by Junyi Lin, Shih-Yin Lin, Daniel David, Laura T Moreines, Emily Franzosa, Abraham A Brody, Melissa D Aldridge, Dena Schulman-Green; 2/26The COVID-19 pandemic complicated hospice and palliative care (HPC) experiences of patients and family caregivers. We sought to understand HPC professionals' perceptions of patients' and family caregivers' HPC experiences during the COVID-19 pandemic in New York City and to make recommendations for improving HPC delivery during future public health crises.