Literature Review

No matter at what stage of our journey,for each of us the inevitability of dyingis always there, like the blank wallof an imprentrable fortress.Or an unexplored planet.Or a looming cliff face before us,with few visible toeholds...Myself, I'm hoping for an airy work spacewith lots of light and booksand some flowering potted plants.And a PC that never gets obsolete.~ Luci Shaw, from Adventures of Ascent: Field Notes from a Lifelong Journey (a poet who died recently, just prior to her 97th birthday)

Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has. ~Margaret Mead

Managing competing interests between appointed surrogates and extended family in end-of-life care available to purchaseAmerican Academy of Pediatrics; by Derek R. Soled, Elizabeth Lanphier, Ianthe R.M. Schepel, Maya Scott; 11/25This Ethics Rounds article brings together perspectives from a clinical ethicist, 2 resident physicians in pediatrics, and a social worker on a case involving a terminally ill, intubated, and sedated young adult patient whose health care proxy, extended family, and health care team disagree on the course of her care. Although the proxy, the patient’s adult sister, seems to agree in principle with the health care team’s recommendation to withdraw life-sustaining treatment, she is unwilling to consent to withdrawal due to perceived pressure from her extended family. From an ethics perspective, we discuss the concept of the “marginalized decision-maker” and how to blend the “best interests” approach from pediatric medicine with the “substituted judgment” standard applied in adult medicine when making decisions for incapacitated young adult patients. From a clinical perspective, we explore features of this case that may contribute to feelings of moral distress within the medical team, identify best practices for leading team and family meetings to avoid values imposition and promote shared decision-making, and argue for the importance of training physicians in clinical ethics and reflective skills to improve the quality of patient care and reduce experiences of moral distress in the workplace. Finally, we explore the role that family dynamics, families’ culture and values, and past experiences in the health care system can play in shared decision-making conversations.

Perceived value of transfusion access and hospice services among patients with blood cancersJAMA Network Open; by Hari S. Raman, Angel M. Cronin, Scott F. Huntington, Hajime Uno, Caitlin Brennan, Susan Lysaght Hurley, Anna Tidswell, Richard M. Kaufman, Sarah M. Lanahan,  Kimberly S. Johnson, James A. Tulsky, Gregory A. Abel, Oreofe O. Odejide; 11/25In this survey study, our analysis suggests that for many patients with advanced hematologic cancers, the ability to maintain access to blood transfusions is the primary factor in deciding whether to enroll in hospice. Given that the majority of hospices in the US do not provide transfusion access, patients with blood cancers are faced with the impossible choice of preserving access to palliative transfusions vs accessing quality home-based hospice care. This dichotomy between transfusion access and hospice care may contribute to the low rate of hospice use in this population. Our findings underscore the need to develop and test novel hospice delivery models that combine palliative transfusions with routine hospice services to effectively alleviate discomfort and optimize the QOL [quality of life] of patients with blood cancers near the EOL [end of life].Assistant Editor's note: In the calendar year 2024 data from Medicare Hospice claims indicate that only 3.0% of beneficiaries had a blood cancer diagnosis, per Hospice Analytics. This article suggests some great ideas about how hospice can address the expense of blood transfusions with CMS. But until that happens, hospices could consider approaching their local transfusion center about a contract for a reduced price for blood transfusions for patients in need. Ultimately, this will benefit the hospice, the transfusion center (potentially more patients), and most importantly, the patient.

Evaluating the impact of the End-of-Life Nursing Consortium Curricula: A systematic review of assessments and outcomesJournal of Hospice & Palliative Nursing; by Olga Ehrlich, Theresa Jizba, Mariela Hristova, Christine S Davidson, Dennis C Powless, Toni L Glover; 12/25The End-of-Life Nursing Education Consortium (ELNEC) curricula prepare nurses to provide high-quality, evidence-based palliative care to patients with serious illness and their families. The original ELNEC program has been adapted to include nursing subspecialties and online learning modules, reaching nurses and students worldwide. This systematic literature review described the outcomes of nursing knowledge, attitudes, practice changes, and patient outcomes in studies that used ELNEC as a primary intervention. The findings revealed significant enhancements in knowledge of palliative care among nursing students and nurses, as well as a notable positive shift in attitudes toward caring for seriously ill and dying patients. However, findings also indicate a need for studies that apply rigorous methods using valid and reliable assessment instruments aligned with nursing competencies.

Impact of prognostic notifications on inpatient advance care planning: A cluster randomized trialJournal of Pain and Symptom Management; by Jessica E Ma, Kayla W Kilpatrick, Clemontina A Davenport, Jonathan Walter, Yvonne Acker, Noppon Setji, Maren K Olsen, Mihir Patel, Michael Gao, Matthew Gardner, Jamie Gollon, Mark Sendak, Suresh Balu, David Casarett;12/25A poor prognosis is an important trigger for advance care planning (ACP) conversations, but clinicians often overestimate prognosis... A pragmatic cluster randomized trial... randomized attending physicians on the inpatient medicine team. An email and page notification was sent to physicians randomized to intervention group for admitted patients at high risk of 30-day and 6-month death based on a machine learning model. The notification recommended to have and document an ACP conversation in the electronic health record (EHR)... Patients of physicians randomized to the intervention group were more likely to have a documented ACP conversation by the randomized physician compared to the control group.

Illinois is newest state to allow medical assistance in dying after Pritzker signs bill CBS News, Chicago; by Sara Tenenbaum and Charlie De Mar; 12/12/25, 11:02 am CST Gov. JB Pritzker signed a new law Friday making Illinois the newest state allowing medically assisted dying in terminally ill residents. Known as "Deb's Lawn," allows eligible terminally ill adults with a prognosis to live six months or less to request a prescription from their doctor that would allow them to die on their own terms. The legislation was narrowly approve by the Illinois Senate in October after the Illinois House passed it in May. People on both sides of the debate over the controversial legislation lobbied the governor up until the last minute. Medical aid in dying, also called assisted suicide or dying with dignity, is already legal in 12 states. Eight more are considering similar legislation. Pritzker's signature makes Illinois the first state in the Midwest to allow medically assisted death.

5 leadership trends that could shape 2026 Forbes; by Sally Percy; 12/8/25 ... [Given] the rapid pace of change, how should leaders prepare for the year ahead? Here are five key trends they should be aware of – leadership trends that could shape 2026:

I asked 6 executives which books have shaped their leadership Business Insider; by Ana Altchek; 12/3/25 Last month, I asked six executives from Big Tech companies like AWS, to financial firms like Mastercard, and style brands like Revlon and Mejuri, about the books that have influenced their leadership style. Their responses included management staples, like "Extreme Ownership: How US Navy Seals Lead,"  and books focused on soft skills, such as "Emotional Intelligence" or "Quiet."

The ethical challenge of negative compassion: How excessive empathy in end-of-life care affects decision-making and patient autonomy Journal of Hospice and Palliative Nursing; by Victoria Pérez-Rugosa, Gina Lladó-Jordan, Pablo de Lorena-Quintal, Esther Domínguez-Valdés, Antonia Rodríguez-Rodríguez, Carmen Sarabia-Cobo; 12/11/25 Online ahead of print ... 3 key themes emerged: decision paralysis and emotional overload, conflicts between personal beliefs and professional responsibilities, and institutional barriers to ethical practice. Findings reveal that excessive emotional involvement can hinder the implementation of patients' documented wishes, potentially compromising patient autonomy and increasing caregiver distress. The study highlights the need for institutional policies that support emotional resilience, structured debriefing, and ethics training. ... These insights are highly relevant for palliative nursing practice, offering guidance for supporting staff and upholding patient-centered care in end-of-life settings.

[United Kingdom] Oakhaven Hospice's Santa Dash raises more than £30,000Daily Echo, United Kingdom; by Deb Gayen; 2/9/25 More than 1,160 Santas braved the rain for this year's Oakhaven Santa Dash. The festive 3km fun run through Lymington's streets took place on Sunday, December 7. Oakhaven Hospice's fundraiser has already brought in more than £30,000, with more sponsorships still being added.