Literature Review

Sunday newsletters focus on headlines and top read stories of the last week (in order) - enjoy!   Also, remember our Job Board to find staff for the new year!

Respecting the right to refuse: Is decision-making capacity disproportionately challenged in patients declining medical care in order to treat?Journal of Neurosurgery: Case Lessons; by Jacqueline Boyle, Nicholas Comardelle, Alexis Carter, Jeffrey Klopfenstein, Todd McCall; 10/25There is a consensus that withholding aggressive medical care in medically futile situations is ethically sound, even if the patient, surrogate, or family wants everything done. The authors aim to evaluate and discuss the situations in which this request is used as justification for intervention, specifically lifesaving surgery, when a situation is defined by a futile outcome. The authors utilize the illustrative case of an older female who presented with a traumatic brain injury and Duret hemorrhage, an unfortunately common scenario faced by neurosurgeons, to discuss the complex ethical and practical implications of these situations. They seek to define futility, provide an overview of basic medical ethical principles, and evaluate both the motivation to operate and the educational gaps among patients, families, and providers. Review of the basic principles of medical ethics lends to the conclusion that the demands of a patient’s family are not adequate justification for surgical intervention in cases, such as the present one, in which a patient is unlikely to benefit.

Slow-tempo music and delirium/coma-free days among older adults undergoing mechanical ventilation-A randomized clinical trialJAMA Internal Medicine; by Babar A. Khan, Sikandar H. Khan, Anthony J. Perkins, Annie Heiderscheit, Frederick W. Unverzagt, Sophia Wang, J. Hunter Downs III, Sujuan Gao, Linda L. Chlan; 10/25Objective: To determine if a slow-tempo music (60-80 beats/min) listening intervention decreases delirium duration, delirium severity, pain, or anxiety in older adults undergoing mechanical ventilation. In this randomized clinical trial of 158 mechanically ventilated older adults, a twice-daily music intervention delivered via noise-canceling headphones and tablets for up to 7 days did not demonstrate a statistically significant decrease in delirium duration, delirium severity, pain, or anxiety.

Heart failure with reduced ejection fractionMedical Clinics of North America; by Ebrahim Barkoudah, Clyde W Yancy; 11/25Heart failure (HF) is no longer centered on the failing ventricle. Various salutary treatment discoveries now support substantially improved survival with lesser likelihood for urgent care or hospitalization. Advanced care strategies are effective, but not only includes mechanical circulatory assist and heart transplantation, but also clinical trial participation, palliative care, and hospice. At the patient level, longer healthier lives, in concert with expert management of ventricular dysfunction, becomes the contemporary expectation.

Errors in electronic health record advance care planning documentation: It's a patient safety issueJournal of Palliative Medicine; by Seth N Randa, Sarah Nouri, Anne M Walling, Kanan Patel, Mike K W Cheng, Christine S Ritchie, Brookelle Li, Gabriela Vanegas, Elle Cardoso, Rebecca L Sudore; 11/25Centralized locations in the electronic health record (EHR) improve access to advance care planning (ACP) information; however, the prevalence of documentation errors in these locations is unknown... Among 10,767 patients, 5374 (49.9%) had ACP in their EHR, and 495 (9.2%) of those had a verified error; 32.9% were Patient Safety Errors. Patients with errors were more likely to self-identify as from a minoritized population, be non-English speaking, and have a serious illness.

AI, health, and health care today and tomorrow-The JAMA Summit Report on artificial intelligenceJAMA; Derek C. Angus, Rohan Khera, Tracy Lieu, Vincent Liu, Faraz S. Ahmad, Brian Anderson, Sivasubramanium V. Bhavani, Andrew Bindman, Troyen Brennan, Leo Anthony Celi, Frederick Chen, I. Glenn Cohen, Alastair Denniston, Sanjay Desai, Peter Embí, Aldo Faisal, Kadija Ferryman, Jackie Gerhart, Marielle Gross, Tina Hernandez-Boussard, Michael Howell, Kevin Johnson, Kristine Lee, Xiaoxuan Liu, Kimberly Lomis, Alex John London, Christopher A. Longhurst, Ken Mandl, Elizabeth McGlynn, Michelle M. Mello, Fatima Munoz, Lucila Ohno-Machado, David Ouyang, Roy Perlis, Adam Phillips, David Rhew, Joseph S. Ross, Suchi Saria, Lee Schwamm, Christopher W. Seymour, Nigam H. Shah, Rashmee Shah, Karandeep Singh, Matthew Solomon, Kathryn Spates, Kayte Spector-Bagdady, Tommy Wang, Judy Wawira Gichoya, James Weinstein, Jenna Wiens, Kirsten Bibbins-Domingo, for the JAMA Summit on AI; 10/25AI will disrupt every part of health and health care delivery in the coming years. Given the many long-standing problems in health care, this disruption represents an incredible opportunity. However, the odds that this disruption will improve health for all will depend heavily on the creation of an ecosystem capable of rapid, efficient, robust, and generalizable knowledge about the consequences of these tools on health. AI is changing how and when individuals seek care and how clinicians interact with patients, establish diagnoses, and implement and monitor treatments. In contrast to drugs or more traditional medical devices, there is little consensus or structure to ensure robust, safe, transparent, and standardized evaluation, regulation, implementation, and monitoring of new AI tools and technologies.

Tellable and untellable stories in suffering and palliative careMortality; by Maxxine Rattner; 3/19The relief of patients’ suffering – both physical and non-physical – is a primary aim of palliative care, and has been described as an obligation and ethical duty for palliative care providers. This paper suggests that common approaches to relieving patients’ non-physical suffering – such as creating opportunities to make meaning, achieve personal growth, and hone one’s resiliencies – comprise the larger, more tellable part of the palliative care discourse. A more marginal, less tellable part of the discourse acknowledges that some non-physical suffering cannot necessarily be relieved.Publisher's note: Though dated, this article offers an honest perspective on the profound challenge of alleviating suffering, and the essential lesson of humble grace when relief is not possible.

Can tech restore the human side of care? Becker's Health IT; by Ella Jeffries; 11/14/25 Technology has been both a promise and a problem in healthcare. When EHRs arrived in hospitals, they were heralded as a revolution — bringing order to messy paper charts and standardizing how care was documented. But soon after, clinicians found themselves staring more at screens than at the patients sitting in front of them. Now, nurse leaders say the very systems that once distanced them from patients could hold the key to rebuilding that connection.

Agentic AI in digital transformation: Why autonomy won’t fix the people and process problems Forbes; by Nono Bokete; 11/25/25 Agentic AI, the buzzy term for autonomous systems that can plan, act and adapt with minimal human input, is being marketed as the holy grail of digital transformation. And don't get me wrong: It's powerful. ... The potential is incredible. But potential means nothing without the people and process infrastructure to sustain it. ... The Common Pitfalls (Why 40% Will Fail): ...

City forced him to cut the oak tree tied to his late wife, so he found a way to save it forever Scoop Upworthy; by Prachi Mallick; 11/4/25 It was where he had proposed to her, where they carved their initials 30 years earlier, where their love had taken root. In a recent post, one husband shared how a city order forced him to say goodbye to the oak tree that had been central to his marriage, and how, instead of letting that final link vanish, he found a way to rebuild it into something he could carry with him forever. ... "For two years, I couldn’t touch it. Then, one day, I saw someone who had turned wood from his grandfather’s barn into furniture. Something clicked inside me. I taught myself woodworking through YouTube videos and practicing at night. Every cut, every curve of that tree became part of a door. The branches that once bore our initials are now the frame for all who enter our home."Editor's Note: Click here and scroll down for a photo of this husband's beautiful artistry.

Bridging the gap: A scoping review of clinical decision support systems in end-of-life care for older adults Journal of Palliative Medicine; by Susanny J Beltran, Lainey Dorris, Marie Hamel, Shanelle Harvey, Mustafa Ozkaynak, Kenan Sualp; 11/17/25 online ahead of print Background: ...  This scoping review maps the current landscape of clinical decision support (CDS) systems in EOL care, identifies key system types, and examines their effectiveness in guiding clinical decisions. ... Results: A total of 31 studies were included, categorizing CDS systems into prognostic tools, referral tools, and care informing tools. ...

Women are telling the truth in their out-of-office messages. It’s devastating Marie Claire, New York, NY; 11/25/25 A national campaign is delivering a radically honest wake-up call about childcare, burnout, and what it means to live in a country without paid leave. ... This year, working women across the U.S. hit a breaking point. More than 450,000 have left the workforce since January—one of the sharpest declines in recent history, according to data from the U.S. Bureau of Labor Statistics. And, overwhelmingly, the women most likely to walk away are mothers with young children. ... Which is why today, some of them are finally saying so out loud. Not in op-eds or protests, but in their out-of-office replies.

Iowa girl to light up Christmas at the Castle KELO, Sibley, IA; 11/24/25 A young girl from Iowa has an important job coming up. She’s a spunky little girl who’s full of life. That’s how Megan Travaille describes her three-year-old daughter, Margarett. “She’s got a sweet side, but she definitely has some spunk to her,” Megan Travaille said. ... Last year, little Margarett was diagnosed with stage 4 hepatoblastoma liver cancer at Sanford Children’s Hospital. Margarett’s cancer journey has included chemo and surgeries. She’s currently receiving full-time hospice care. The young girl has been selected for a big role at Sanford’s Christmas at the Castle this year. “Put the lights on,” Margarett Travaille said. As switch master, Margarett will turn on the holiday lights outside the Castle next month.