Literature Review

Respecting spinal cord injury patient autonomy in the context of terminal extubationJournal of Palliative Care; by Rainy B S Wortelboer, Lauren Hall, Fareea Khaliq; 9/26Terminal extubation ... is a legally and ethically accepted practice in the United States where mechanical ventilation is withdrawn when ongoing life-sustaining treatment no longer aligns with a patient's stated goals of care. Nearly 42% of intensive care unit deaths involve withdrawal of such measures. Discussions regarding goals of care may be complicated by quality-of-life concerns and potential ableist bias when physical dependence is misinterpreted as incompatible with meaningful life. We present a case-based ethical analysis of an 88-year-old male with traumatic high-level cervical SCI [spinal cord injury] who requested terminal extubation following prolonged hospitalization. After interdisciplinary evaluation confirmed decision-making capacity and with strong family support, he elected hospice care. He was extubated with palliative support and passed 48 h later. This case highlights the intersection of autonomy, capacity, and ethics in end-of-life decisions for patients with SCI and underscores the importance of ethical, patient-centered approaches when considering withdrawal of life-sustaining treatment.

A pilot feasibility study of PAL-CHW-PDAC, a digitally enhanced community health worker-led intervention to facilitate stepped palliative care in patients with pancreatic cancerJournal of Palliative Medicine; by Nikhil R Thiruvengadam, Maud Celestin-Joachim, Lizbeth Rivas, Nishita Matangi, Arman Bahmani, Matthew Oroso, Joel Brothers, Kendrick Che, Andrew Chang, Emmanuel Eguia, Paul Leonor, Gina Mohr, Raja Narayan, Sagar Pathak, Susanne Montgomery, Betty Ferrell; 9/26Pancreatic Ductal Adenocarcinoma (PDAC) is associated with substantial morbidity and poor quality of life (QOL). Early palliative care (EPC) has been shown to improve QoL and reduce symptom burden in PDAC, but only a minority of PDAC patients receive it. Using three conceptual models, we developed a community health worker (CHW)-led intervention to help facilitate stepped PC. Ninety-four percent of patients strongly agreed that the intervention was acceptable. Themed common responses highlighted by patients centered around the critically important role of the CHW in their care, especially as symptoms worsened. Patients' physical QoL and symptom burden improved from baseline to 12 weeks, while 83% of patients completed their ACP [advance care planning].

[Germany] Organ donation and brain preservation after assisted dying: Case report and considerations for a potential pathwayBMC Medical Ethics; by Alexander German, Alexander Grotemeyer, Katharina Koller, Markus Eckstein, Hannes Wolff, Stefan Rampp, Patrick Süß, Vincent C Müller, Dieter Birnbacher, Jürgen Winkler, Martin Regensburger; 9/26Protecting life and restoring health have been at the core of the conception of medical care since antiquity, for health professionals and the public alike. Assisted dying represents a practice that appears to challenge this traditional conception. In jurisdictions where assisted dying is condoned, the question remains as to whether the practice should be medicalized or deferred to non-medical actors. Irrespective of the divisive controversy surrounding assisted dying and its medicalization per se, the practice gives rise to high-stakes ethical, legal and organizational challenges when intersecting with organ transplantation, tissue banking, and Structural Brain Preservation or cryonics. In this narrative account, we describe the contextual framework and outline our experience and operational scope for addressing them at a university hospital in Germany. Based on this description we propose a structured pathway for increasing donation and preservation options for terminal patients while retaining ethical integrity and professional accountability.

Saturday newsletters focus on headlines and research - enjoy!

Hospice of Orange & Sullivan Counties brings veterans together for a salute to servicefocusmedia, Montgomery, NY; Client News; 9/30/26 Hospice of Orange & Sullivan Counties brought veterans, families and community members together on September 23 for a Veterans Brunch: A Salute to Service at The American Grill at Stony Ford Golf Course in Thomas Bull Memorial Park. The gathering honored local veterans and provided an opportunity to share experiences, form connections and learn about available support.With the surrounding mountains in view on a bright fall morning, attendees exchanged stories across generations and branches of service. Before the panel discussion, the program featured a medley of military service songs, with veterans standing for their branches.

Rep. Panetta: Congress must listen to hospice providers Hospice News; by Jim Parker; 10/1/26 Though the U.S. Centers for Medicare and Medicaid Services (CMS) has regulatory authority over hospices, Congress has a role to play. To fulfill that role, they should listen to the concerns of hospice providers, according to Rep. Jimmy Panetta (D-Calif.). Panetta first took office in 2017 and currently serves on the Ways and Means Committee, which is among the most important congressional bodies for hospices to watch. ... "...  The federal government has a responsibility to get that process right by rooting out fraudsters without targeting the hardworking providers offering this critical service.” 

Kendall Burrows Foundation works toward $1 million for pediatric care WMAR-2 ABC, Baltimore, MD; by Elsa M.; 9/20/26  The Kendall Burrows Foundation is encouraging Marylanders to make a difference in the lives of children and families facing serious medical challenges. Since 2015, the foundation has partnered with the Johns Hopkins Children's Center Harriet Lane Compassionate Care Program to help create supportive and healing environments for children receiving pediatric palliative care and for the families who care for them. ... This year, organizers are aiming to reach a significant milestone. The foundation reports that it has raised and donated $882,000 to date and hopes to surpass $1 million through continued community support.

The home health and hospice moratorium at six months: what CMS’ anti-fraud CRUSH initiative has meant for providers JD Supra; by Lanchi Nguyen Bombalier; 10/1/26 Key Takeaways

SBL Hospice Binga raises $31,000 for Willow Breeze Sarah Bush Lincoln; Press Release; 9/24/26 Sarah Bush Lincoln’s Hospice Binga event held in early September raised more than $31,000, with proceeds benefiting the Willow Breeze Hospice House Endowment. Earnings from the endowment help families with no or limited resources pay for their stay. ... “We’re so very grateful for our sponsors, donors, volunteers and Binga participants who come together to raise funds to help those in need,” said Amy Card, SBL Health Foundation director. “... The endowment is so important to help make it accessible to those who otherwise may not have the means to stay there.” Most insurance companies cover care in a hospice house, but many won’t cover room and board.   

Hospice of the Valley receives $100,000 grant to support dementia caregivers Arizona Foothills Magazine, Phoenix, AZ; by Mallory Gleich; 10/1/26 Hospice of the Valley has received a $100,000 Mercy C.A.R.E.S. Community Reinvestment Grant to support its Supportive Care for Dementia Program across Maricopa, Pinal and Pima counties. The program provides in-home clinical and emotional support for families caring for loved ones with dementia at any stage of the disease. It is the only program of its kind in Arizona to provide this type of comprehensive in-home support. Services include personalized guidance and care plans from an experienced dementia team, free education and support for family caregivers, low-cost in-home respite care through the RISE student engagement partnership and 24-hour access to clinical advice and care coordination.

A hole lot of help: hospice golf tournament raises more than $220,000 Baynet, Pasadena, MD; by Hospice of the Chesapeake; 9/29/26 Golfers, volunteers and sponsors came together once again to make Hospice of the Chesapeake’s annual Golf Tournament a resounding success. The event brought in more than $220,000 to support the nonprofit’s work caring for families across Anne Arundel, Calvert, Charles and Prince George’s counties. The tournament took place Sept. 24 at Queenstown Harbor Golf Course, where players enjoyed a day full of friendly competition and outstanding food ...

Life starts all over again when it gets crisp in the fall. ~ F. Scott Fitzgerald, The Great Gatsby Happy October, from Hospice & Palliative Care Today