Literature Review

Private equity’s impact on medical traineesHealth Affairs; by Alexander P. Philips, Viknesh Kasthuri, Russell Hawes, Hunter Kramer, Barbara Chiu, Pragi Patel, Hannah Harrelson; 4/14/25Over the past decade, private equity (PE) ownership of physician practices and health care delivery systems in the United States has increased substantially. It is widely acknowledged that the trend toward short-term, profit-driven ownership challenges physician autonomy and raises ethical questions for physicians and patients. However, current discussions must more adequately recognize the effect of these trends on medical trainees. As medical students, we provide a perspective as future stakeholders amid a rapidly evolving landscape. In this Forefront article, we review PE’s involvement in health care, its impact on physicians and patients, the persistent professional and ethical challenges that directly affect medical trainees of all levels, and advocate for policy changes to protect trainees and address the underlying incentives that cause physicians to sell to PE.

[Sweden] A human right to assisted dying? Autonomy, dignity, and exceptions to the right to lifeNursing Ethics; Jon Wittrock; 4/25 Debates on assisted dying remain controversial and call out for conceptual clarification. What is the moral basis for assessing competing arguments, and what is the best way to frame these arguments in terms of actual and potential human rights? This article aims to investigate whether autonomy alone suffices as a moral source for human rights and whether, on this basis, there should be a positive human right to assisted dying, and a negative human right to assist others in dying. Drawing upon discussions in political theory, medical ethics, and human rights scholarship, the article develops an account of autonomy as multidimensional and subject to trade-offs.

Riders Up! ... Simone Biles will be calling  the "Riders Up!" command at today's Kentucky Derby 2025. "Rider Up" serves as the signal for jockeys to mount their horses in preparation for the race. 

[Taiwan] Palliative care with negative pressure wound therapy application in malignant wounds: a systematic reviewJournal of Wound Care; Xiao-Feng Yao, Yen-Jen Wang, Yang-Sheng Lin; 4/25Of 765 articles screened, 14 eligible studies were included in the review. The location of the hard-to-heal wounds was widely distributed: five wounds on the scalp; three wounds over the anogenital area; and the remaining wounds on the trunk and extremities. The reported outcomes included: improvement of wound healing; decreased exudation and malodour of the wound; decreased pain sensation; eligibility for further treatment; and a shift to the homecare system. The findings of this study suggested NPWT [negative pressure wound therapy] could be a choice in palliative care for patients with malignant wounds. However, more studies are needed to evaluate the efficacy of NPWT in these wounds.

Courts diverge in challenges to CMS's minimum staffing requirements for LTC facilities JD Supra; by Kayla Stachniak Kaplan, Scott Memmott, Sydney Menack, Jonathan York, Howard Young; 4/30/25On May 10, 2024, the Centers for Medicare and Medicaid Services (CMS) published its Final Rule to implement minimum staffing standards for long-term care (LTC) facilities in the United States. However, as discussed in our prior blog post, the Final Rule was immediately challenged under the Administrative Procedure Act (APA) in two major lawsuits. These cases have resulted in divergent rulings, injecting more uncertainty across the LTC industry about the future of the application and validity of the Final Rule. ... This and further developments in these cases will have significant impact on the future of CMS’s oversight of the country’s nursing homes.

Administration to close HHS Civil Rights office Newsmax; by Brian Freeman; 4/28/25 As part of massive cutbacks at the Department of Health and Human Services, the Centers for Medicare & Medicaid Services will shut down their civil rights office in June, according to an email sent to staff on Monday and viewed by Politico. HHS has already been reduced by some 20% as part of overall downsizing, with Secretary Robert F. Kennedy Jr. and President Donald Trump focusing on eliminating those programs and agencies they say promote diversity, equity, and inclusion. ... Complaints that are nearing completion connected to workplace harassment and discrimination will be closed out in the coming weeks, and remaining complaints will be "transferred to an appropriate entity," the email stated.Editor's note: Data from the 2024 NHPCO Facts and Figures Report states: "In CY 2022, 51.6% of White Medicare decedents used the Medicare Hospice Benefit. 38.1% of Asian American Medicare decedents and 37.4% of Black Medicare decedents enrolled in hospice. 38.3% of Hispanic and 37.1% of North American Native Medicare decedents used hospice in 2022." The discrepancies between white and non-white decedents demonstrate double-digit differences. Extensive evidence-based research validates wide gaps in hospice/healthcare for persons whom the HHS Civil Rights office is charged with protecting. For more, visit Office of Civi Rights Home | HHS.gov and Office of Civil Rights About Us. 

Executive Personnel Changes - 5/2/25

Safe Harbor Estate Law launches “Dignity Drive” to support Minnesota hospice patients during Elder Law Month The Luverne Journal, PR Underground; 5/1/25 In recognition of May as Elder Law Month, Safe Harbor Estate Law is proud to announce the launch of the Safe Harbor Dignity Drive, a community-wide campaign to collect clean, comfortable clothing and comfort items for hospice patients facing end-of-life care with limited resources. Inspired by conversations with their partners at St. Croix Hospice, Safe Harbor learned that many patients spend their final days without appropriate clothing—often due to significant weight loss, mobility challenges, or a lack of support. Soft, well-fitting clothing can provide warmth, dignity, and peace during an incredibly sacred time. “We believe everyone deserves to feel respected and cared for—especially in their final days,” said Margaret Barrett, founder of Safe Harbor Estate Law. “The Dignity Drive is our way of helping ensure no one spends those moments without the basic comfort of clean, cozy clothing.”

Interim HealthCare expands Alzheimer’s offerings through new partnership Home Health Care News; by Audrie Martin; 4/30/25 Interim HealthCare has expanded its Alzheimer’s care program through a new partnership with the Alzheimer’s Association. The partnership, announced on Wednesday, will enable Interim to bolster its existing Alzheimer’s offerings through additional educational programs and opportunities to participate in Alzheimer’s Association events.

A powerful film chronicles one man’s last days within a loving community for all to witness. Monterey County Now, Seaside, CA; by Pam Marino; 5/1/25 Facing certain death from a brain tumor, Ethan “E3” Sisser adopted a mantra. “I am embodied. I am empowered. I am ecstatic,” the 36-year-old would tell himself, in order to ward off oncoming seizures, carry himself through pain or recite for his many followers on social media. “E3” became his nickname. We see Sisser, looking into the camera, recite the mantra early in the documentary, The Last Ecstatic Days, released in 2024. We also meet his hospice and palliative care physician, Aditi Sethi, who leaves her position to become his death doula and friend. She fulfills his wishes for a peaceful death surrounded by a caring community, filmed for others to learn from. Director Scott Kirschenbaum – who made one of the definitive documentaries about birth, These Are My Hours – spent the last two weeks of Sisser’s life near his side with a camera, capturing each moment.

Think you know what nursing research looks like? Think again Boise State News, Boise, ID; 4/30/25 “Research” doesn’t just mean generating new discoveries through experimentation. Boise State supports Boyer’s model of scholarship, which expands the definition of research and creative activity to include applying and integrating knowledge into other settings, as well as teaching it. ... [An] interdisciplinary team is working to improve hospice and palliative care for refugees. ... Clinicians and refugees often do not share common cultures, languages or communication norms, so [Kate] Doyon has been building a community advisory board to create a communication guide. They’re working with stakeholders–including refugees and providers–to develop prompts that will enhance the care refugees receive, starting on the level of communication. Ornelas said the refugees they interviewed “gave us a lot of insight on different cultures and how we can go about and make prompts.” The prompts are short phrases to remind the healthcare team of best ways to interact with refugees and productively approach conversations.

The Big Bend Hospice linen drive brings comfort to patients in rural communities: Addressing a critical need in underserved areas ABC WTXL-TV 27, Tallahassee/Monticello, FL; by Lentheus Chaney; 4/30/25 In Jefferson County, kindness sometimes comes in the form of cotton. Big Bend Hospice is collecting linens here to help patients face their final days with dignity. Big Bend Hospice just launched a linen drive. It's asking neighbors to donate new Twin XL-sized bed sheets. They'll be used for patients across Jefferson, Madison, and Taylor counties. The drive's goal is to ensure no one spends their final days without the comfort of clean sheets—something most of us take for granted. The  need is especially great in rural areas. According to state data, hospice use in parts of North Florida lags behind the statewide average—just 57%. That's compared to nearly 66% across Florida. That gap means fewer resources in the places that need them most.