Literature Review
Today's Encouragement
03/29/25 at 03:55 AMBitterness is like a cancer that enters the soul. ~ Sir Terry Waite
Multidisciplinary clinician perceptions on utility of a machine learning tool (ALERT) to predict 6-month mortality and improve end-of-life outcomes for advanced cancer patients
03/29/25 at 03:30 AMMultidisciplinary clinician perceptions on utility of a machine learning tool (ALERT) to predict 6-month mortality and improve end-of-life outcomes for advanced cancer patientsCancer Medicine; Nithya Krishnamurthy, Melanie Besculides, Ksenia Gorbenko, Melissa Mazor, Marsha Augustin, Jose Morillo, Marcos Vargas, Cardinale B. Smith; 3/25There are significant disparities in outcomes at the end-of-life (EOL) for minoritized patients with advanced cancer, with most dying without a documented serious illness conversation (SIC). This study aims to assess clinician perceptions of the utility and challenges of implementing a machine learning [ML] model (ALERT) to predict 6-month mortality among patients with advanced solid cancers to prompt timely SIC. Our study found that clinicians expressed widespread acceptability of ALERT and identified clear benefits, particularly in triggering earlier SIC and standardizing prognosis discussions across care teams. [Additionally,] a recent study found that ML prognostic models decreased use of aggressive chemotherapy at EOL and increased SIC frequency fourfold.
Bioethics Artificial Intelligence Advisory (BAIA): An Agentic Artificial Intelligence (AI) framework for bioethical clinical decision support
03/29/25 at 03:25 AMBioethics Artificial Intelligence Advisory (BAIA): An Agentic Artificial Intelligence (AI) framework for bioethical clinical decision support Cureus; by Taposh P. Dutta Roy; 3/12/25 Healthcare professionals face complex ethical dilemmas in clinical settings in cases involving end-of-life care, informed consent, and surrogate decision-making. These nuanced situations often lead to moral distress among care providers. This paper introduces the Bioethics Artificial Intelligence Advisory (BAIA) framework, a novel and innovative approach that leverages artificial intelligence (AI) to support clinical ethical decision-making. The BAIA framework integrates multiple bioethical approaches, including principlism, casuistry, and narrative ethics, with advanced AI capabilities to provide comprehensive decision support.
Ethics in patient preferences for artificial intelligence–drafted responses to electronic messages
03/29/25 at 03:20 AMEthics in patient preferences for artificial intelligence–drafted responses to electronic messagesJAMA Network Open; Joanna S. Cavalier, MD; Benjamin A. Goldstein, PhD; Vardit Ravitsky, PhD; Jean-Christophe Bélisle-Pipon, PhD; Armando Bedoya, MD, MMCi; Jennifer Maddocks, PT, MMCi; Sam Klotman, MPH; Matthew Roman, PT, MHA, MMCi; Jessica Sperling, PhD; Chun Xu, MB; Eric G. Poon, MD, MPH; Anand Chowdhury, MD, MMCi; 3/25The rise of electronic communication sent to clinicians via the patient portal has directly led to clinician burnout and dissatisfaction. With patients increasingly messaging their clinicians, replying to in-basket messages (akin to email) has become a burdensome task consisting of medical questions, refill requests, and administrative and scheduling requests. This survey study of 1,455 respondents showed that while overall satisfaction was high (>75%) regardless of author, respondents preferred responses written by AI [artificial intelligence] over those written by a human ... However, when an AI author was disclosed, satisfaction was lower for AI compared with a human author ... Meaning: Reduced satisfaction due to AI disclosure should be balanced with the importance of patient autonomy and empowerment.
Children as living solid organ donors: Ethical discussion and model hospital policy statement
03/29/25 at 03:15 AMChildren as living solid organ donors: Ethical discussion and model hospital policy statementThe Journal of Clinical Ethics; Gyan C. Moorthy, Aidan P. Crowley, and Sandra Amaral' Spring 2025In recent years, more attention has been paid to living donation as a means to reduce the suffering of individuals with end-stage kidney or liver disease. Implicated ethical issues include medical risk and risk of coercion, counterbalanced by improved medical outcomes and the benefits of saving a life. Living donation becomes particularly ethically complicated with the prospect of child donation, given the child’s developing autonomy and uniquely dependent status. We outline four broad ethical considerations pertinent to living child organ donation: (1) beneficence, (2) respect for the family as a moral unit, (3) respect for the child as a person, and (4) justice. We conclude that it can be ethical for a healthy child to donate a kidney or liver lobe to a close relative who has exhausted other options provided that certain protections are put into place.
Racial disparities in ALS progression: Time to clinical events observed in a single center
03/29/25 at 03:10 AMRacial disparities in ALS progression: Time to clinical events observed in a single center Wiley Online Library; by Shanshan Chen, Demetrius Carter, Jillian Prier, JoBeth Bingham, Shital Patel, Manisha Kotay, Paula Burke Brockenbrough, Kelly Gwathmey; 3/10/25 Studies examining racial differences in ALS have previously focused on diagnostic delay and disease severity. Time to critical clinical events has rarely been investigated, despite its importance in revealing differences in ALS patients' disease courses. This study explores racial disparities in time to specific clinical events in Black and non-Hispanic White ALS patients at a single center. ... Our single-center findings demonstrate a large racial difference in time to clinical events for Black versus White ALS patients referred for NIV, AAC, hospice, and wheelchair, suggesting more advanced disease at the time of presentation or more rapid progression.
Population-based payments to deliver health care to unhoused individuals
03/29/25 at 03:05 AMPopulation-based payments to deliver health care to unhoused individualsJAMA Health Forum; Sudhakar V. Nuti, MD, MSc; Amanda K. Johnson, MD, MBA; Theodore Long, MD, MHS; 3/25The 770,000 people experiencing homelessness in the US have a high prevalence of disease and high health care utilization. Compared to the general population, unhoused individuals in the US have a 3.5 times higher mortality rate and 27-year reduced life expectancy. To this end, we propose population-based payment models (PBPs) as a novel mechanism to provide increased, stable, and predictable funding for health care for unhoused individuals. PBPs are the most advanced category of value-based alternative payment models, where health care organizations are given a prospective payment to care for a population of patients, with the flexibility to tailor care without incentivizes to optimize billable encounters, while being held accountable for improved outcomes and costs. The flexibility in how to invest and earn funding is essential for focused investment in these models, as increased reimbursement alone is insufficient.
[Canada] Death doulas’ experiences with and perspectives on unusual end-of-life phenomena
03/29/25 at 03:05 AM[Canada] Death doulas’ experiences with and perspectives on unusual end-of-life phenomenaOmega-Journal of Death and Dying; Stephen Claxton-Oldfield, Madeleine de Ste-Croix Killoran; 2/25In this article, the term ‘unusual end-of-life phenomena’ (EOLP) is used to refer to extraordinary experiences that can happen when someone is approaching death, at the time of death, and after death. Consistent with the results of previous studies involving people who work with the dying (i.e., doctors, nurses, hospice palliative care volunteers, nursing home staff) death doulas had commonly observed or been told about various EOLP in their work supporting people through the dying process. Deathbed visions were the most witnessed and reported EOLP. Death doulas indicated that they were comfortable talking about EOLP with their clients and clients’ families and most or almost all endorsed spiritual or transpersonal explanations for EOLP over scientific or medical ones. Death doulas have an important role to play in normalizing, validating, and educating their clients and clients’ families about EOLP.
Quality of life in heart failure. The heart of the matter. A scientific statement of the Heart Failure Association and the European Association of Preventive Cardiology of the European Society of Cardiology
03/29/25 at 03:00 AMQuality of life in heart failure. The heart of the matter. A scientific statement of the Heart Failure Association and the European Association of Preventive Cardiology of the European Society of CardiologyEuropean Journal of Heart Failure; Maurizio Volterrani, Geza Halasz, Stamatis Adamopoulos, Pier Giuseppe Agostoni, Javed Butler, Andrew J.S. Coats, Alan Cohen-Solal, Wolfram Doehner, Gerasimos Filippatos, Ewa Jankowska, Carolyn S.P. Lam, Ekaterini Lambrinou, Lars H. Lund, Giuseppe Rosano, Marco Metra, Stefania Paolillo, Pasquale Perrone Filardi, Amina Rakisheva, Gianluigi Savarese, Petar Seferovic, Carlo Gabriele Tocchetti, Massimo Piepoli; 3/25 Patients with heart failure (HF) experience much worse QoL [quality of life] and effort intolerance than both the general population and people with other chronic conditions, since they present a range of physical and psychological symptoms, including shortness of breath, chest discomfort, fatigue, fluid congestion, trouble with sleeping, and depression. The importance of QoL for patients with HF is highlighted in a survey showing that 61% attached more weight to QoL over longevity, with 9% and 14% willing to trade 6 and 12 months, respectively, for perfect health and better QoL.It is for these reasons that the Heart Failure Association is developing a new score for QoL in HF, sensitive to mechanism-specific interventions and tailored to be sensitive to changes within individual patients.
Saturday newsletters
03/29/25 at 03:00 AMSaturday newsletters focus on headlines and research - enjoy!
[Switzerland] The use of artificial nutrition at the end-of-life: a cross-sectional survey exploring the beliefs and decision-making among physicians and nurses
03/29/25 at 03:00 AM[Switzerland] The use of artificial nutrition at the end-of-life: a cross-sectional survey exploring the beliefs and decision-making among physicians and nursesSupport Care Cancer; by Christophe Pala, Claudia Gamond, Steffen Eychmuller, Francois Herrmann, Sophie Pautex; 3/17/25 Background: The use of artificial nutrition in the last month of life raises many concerns for patients, relatives, and healthcare professionals. Conclusion: Whereas decisions on artificial nutrition at the end of life are common they may be mostly guided by physicians and nurses' beliefs, and patients' requests more than by robust evidence. Fostering palliative care education is pivotal. Our results emphasize the need to improve physicians and nurses' awareness of the complex interplay between values and evidence when decisions concerning artificial nutrition are taken.
Today is the National Vietnam War Veterans Day, honoring 50 years since the war's end
03/29/25 at 03:00 AMToday is the National Vietnam War Veterans Day, honoring 50 years since the war's end U.S. Department of Veterans Affairs - The United States of America Vietnam War Commemoration Join us on 29 March, National Vietnam War Veterans Day, as Americans unite to thank and honor Vietnam veterans and their families for their service and sacrifice. ... The United States of America Vietnam War Commemoration honors all veterans who served on active duty in the U.S. Armed Forces at any time from November 1, 1955 to May 15, 1975, regardless of location, and their families. Editor's note: Several hospice "We Honor Veterans" programs have been using this commemoration to thank their community's Vietnam veterans, especially in light of differences between their returns home from those of WWII veterans. Within your networks of colleagues, friends and families, whom can you informally honor, today?
10 top health system workplaces, per USA Today
03/28/25 at 03:10 AM10 top health system workplaces, per USA TodayBecker's Hospital Review; by Giles Bruce; 3/21/25Ten health systems were named top workplaces March 21 by USA Today and human resources technology company Energage. The Top Workplaces USA 2025 list was determined using Energage’s confidential employee engagement surveys and participating company benchmarks that take into account years of workplace culture research.Here are the health systems that ranked in the top 100 among organizations with 2,500-plus employees:
New musical asks, 'How do we deal with the end?' (with a singalong)
03/28/25 at 03:00 AMNew musical asks, 'How do we deal with the end?' (with a singalong)Edge Media Network; by Kilian Melloy; 3/25/25 Worcester, Massachusetts natives and brothers Daniel Lazour and Patrick Lazour started making theater when they were still kids, ... "It was a really beautiful coming together of the whole [theater] community to do these shows," Daniel adds. That communal spirit lives on in the brothers' latest work, "Night Side Songs," a production of the American Repertory Theater that's scheduled to play ... from March 27 – April 6 [and] April 8 - 20. Bringing audiences together for a full-length play that makes singing an integral part of the experience – the songs are written to be easy for the audience to sing and to participate in performing, much like hymns at a church service, the brothers say – "Night Side Songs" makes a cathartic shared experience from the story of Yasmine (Brooke Ishibashi), a woman facing cancer and chemotherapy but finding love, meaning, and her own voice as part of the journey. [Continue reading ...]
Thompson Scholars and AdventHealth host successful Health Equity Health Fair
03/28/25 at 03:00 AMThompson Scholars and AdventHealth host successful Health Equity Health Fair AdventHealth Manchester, Manchester, KY; by Christina Couch; 3/25/25 The Thompson Scholars Foundation and AdventHealth are proud to announce the successful completion of the Health Equity Health Fair held [March 24] ... in Manchester, KY. With over 250 participants, the event brought together medical professionals, community representatives, and attendees to address health disparities and promote wellness within the community. The Health Equity Health Fair featured a wide range of activities and resources, including: ... Hospice Care ...
Today's Encouragement: Basketball doesn't care ...
03/28/25 at 03:00 AMBasketball doesn’t care what color your skin is. It doesn’t care what language you speak or what religion you practice. It doesn’t care if you’re big or small, fast or slow. It just asks you to play, to complete, to lose with dignity, to win with humility. ~ Coach Jim Calhoun, Basketball Hall of Fame and 3-time NCAA champion
Executive Personnel Changes - 3/28/25
03/28/25 at 03:00 AMExecutive Personnel Changes - 3/28/25
Kennedy slashing 10,000 jobs in health department overhaul
03/28/25 at 03:00 AMKennedy slashing 10,000 jobs in health department overhaul USA Today, Washington, DC; by Joey Garrison; 3/27/25 Health and Human Secretary Robert F. Kennedy Jr. said Thursday he will cut about 10,000 full-time jobs from the Cabinet department in a dramatic reduction that includes closing half its regional offices as part of a wider Trump administration overhaul of the federal government. Combined with HHS employees who previously accepted buyouts and others who were already fired, the agency's workforce will be sliced by one-quarter from 82,000 full-time employees to 62,000 since President Donald Trump returned to the White House. The Department of Health and Human Services ‒ which oversees the Centers for Disease Control and Prevention and Centers for Medicare and Medicaid Services ‒ will consolidate the agency's 28 divisions into 15 new divisions in Kennedy's shakeup. ... Among the cuts in key divisions:
Five key CDC leaders abruptly retire amid agency shakeup: What to know
03/28/25 at 03:00 AMFive key CDC leaders abruptly retire amid agency shakeup: What to know Newsweek; by Gabe Whisnant; 3/25/25 The Centers for Disease Control and Prevention (CDC) is facing a major leadership shakeup, with five high-level officials stepping down in what marks the latest wave of internal turmoil for the nation's premier public health agency. According to the Associated Press, which confirmed the resignations through two CDC officials who requested anonymity because they were not authorized to speak publicly, the resignations were revealed during a senior leadership meeting on Tuesday. The announcement follows three other recent departures, and together, these changes amount to nearly a third of the CDC's top management either having already left or planning to do so. ... Why It Matters: The CDC, headquartered in Atlanta, operates more than two dozen centers and offices. The five latest officials to exit lead critical divisions, and while their departures have been described internally as retirements, they were not publicly announced.
[UK] Man to sell his 4,000 books in aid of hospice
03/28/25 at 03:00 AM[UK] Man to sell his 4,000 books in aid of hospice BBC News; by Emily Coady-Stemp and Jo Burn; 3/26/25 A man has opened a shop to sell his collection of 4,000 books to raise money for the hospice where he is receiving care. Rob McCann, from the Kent village of Sutton Valence, was diagnosed with pancreatic cancer in July 2023 and given just weeks to live. "Yet here I am, 18 months later, still going strong," he added. He opened Capelli's Books in his village on Tuesday to raise money for the Heart of Kent Hospice. [Continue reading ...]
Mitchell Hospice House celebrates upcoming grand opening
03/28/25 at 03:00 AMMitchell Hospice House celebrates upcoming grand opening KTIV-4 News, Sioux City, IA; by Acacia Phillips; 3/25/25 ... On Tuesday, Mitchell Hospice House celebrated its grand opening, which is less than a week away. At the celebration, members of the community had the opportunity to tour the facility. ... Mitchell Hospice House has a total of 9 rooms. ... They also have rooms for family members so they can be close to their loved ones. The goal is to provide a space for those who need that end-of-life care but want a place that feels like home. They officially open next Monday, March 31. [Contintue reading ...]
Saying goodbye to Dad
03/28/25 at 03:00 AMSaying goodbye to Dad MidlandsLife; by Jeff Becraft; 3/27/25 I know my last article talked about my Dad moving on to Higher Ground, but while it is still fresh on my mind, I’m going to delve into the process of saying goodbye. Perhaps it will resonate with someone who has already been down this path… or maybe someone who will be going down this path. I know that many people have been on a longer road than what I am going to describe. I won’t try to cover everything and there are some very significant things that are left out because of space; I will be simply giving my perspective on the overall experience of the last days. [Continue reading ...]Editor's note: If you have to dive into only one article today, this is the one. If you have experienced the vigil of a loved one's final days, this likely gives voice to your journey: "Each day we thought was going to be Dad’s last. It was certainly a time of changing emotions." If you have not experienced this, read to learn common rhythms and themes, dissonances harmonies, and final release into death. Thank you Jeff Becraft for your meaningful reflection.
Moral agency in healthcare: What does it mean?
03/28/25 at 03:00 AMMoral agency in healthcare: What does it mean? Healthcare Business Today; by Editorial Team; 3/27/25 ... Moral agency, as defined by the American Association of Colleges of Nursing, is ”having the intent and then acting to pursue, achieve, and maintain optimal beneficial outcomes consistent with the moral/ethical principles of one’s practice.” ... A moral agent is a person who can tell right from wrong and is held accountable for his or her actions. Moral agents have a moral responsibility not to cause unjustified harm, which is especially important in a healthcare setting. ...
Ohio payer beats UnitedHealthcare in racketeering lawsuit, awarded $50M
03/28/25 at 03:00 AMOhio payer beats UnitedHealthcare in racketeering lawsuit, awarded $50M Becker's Payer Issues; by Jakob Emerson; 3/19/25 An Ohio jury awarded Medical Mutual of Ohio over $50 million in damages on March 12 after the payer prevailed in its lawsuit against FrontPath Health Coalition and HealthScope Benefits, a subsidiary of UnitedHealthcare. FrontPath offers employee benefits solutions, and HealthScope is a third-party administrator. .. The defendants were found to have committed federal wire fraud, telecommunications fraud, tampered with records, and obstructed justice by submitting false bid information. The jury found that the conspiracy resulted in significant damages to Medical Mutual and ultimately caused taxpayers to pay higher healthcare costs than necessary.