Literature Review

Trump administration hands over Medicaid recipients’ personal data, including addresses, to ICE Associated Press (AP), Washington, DC; by Kimberly Kindy and Amanda Seitz; updated 7/17/25 Immigration and Customs Enforcement officials will be given access to the personal data of the nation’s 79 million Medicaid enrollees, including home addresses and ethnicities, to track down immigrants who may not be living legally in the United States, according to an agreement obtained by The Associated Press. The information will give ICE officials the ability to find “the location of aliens” across the country, says the agreement signed Monday [7/14] between the Centers for Medicare and Medicaid Services and the Department of Homeland Security. ... Such disclosures, even if not acted upon, could cause widespread alarm among people seeking emergency medical help for themselves or their children. ... The database will reveal to ICE officials the names, addresses, birth dates, ethnic and racial information, as well as Social Security numbers for all people enrolled in Medicaid. The state and federally funded program provides health care coverage program for the poorest of people, including millions of children. ... [Federal] law requires all states to offer emergency Medicaid, a temporary coverage that pays only for lifesaving services in emergency rooms to anyone, including non-U.S. citizens. Emergency Medicaid is often used by immigrants, including those who are lawfully present and those who are not.

Palliative video consultation and symptom distress among rural inpatients-A randomized clinical trialCritical Care Medicine; by Marie A. Bakitas, Shena Gazaway, Felicia Underwood, Christiana Ekelem, Vantrice T. Heard,  Richard Kennedy, Andres Azuero, Rodney Tucker, Susan McCammon, Joshua M. Hauser, Lucas McElwain, Ronit Elk; 7/25The triple threat of rural geography, racial inequities, and older age has hindered access to high-quality palliative care for many people in the US. Only 70% of the deep South vs 85% to 94% of the rest of the US has palliative care despite the deep South having the greatest needs due to suboptimal health care access and elevated morbidity and mortality. In this RCT [randomized clinical trial] among Black or African American and White chronically ill hospitalized adults, culturally based specialist palliative care video consultation was not associated with statistically significant reduced symptom distress compared with usual care, but there was a clinically meaningful difference ... between groups. Contrary to our hypotheses, intervention participants’ QOL [quality of life] and resource use (secondary outcomes) also were not improved.Assistant Editor's note: This study reminds us that palliative care delivered virtually, as opposed to in-person, may not be of benefit to some individuals. It also reminds us that palliative care, in its finest form, usually works best when delivered on an ongoing basis by a known, trusted professional(s). 

Hochul weighs political risk of aid-in-dying bill Fingerlakes1.com, Seneca Falls, NY; by Staff Report; 7/18/25 Gov. Kathy Hochul is under pressure as she considers signing New York’s Medical Aid in Dying Act, a controversial bill allowing terminally ill patients access to life-ending medication, according to Politico. The bill has strong support from advocates and many voters, but faces fierce opposition from religious groups and conservatives. Hochul, a practicing Catholic eyeing reelection, must balance public opinion, personal beliefs, and political risk.

CHP Home Care & Hospice celebrating 50 years of service The Van Wert Independent, Van Wert, OH; by Greg Yinger; 7/20/25 CHP Home Care & Hospice is celebrating a half century of providing home-based health care services in northwest and west central Ohio. The non-profit, 501c3 organization was incorporated in December of 1974 and served its first patient on March 1, 1975. Dr. E. E. White, a local physician, initiated the establishment of a home health care service because Van Wert County was one of five Ohio counties at the time that lacked these services. Dr. White hired Donna Grimm, a registered nurse, and with the help of a $3,000 grant from the United Way of Van Wert County, Van Wert Area Visiting Nurses Association – later changed to Community Health Professionals (CHP) – was established.  

Two programs recognized as 2025 AHA Circle of Life Award Honorees | AHA American Hospital Association, Washington, DC; Press Release; 7/17/25 Two programs will be honored with the American Hospital Association 2025 Circle of Life Award for their efforts in palliative and end-of-life care. The winning programs are Gilchrist, Baltimore, Maryland, and Bristol Hospice – Hawaii, Honolulu, Hawaii. Both winners will receive this prestigious recognition during the AHA’s Leadership Summit in Nashville on July 20-22. The Circle of Life Award honors hospital and palliative care programs that are ensuring equitable access to care, implementing nontraditional models of care delivery and payment, fully integrating palliative care into a system of care or a community, making palliative care financially sustainable, developing meaningful measures and metrics to track progress, or partnering with payers, other providers, community groups and faith communities.Editor's Note: For more information,

True terror is to wake up one morning and discover that your high school class is running the country. ~Kurt Vonnegut

Evaluating a large language model in translating patient instructions to Spanish using a standardized frameworkJAMA Pediatrics; Mondira Ray, MD, MBI; Daniel J. Kats, MD, MBI; Joss Moorkens, PhD; Dinesh Rai, MD; Nate Shaar, BA; Diane Quinones, MS, RN, CPNP; Alejandro Vermeulen, BFA, CMI; Camila M. Mateo, MD, MPH; Ryan C. L. Brewster, MD; Alisa Khan, MD, MPH; Benjamin Rader, PhD; John S. Brownstein, PhD; Jonathan D. Hron, MD; 7/25Patients and caregivers who use languages other than English in the US encounter barriers to accessing language-concordant written instructions after clinical visits. Large language models (LLMs), such as OpenAI’s GPT-4o ... can translate Spanish translations of real-world personalized written patient instructions that are comparable in quality to those generated by professional human translators. Independent professional medical translators preferred the GPT-4o–generated translations over the human translations, and error analysis revealed a higher rate of mistranslation errors in the human translations. These findings demonstrate GPT-4o’s ability to produce quality translations in Spanish ...

How health care systems shape end-of-life care—A step toward transparencyJAMA Network Open; by Jacqueline M. Kruser, Gordon D. Rubenfeld; 7/25Our health care systems, in all their multifaceted complexities, are more influential in shaping the delivery of care than individual human effort or error. Influential system-level factors span many different domains: how we are paid, the buildings we work in, the technology around us, who and how many we have on the team caring for patients, our workload, and our local social networks of influence. One pragmatic first step in addressing the problem of invisible, inaccessible, and/or inflexible patterns of end-of-life care is to build awareness of and foster transparency about the current patterns and their default orientation. Building from this deeper understanding of how our everyday routines and practice patterns influence care, we can then take the bigger step of intentionally designing our routine clinical practice patterns to be systematic yet flexible in their support of patients with serious illnesses.

Parental goals of care for children with rare diseases: A content analysis of pediatric advance care planning conversationsAmerican Journal of Hospice and Palliative Medicine; Tamiko Younge, MD, MSHS; Hailey Moore, MS; Jessica D. Thompkins, BSN, RN, CPN; Maureen E. Lyon, PhD; 7/25Caregivers and surrogate decision makers for children with rare diseases often make complex medical decisions with limited prognostic information specific to their child’s disease. Our objective was to describe goals of care as explored through advance care planning conversations among the high-risk and high-need community of families with children with rare diseases. We identified 13 goals of care themes: maintaining stability, being happy, moving the body, thriving along their own path, reducing interventions, living a long life, curing disease, avoiding complications, connecting with others, having a village, an understanding world, knowing our child, and partnering with our medical team. Conclusions:Parents of children with rare diseases have a multitude of holistic goals related to their child’s care. High-quality advance care planning conversations may help families articulate these goals.

Benefits of emergency department-initiated goals of care conversations and palliative care consultations among older adults with chronic or serious life-limiting illnessesJournal of the American College of Emergency Physicians Open; by Jennifer Johnson, Timmy Li, Megan Mandile, Santiago Lopez, Molly McCann-Pineo, Landon Witz, Payal Sud; 8/25Initiating goals of care (GOC) conversations and palliative care consultations in emergency departments (EDs), compared with inpatient settings, may be associated with improved outcomes among older adults with chronic or serious life-limiting illnesses. ED-initiated GOC conversations were associated with approximately 3-day shorter hospitalizations and a $2689 contribution margin increase, suggesting increased health care cost savings. ED-initiated palliative care consultations were associated with approximately 7-day shorter hospitalizations, 6 fewer excess days in acute care, 1 fewer intensive care day, and higher odds of hospice discharge. Starting these discussions earlier in the ED may help hospitals optimize resources while ensuring treatment aligns with patients’ palliative needs and care preferences.

Systemic strategies to prevent nonbeneficial treatments near the end of lifeJAMA Network Open; by Sofia Weiss Goitiandia, Amy Z. Sun, Amy Rosenwohl-Mack, Catthi Ly, Katherine E. Sleeman, Daniel Dohan, Elizabeth Dzeng; 7/25There exists a default toward high-intensity treatments near the end of life in the United States, including for people living with advanced dementia (PLWD). Clinical momentum, a cascade of increasingly intensive treatments facilitated by systemic factors, contributes to this default. The intensity of treatments provided to PLWD near the end of life is lower in Great Britain. Using Great Britain as a counterexample to the United States, this study examines factors that may contribute to lower-intensity treatment patterns.