Literature Review

Hastening death by stopping eating and drinking: Hope Wechkin, Thaddeus Pope, and Josh Briscoe GeriPal Podcasts; by Hope Wechkin, Thaddeus Pope, and Josh Briscoe Eric and Alex have featured discussions about complex bioethical concepts around caring for people at the end of life, including voluntarily stopping eating and drinking (VSED), and multiple episodes about the ethical issues surrounding medical aid in dying (MAID). Recently, discussion has emerged about how these issues intertwine in caring for patients with advancing dementia who have stated that they would not want to continue living in that condition: for those with an advanced directive to stop eating and drinking, how do we balance caring for their rational past self and their experiential current self? Should these patients qualify for medical aid in dying medications? And is there a middle path to provide some degree of comfort while also hastening the end of life?

Social Media Watch

Delaware House passes end-of-life option bill for terminally ill adults ABC Action News 6, Dover, DE; by 6abc Digital Staff; 3/20/25 Currently, medical aid for euthanasia is legal in 10 U.S. states and the District of Columbia. Delaware's House of Representatives has passed a bill giving some terminally ill residents the right to take their life. The bill allows mentally capable adult residents, who have been given a prognosis of six months or less to live, the option to request and obtain life-ending medication. The bill now heads to the Senate. ... Now, for the 10th time, Delaware lawmakers are trying once again to get the bill passed. ... Governor Matt Meyer has signaled his support if the bill passes the Senate,  ...

Hospice community responds to proposed DEA telehealth prescribing rule Hospice News; by Jim Parker; 3/20/25 A proposed rule by the U.S. Drug Enforcement Administration (DEA) could impede timely access to medications for hospice and palliative care patients, according to members of the hospice community. ... If finalized, this proposed rule would require prescribers to register with the DEA before they are allowed to prescribe schedule II-V controlled substances, along with some monitoring and other requirements.  ... Implementation of the proposed rule would have adverse consequences for hospice and palliative care patients, according to the National Alliance for Care at Home. ... The Alliance made several recommendations to the DEA regarding the proposal: 

From heroes to burnout: How we failed our frontline health workers MedPage Today's KevinMD.com, and excerpt from Health Care Nation; by Tom Lawry; 3/15/25 Of all the lessons learned from fighting a pandemic, none was more frightening or important than discovering how dependent the system is on how we treat our doctors, nurses, and frontline caregivers.  They were already in short supply, with burnout on the rise, when the pandemic hit. As multiple waves of COVID-19 variants washed over us, frontline health workers stepped in at great risk and personal sacrifice to care for highly infectious patients. ... Some witnessed more deaths on a double shift than they did in a normal year. They delivered the bad news to families and managed end-of-life care. They were often the last face and warm voice a COVID-19 victim saw and heard. In the end, they not only saved lives but saved the system from total collapse. ... We called them heroes. And we promised to do better in how we treated them once the COVID-19 crisis passed. Promises made should be promises kept. While we continue to talk about workforce burnout using polite terms with concern in our voices, let us be clear: A system with a mission of healing continues to harm in record numbers the very people in short supply who are there to take care of the rest of us. ... [Click on the title's link for more.]

Certified nurses at Mount Sinai: Representing a commitment to excellence and to their profession Mount Sinai Today - Featrued, Nursing; 3/18/25 Nursing Certification is an important, independent validation of specialized nursing knowledge and expertise that meet or exceed professional standards. In fact, empirical evidence shows an association between nursing certification and better patient outcomes, ... Across the Mount Sinai Health System, an impressive near 50 percent of nurses have earned board certification in their chosen specialties. Their patients, families, colleagues, and teams are the direct beneficiaries of nursing expertise that is recognized as meeting or exceeding the highest professional standards. ... [From Carla Alves-Miraldo, MS, MSN-Ed, RN, CHPN, KP6,] "Becoming a Certified Hospice and Palliative Care Nurse is a reflection of my commitment to ensuring every patient receives comfort, dignity, and compassionate care during life’s most challenging moments. This certification is more than a title—it represents my dedication to guiding patients and families with expertise, empathy, and unwavering support."

The Stanford Letter Project helps you discuss your end-of-life wishesKALW 91.7 FM - Your Call, Bay Area, CA; by Rose Aguilar and Nina Kissinger; 3/18/25 On this edition of Your Call, we discuss the importance of conversations, letters, and advance directives in communicating your end-of-life care wishes to loved ones and doctors. Although 92 percent of US adults say it's important to discuss their end-of-life care wishes, only 32 percent have had this conversation, and less than one-third have advanced-care directives in place. ... The Stanford Letter Project was designed to give you the tools you need to start the process. Dr. VJ Periyakoil, the founder and director of the project, shares her insights into making end-of-life care plans and resources to help guide you through the process. ... Resources [with links to the content]:

Dr. Sean O’Mahony aims to expand UTMB’s Division of Palliative Care UTMB Health - The University of Texas Medical Branch at Galveston;  3/18/25 Palliative care should be more accessible, bridge gaps in health care environment. ... Dr. Sean O’Mahony, director of the Palliative Medicine division, came to UTMB in June, having served as professor and Director of Supportive Oncology and Section Chief at Rush University Medical Center in Chicago, and in key roles at Albert Einstein College of Medicine and Memorial Sloan-Kettering Cancer Center. ... O’Mahony said, “I was attracted to UTMB’s commitment to underserved patients, its prison health population, and its large population of underinsured patients. I’m also interested in the opportunity to develop palliative medicine from the ground up in the mainland hospitals.” ... 

AI scribes: Can technology do more than free doctors from data entry? Penn LDI - Leonard Davis Institute of Health Economics; by Hoag Levins; 3/17/25 Since the widespread adoption of electronic health record (EHR) systems in the 1990s, the health care industry has been on a relentless quest to digitally optimize the doctor-patient interaction. Today, many predict this pursuit will be dramatically changed by the integration of artificial intelligence (AI) into nearly all aspects of EHR systems, transforming patient care and clinical workflows in ever more revolutionary ways. AI-powered EHRs are now theoretically capable of automating administrative tasks, providing real-time clinical insights, personalizing treatment plans, and allowing health care providers to focus more on patient care and less on data entry.

Improvement plans for hospital car park BBC News; by Ruth Lucas; 3/18/25 ... NHS Frimley has announced plans to make "positive improvements" to the car park at Frimley Park Hospital in Surrey Heath. ... NHS Frimley says this will increase capacity by 10%, while LED lighting and improved parking bay markings will also be installed. ... Free parking is currently available for disabled people, frequent outpatient attenders, parents of sick children staying overnight and visitors with relatives who are gravely sick, terminally ill or under palliative care.Editor's note: For hospital-based hospice/palliative care, do you provide any type of free parking, vouchers, middle-of-the-night security, or some other type of support for families of persons in your hospice/palliative care units? Consider the common experience of the patient dying in the middle of the night, and family leaving the hospital--especially if your parking conditions are unsafe or expensive. 

Salutes hospice staff, volunteers The Messenger, Fort Dodge, IA; Letter to the Editor by Mary E. Larson; 3/19/25 My heart was saddened when I heard that the Paula J. Baber Hospice Home is closing. I was the volunteer coordinator for UnityPoint Hospice volunteers from 2003-2022. A lot of our volunteers spend many hours in our wonderful Hospice Home helping our patients, their families and guests and staff. This home is such a blessing to our community. When our patients would come to the hospice home, our staff would care for them so their loved ones could spend more time being with them in their final days. ... It will be a huge loss for our community when it closes. Mary E. Larson

Assisted Living Facility owner indicted, facing numerous felony charges Knoxville Daily Sun; 3/17/25 ... In June 2024, after receiving a referral from Adult Protective Services, [the Tennessee Bureau of Investigation Medicaid Fraud Control Division (TBI)] special agents began investigating allegations involving Wendy Henley, the owner of Sunset Gardens Assisted Living Facility in Mountain City. ... [Agents] learned that Henley used a patient’s insurance benefits card to purchase items for the facility. In July, ... they discovered that seventeen residents, including two hospice patients, had been left in the care of two juveniles who were not authorized to provide direct patient care. Agents requested an immediate response from the Tennessee Health Facilities Commission and evacuated the facility, transferring the residents to other local facilities to assure their safety and continued care.