Literature Review

It was one of those March days when the sun shines hot and the wind blows cold: when it is summer in the light, and winter in the shade. ~ Charles Dickens, Great ExpectationsGoodbye to 2026 March days when weather felt like April Fools' jokes.

The demoralization of America's doctors Straight Arrow News; by Jess Craig; 3/30/26 Key takeaways:

Lost in transmission: Changes in organ donor status can fall through cracks in the system KFF Health News,  Akron News Reporter; by Céline Gounder; 3/29/26 When Raven Kinser walked into a Virginia Department of Motor Vehicles office two summers ago, she completed a driver's license application that included the option to register as an organ donor. The form provides a checkbox to opt in, but not one to opt out. Kinser left the donor registration box unchecked, reflecting her decision to reverse an earlier donor registration. Six months later, after she was declared dead at Riverside Regional Medical Center in Newport News, Virginia, her parents say, they learned that her decision did not prevent organ procurement. Raven's case reveals a little-known gap in the U.S. donation system: There is no clear, nationally binding way to opt out or to ensure a later "no" overrides an earlier "yes" in a different state.

Mike Schramm: 'The Pitt' and the doctrine of double effect 1819 News, Birmingham, AL; by Mike Schramm; 3/27/26 ... In season two [of The Pitt], episode eight, Drs. “Robby” and McKay begin a conversation about a patient with terminal cancer in agonizing pain who is nearing death. “Where are we with the morphine?” Robby asks, suggesting they raise the dosage. After being told (surely for the viewers) “she could stop breathing,” he gestures and asks, “Are you familiar with the doctrine of double effect?” ... “We treat pain,” Robby explains. “And if, in doing so, there’s a negative side effect, we accept it.” “Even if the negative side effect is death?” McKay asks. While this might seem intuitive to some, its history and reasonability cannot be taken for granted. This doctrine of double-effect basically affirms that a good or neutral action may be morally undertaken in good conscience, even if one knows that a secondary bad result will occur from that action.

‘No silver bullet’: The iterative staffing strategies home-based care providers need Home Health Care News; by Morgan Gonzales; 3/26/26 The home-based care staffing landscape is undergoing a shift, as worker demographics, desires and motivations evolve. ... [There] there is no single technique that serves as a panacea, and providers must continually iterate their strategies, according to Kerin Zuger, the chief operating officer at Caretech. “There is no silver bullet,” Zuger said on a recent Home Health Care News webinar. “What do we need to do with our recruiting and onboarding strategy so that we can hire more caregivers and get them to stay? The answer is, everything. The answer is, try it all and then try it again. 

Hospice of Wichita Falls celebrates donors and volunteers KFDX/KJTL, Wichita Falls, TX; Press Release; 3/27/26 An evening of gratitude took stage as Hospice of Wichita Falls celebrated the people who make its mission possible. The organization hosted its annual Maverick Appreciation Dinner at the MPEC on Thursday, March 26, bringing together donors, volunteers, staff, media and community partners for a night focused on recognition and connection. 

Part of the ‘nephrology toolbox’: ASN releases conservative kidney management guidance Healio; by Lucas Laboy, Susan P. Y. Wong, MD, MS, Jane O. Schell, MD, MHS; 3/27/26 The American Society of Nephrology issued new kidney health guidance on conservative management as a practical treatment option for patients with kidney failure. Key Takeaways:

If you really look closely, most overnight successes took a long time. ~ Steve JobsHere's to this week's tasks for wrapping up 2026's Quarter 1 and moving into Quarter 2.

The clinical dilemma of withholding futile treatment Medscape; by Brenda Sandburg; 3/27/26 During hospital rounds, Kenneth Covinsky, MD, MPH, a professor of medicine and clinician researcher in the Division of Geriatrics at the University of California San Francisco, sometimes meets families at a wrenching crossroads: a loved one with advanced dementia is no longer eating, slowly losing weight because they no longer are hungry. They ask the question almost every time — can’t something be done? ...

Documented California hospice fraud prompts broad ranging inquiry from national oversight and accountability organization Empower Oversight - Whistleblowers & Research, Washington, DC; 3/26/26 Empower Oversight today pressed for comprehensive records from the California Department of Public Health (CDPH) related to hospice fraud and oversight failures across California — with a particular focus on Los Angeles County. The records request targets widespread regulatory failures in the county. The letter request spans five broad categories asking for:

Gone from my sight: Barbara Karnes on what happens in the final days of life | part one Teleios Collaborative Network (TCN); podcast hosted by Chris Comeaux with Barbara Karnes; 3/25/26 Drawing from over four decades of bedside experience, Barbara shares how Hospice Care began as a movement outside the traditional medical model, rooted not in treating disease, but in caring for people and their families during life’s most vulnerable moments.  Her insights challenge modern healthcare to return to a more human-centered approach—one that prioritizes presence, education, and compassion.

Haven Hospice simulations help caregivers understand dementia Levy Citizen, Chiefland, FL; by Antoniette Meyer; 3/19/26 A program offered by Haven Hospice is helping caregivers, medical professionals and community members better understand what daily life can be like for someone living with dementia. ... Through Haven’s Dementia Care Program, participants can take part in hands-on simulations designed to replicate some of the sensory and cognitive challenges people with dementia experience. During the exercises, attendees may wear specialized goggles or gloves, listen to music or attempt tasks that simulate symptoms such as vision loss, hearing impairment, reduced motor function and changes in perception. ... Attendees who participate in the simulations often report that the experience is eye-opening, helping them develop greater empathy and learn ways to communicate more effectively with people living with dementia.Editor's Note: Experiential education like this offers something lectures alone cannot—an embodied understanding of what it may feel like to live with dementia. These kinds of empathy-building simulations are not only powerful, but also adaptable for many settings. Consider how similar approaches could support your interdisciplinary team, volunteers, and non-clinical staff—especially those who both contribute to patient care in meaningful ways and navigate dementia in their own families.

The good deaths of people who never marry: Lifelong single people are most likely to die pain-free and at peace. Psychology Today; by Bella DePaulo, PhD; 3/8/26 People who are single and want to stay that way are often taunted with scare stories about what will happen to them toward the end of their life—they will grow old alone, they will die alone, and all the rest. Same for people who have no children. But is the quality of the end of their lives really worse for those who never marry (or never have kids) than it is for those who are married, remarried, divorced, or widowed (or who have grown children)? We now have an answer, and it is not at all what those dire warnings predicted.Editor's Note: This Psychology Today article provides a new lens in the research we shared on 3/20/26, “We make our own families”: Do child-free people die alone? Hospice worker shares her experience. Important: “child-free” does not necessarily mean a person never married, and “never married” does not necessarily mean a person is child-free. Together, they raise a deeper question: is a “good death” defined by traditional family—or by the presence of meaning, connection, and peace, however we choose to build it?