Literature Review

Closing the palliative care workforce gap through state lawmaking: a survey of legislation 2010-2023 Journal of Pain and Symptom Management; by Eugene Rusyn, JD and Stacie Sinclair, MPP; 4/6/26Results: From 2010-2023, we identified 723 bills and laws pertaining to palliative care. Of those, fourteen related in whole or in part to workforce (representing 2% of the total) with five becoming law—representing a pass rate of 36%. Fifty-five legislative entries pertained to clinical skill-building (comprising 7.6% of bills or laws from 2010-2023), with seventeen becoming law—representing a pass rate of 31%. Taken together, these efforts represented a minority (9.5%) of state legislative action during the study period.

Arizona lawmakers reject bill to legalize assisted suicide Live Action; by Angeline Tan; 4/13/26 Arizona lawmakers have dismissed a rejuvenated attempt to legalize assisted suicide, dealing a setback to its proponents in the state. House Bill 2569 — also referred to as the Thomas M. Dow Act — did not move forward in the Arizona Legislature this session, and it was not scheduled for a hearing in a House committee. ... In Arizona, concerns about coercion and inadequate oversight contributed to the bill’s defeat. Lawmakers raised questions about how eligibility criteria would be enforced and whether vulnerable individuals could be influenced by family members, financial considerations, or systemic health care inequalities. For over 20 years, Arizona legislators have considered similar measures. 

Oregon governor signs Ryan’s Law, requiring care facilities to allow medical marijuana The Marijuana Herald; by Anthony Martinelli; 4/10/26 Oregon’s governor has signed House Bill 4142, known as Ryan’s Law, establishing new requirements for certain care facilities to allow qualified patients to use medical marijuana while also setting statewide standards for safety, storage and staff training. The measure was approved by the House in a 39 to 3 vote and by the Senate 20 to 8 before being sent to the governor. With the governor’s signature, the legislation now moves toward implementation, with most provisions taking effect in 2027. 

New measure likely to relax antipsychotic prescribing for certain hospice patients McKnights Home Care; by John Roszkowski; 4/8/26 Appropriate prescribing of antipsychotic medications to hospice patients no longer will negatively affect skilled nursing facilities’ quality ratings under a new federal rule change, potentially opening the door for SNFs to accept more hospice patients. The Centers for Medicare and Medicaid Services recently revised its Long-Stay Antipsychotic Quality measure to exclude residents receiving hospice services from the measure denominator for quality reporting. As a result, antipsychotic use for hospice residents will not influence a SNF’s Five-Star Quality Measure score.

LACo Board presses for stepped-up enforcement of hospice, home care fraud MyNewsLA.com; by Contributing Editor; 4/7/26 The county Board of Supervisors directed its staff Tuesday to develop recommendations aimed at improving coordination with other agencies to crack down on home health and hospice fraud. “Fraud in home health and hospice care is not just a financial crime — it is a direct threat to the health and safety of some of our most vulnerable residents,” Supervisor Lindsey P. Horvath said in a statement after the board’s unanimous vote. 

More people are choosing the option to die under Oregon’s Death with Dignity Act The Oregonian/OregonLive; by Kristine de Leon; 4/3/26 More people are turning to Oregon’s Death with Dignity Act – and more than ever are getting prescriptions for life-ending drugs, according to a new state data released Thursday [4/2]. For nearly three decades, the law has allowed Oregonians who meet certain conditions to receive prescription medications to help them end their lives, rather than waiting for a disease to run its course. ... An annual report compiled by the Oregon Health Authority shows more patients are seeking the option. Last year, doctors wrote 637 prescriptions under the Death with Dignity Act -- the highest number on record, according to state data. That’s a modest 5% increase from 2024, but part of a longer trend that has pushed participation steadily upward.

California targeted in House Committee investigation of hospice fraud

3 potential policy options for high-acuity palliative services Hospice News; by Jim Parker; 3/24/26 The Medicare Payment Advisory Commission (MedPAC) is considering new policy options to expand access to high-acuity palliative services for hospice patients. The treatments under exploration include palliative radiation, chemotherapy, dialysis and blood transfusions. Though these treatments can aid in palliation, patients often do not receive them due to high costs and questions as to whether they fall within the scope of the Medicare Hospice Benefit. To identify potential approaches, MedPAC conducted a literature review, stakeholder interviews, site visits and data analyses. 

50 years ago, Karen Quinlan’s coma sparked the movement for patients’ rights near the end of life The Conversation; by Kalpana Jain; 3/23/26 March 31, 2026, marks 50 years since a landmark decision that shapes American patients’ rights every day: the New Jersey Supreme Court ruling in the case of Karen Ann Quinlan, who had suffered an irreversible coma. Quinlan’s case established for the first time that decisions near the end of life should be made by patients and families, not by doctors and hospitals alone. As a bioethicist, I have taught and written extensively about the profound impact the Quinlan case has had on law, bioethics and the pursuit of death with dignity. A decade after the Quinlan case, New Jersey created a Bioethics Commission to study advancing health care technology in light of the decision’s principles. The commission’s proposed legislation establishing advance directives was enacted on July 11, 1991. I was privileged to lead this project, as staff to the commission. Today, all 50 states have advance directive laws that allow competent adults to plan ahead and put their wishes for end-of-life care in writing.

Scotland rejects assisted dying at final stage: MSPs cite coercion fears and palliative care gaps in decision Newser; by Arden Dier; 3/18/26 Scotland has just turned down a chance to become the first part of the UK to allow assisted dying despite widespread support among the public. After five debate sessions and a rare Friday sitting, members of the Scottish Parliament rejected the Assisted Dying for Terminally Ill Adults (Scotland) Bill late Tuesday by 69 votes to 57, ... The free vote cut across party lines, ... Opponents repeatedly warned of coercion ... and arguing efforts should instead focus on better end-of-life care. Supporters ... shared personal stories of family members' suffering, insisted robust protections—including doctor checks to determine whether a person was being coerced—were built in.Editor's Note: Scotland's debate resonates with those throughout the U.S. and other countries. I invite you to revisit a "most read" article from our newsletters, "PositivelyJAX Award: The purple bench of Compassionate St. Augustine." Pair these with Daniel Goleman's "cognitive empathy," for which you might not agree--or feel it the same as another--but you do seek to learn and understand the other person's perspective.

Hospice CARE Act reintroduced Hospice News; Jim Parker; 3/18/26 Rep. Linda T. Sánchez (D-Calif.) and Sen. Mark Warner (D-Va.) have re-introduced the Hospice Care Accountability, Reform, and Enforcement (Hospice CARE) Act, designed to modernize the Medicare Hospice Benefit, fight fraud and expand access to care. The bill contains a blend of program integrity provisions and payment reforms intended to “strengthen” the benefit, according to the lawmakers. The bill would establish new safeguards to prevent fraudulent providers from enrolling in Medicare and bolster federal oversight of hospices. It would also change payment structures to incentivize high-quality care. 

More states push to let terminally ill patients use cannabis in hospitals GreenState; by Taylor Engle; 3/4/26 ... Across multiple state legislatures, lawmakers are now advancing bills to let seriously ill patients use medical cannabis inside hospitals, hospice centers, and other care facilities. In the current session, proposals in Connecticut, Hawaii, Oregon, Virginia, and Washington State have moved forward, even as one similar bill stalled in Mississippi this week. At the heart of this push is a moral question that many find hard to dismiss: if a qualifying patient is legally using cannabis to manage pain, nausea, anxiety, or other symptoms at home, why should that care stop the moment they enter a hospital or hospice? Advocates have framed it less as a legal loophole and more as a gap in dignity and continuity of care: one that these bills aim to close.

Oregon legislature passes bill Stop Bad Actors from Taking Advantage of Hospice Patients OregonLegislature.gov, Salem, OR; Press Release, Office of Senator Deb Patterson; 3/4/26 Hospice began as a movement to provide end-of-life care for terminally ill patients. However, corporate investors have started buying up hospice agencies and reducing services as they try to maximize profits. In some states, this has led to patterns of fraud, abuse, and neglect. Today, the Oregon Legislature passed the Protecting the Dying Act (SB 1575), which enhances state oversight of hospice agencies. ... Senator Patterson began work on this issue after it was brought to her by a local hospice provider in her community. Iria Nishimura, CEO of Willamette Vital Health in Salem, said, “Hospice serves patients and families during the most vulnerable time of life. The state has a responsibility to ensure that providers entering this field are qualified, ethical, and capable of deliver high-quality care.”