Literature Review
All posts tagged with “Clinical News | Ethics.”
Prairie Doc Perspective: Navigating spiritual pain and grief
07/25/25 at 03:00 AMPrairie Doc Perspective: Navigating spiritual pain and grief Rawlins Times - Prairie Doc Perspective, Rawlins, WY; by Rev. Kari Sansgaard, Avera Hospice; 7/23/25 After nearly 20 years of parish ministry, I entered the world of health care, which, I learned, abounds in acronyms. My first clue was in chaplaincy training, known as CPE (Clinical Pastoral Education), the required education for most hospital and hospice chaplains. CNA, SoB (Shortness of Breath), PRN, HoH (Hard of Hearing), and a myriad of other acronyms are now part of my own vernacular. QoL (Quality of Life) is the big one in hospice, sometimes called “comfort care.” When quantity of life becomes diminished, it’s all about quality. ... In hospice, when death is impending, spiritual pain can lead us to ponder existential questions, such as the following:
Hochul weighs political risk of aid-in-dying bill
07/23/25 at 03:00 AMHochul 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.
Parental authority and the weight of assent: Navigating moral dilemmas in adolescent end of life care
07/19/25 at 03:25 AMParental authority and the weight of assent: Navigating moral dilemmas in adolescent end of life careJournal of Bioethical Inquiry; A. L. Heifner, M. M. Ortiz, T. L. Major-Kincade, C. O’Connor; 6/25 In the current era of moral pluralism, medical decisions must account for much more than clinical considerations: they must abide by legal standards of decision-making which usually prioritize parental preferences. Conflict abounds between the parent or other legal decision-maker and healthcare team in situations where the parent prefers not to disclose the severity of the adolescent’s illness or the healthcare team believes continuing lifesaving therapies are not in the adolescent’s best interest. These dilemmas challenge how we solicit adolescents’ preferences (assent) and their options for refusal (dissent). We explore the moral distress healthcare workers face navigating conflict amongst various stakeholders involved in the adolescent’s end-of-life care. Strategies to minimize moral distress are also provided.
My health and my politics walk into a doctor’s office …
07/18/25 at 02:00 AMOpinion: My health and my politics walk into a doctor’s office … The Washington Post; by Kim Fellner; 7/16/25 [Note: Access is behind a paid firewall, with an option to set up a temporary free account]... My palliative care doctor and I have almost nothing in common. We’re still learning from each other. ... It began simply enough. By October, my sarcoma had moved from possibly curable to definitively terminal, and, since metastasis to the bones can be painful, my anchor oncologist offered to connect me with a palliative care doctor to help with the physical and conceptual aches and pains of dying. Which seemed like a good thing to do. ... I did not anticipate, however, that the personal and the political would collide in my doctor’s office. ... [Descriptions unfold of significant, conflicted dialogue between (1) this Jewish daughter of holocaust survivors whose life-long vocation was social justice and (2) this Christian palliative care physician who asked about mental health and then dismissed this person's primary concerns that were affecting her dying.] ... Clearly, my doctor and I shared some beliefs about the importance of the palliative approach. ... But as the doctor noted, the best palliative care goes beyond the purely physical to address the more cosmic questions of life and death, and I was uncertain we were well matched as partners for this intimate process. ... I had no idea how to proceed. ... [More descriptions.] ... And that’s where the magic happened. Within a few days, my palliative care doctor sent me back a transparent, thoughtful and moving response. ... Her courage and openness, her willingness to risk a forthright response, have precipitated a remarkable dialogue about what each of us brings into the room, and how we can honor the space and each other once we get there. ... Editor's Note: Whatever one's political or religious stance, this article is sure to spark fireworks—of conflict, dissonance, and, hopefully, powerful insight. I encourage readers to engage with it attentively, attuned to three things:
[Germany] A Berlin doctor goes on trial, accused of murdering 15 patients who were under palliative care
07/16/25 at 03:00 AM[Germany] A Berlin doctor goes on trial, accused of murdering 15 patients who were under palliative care U.S. News & World Report; by Associated Press; 7/14/25 A German doctor went on trial in Berlin Monday, accused of murdering 15 of his patients who were under palliative care. The prosecutor’s office brought charges against the 40-year-old doctor “for 15 counts of murder with premeditated malice and other base motives” before a Berlin state court. The prosecutor’s office is seeking not only a conviction and a finding of “particularly serious” guilt, but also a lifetime ban on practicing medicine and subsequent preventive detention. ... Parallel to the trial, the prosecutor’s office is investigating dozens of other suspected cases in separate proceedings. The man, who has only been identified as Johannes M. in line with Germany privacy rules, is also accused of trying to cover up evidence of the murders by starting fires in the victims' homes. He has been in custody since Aug. 6.
Family of brain-dead mom, Adriana Smith, inspires Georgia bill to protect pregnant patients
07/15/25 at 02:00 AMFamily of brain-dead mom, Adriana Smith, inspires Georgia bill to protect pregnant patients BET*; by Jasmine Browley; 7/7/25 During a memorial to Adriana Smith, state Rep. Park Cannon unveiled new legislation aimed at giving patients and their families more control over Georgia's severe abortion law. ... Smith's case received global attention due to its unique and contentious circumstances. On February 9, Smith began complaining about headaches. The young nurse and her mother sought assistance at two separate hospitals before being discharged with medicine but no CT scan. A week later, Smith was discovered unresponsive at home, and on February 19, she was formally pronounced brain-dead and placed on life support. Her mother, April Newkirk, told WXIA that doctors at Emory Hospital claimed they couldn't legally examine any additional choices. ... In June, a few days after doctors performed an emergency cesarean surgery to prematurely deliver her baby, the young mother of two was taken off life support. ... Smith's son Chance, born at six months, weighed only one pound and thirteen ounces. ... Cannon's proposed new law would have returned control of Smith's end-of-life care to her family, who were not consulted before physicians put her on life support to save her six-week-old fetus. ... Adriana's Law would take precedence over Georgia's LIFE ACT, ...
Wisconsin author discusses her mother’s aging, dying in the American health care system: The long-term care system failed both her and her mother, she writes
07/01/25 at 02:00 AMWisconsin author discusses her mother’s aging, dying in the American health care system: The long-term care system failed both her and her mother, she writes Wisconsin Public Radio; by Colleen Leahy; 6/27/25At age 99, Judy Karofsky’s mother was kicked out of her Wisconsin hospice facility. Within 48 hours of that decision, Karofsky became her mother’s default nurse. “I had to find a wheelchair for her. I had to keep track of her meds. I had to buy all the bandages and supplies that she would [need],” Karofsky told WPR’s “Wisconsin Today.” Karofsky is the author of “Diselderly Conduct: The Flawed Business of Assisted Living and Hospice.” In it, she chronicles nightmare scenarios as her mother aged and died in the American healthcare system: making her way through independent living, six different assisted living facilities, memory care, skilled nursing and hospice.
How long was Adriana Smith on life support? Brain‑dead nurse's baby delivered by C‑section
06/20/25 at 03:00 AMHow long was Adriana Smith on life support? Brain‑dead nurse's baby delivered by C‑section Enstarz; by David Unyime Nkanta; 6/18/25 The 31-year-old nurse was declared brain dead early in her pregnancy—her baby was born via C-section nearly four months later, sparking legal and ethical debate. Adriana Smith, a 31‑year‑old nurse in Atlanta, was declared brain dead in mid‑February after suffering serious blood clots in her brain. Despite devastating diagnosis, she remained on life support for nearly four months—a decision doctors said was legally necessary under Georgia's strict abortion laws. This rare case of maternal somatic support—keeping a brain-dead woman alive to deliver a baby—is highly unusual. On 13 June, doctors at Emory University Hospital performed an emergency c‑section, delivering a boy they named Chance, weighing just 1 lb 13 oz (around 830 g). ... Smith's mother, April Newkirk, described the ordeal as 'torture,' saying: 'I see my daughter breathing, but she's not there.' The family maintain that they were never allowed to make treatment decisions, a situation that has deeply distressed them and prompted calls for change.
“Her toes fell off into my hand”: 50 moments that changed healthcare workers forever
06/20/25 at 02:00 AM“Her toes fell off into my hand”: 50 moments that changed healthcare workers forever BoredPanda; by Dominyka; 6/18/25 When we go through traumatic events, our brain can shut out feelings and thoughts as a way to protect us from emotional or physical damage. This can make people go numb in stressful situations, so our bodies have time to figure out the best course of survival. Healthcare workers are frequently exposed to traumatic experiences, so when they were asked what event made them go permanently numb, they shared many devastating stories. Scroll down to find them below, and don’t forget to share similar ones if you have any.
[UK] Palliative sedation at the end of life: Practical and ethical considerations
06/19/25 at 08:10 PM[UK] Palliative sedation at the end of life: Practical and ethical considerationsClinical Medicine; Dr Caroline Barry MBBS FRCP LLM FHEA PG Cert; Dr Robert Brodrick MB ChB (Hons) MA MRCP FHEA; Dr Gurpreet Gupta MBBS BSc PG Cert; Dr Imranali Panjwani LLB, PGDip, PG Cert, PhD; 6/25Highlights: The aim of palliative sedation is to relieve refractory suffering with the use of medications to reduce consciousness. Where palliative sedation is being used to treat agitation at the end of life, it is important to exclude and/or address reversible causes prior to starting medication. The drug, dose and route of administration of palliative sedation may vary according to the indication for treatment. Appropriate and proportionate use of palliative sedation does not hasten death. Suffering may have different meanings for people depending on their backgrounds and life experiences.
My dad had an Advance Directive. He still had to fight to die
06/13/25 at 03:00 AMMy dad had an Advance Directive. He still had to fight to die Newsweek - My Turn; by Maggie Schneider Huston; 8/26/24, published in our newsletter 8/27/24My mom died peacefully. My dad died 72 days later, angry at the doctors for ignoring his wishes. ... Dad had heart surgery on December 20, 2023. An hour after the surgery ended, his vital systems started shutting down. A cascade of interventions, one after another, kept him alive. Four days later, he said: "Put me on hospice." The doctor dismissed this request, rolling his eyes and saying: "Everyone on a ventilator says that." On Christmas Day, my father asked for hospice again. He was in pain. He knew his recovery would be long and ultimately futile. He would never have an acceptable quality of life again. ... Dad's care team insisted palliative care was the same as hospice care, but he knew the difference. He wanted hospice care. Finally, they reluctantly agreed and called for a social worker to make arrangements. It wasn't necessary. Once they removed his treatment and relieved his pain, he died five hours later. ... Editor's Note: This article is not about Medical Aid in Dying (MAiD). It is about honoring Advance Directives, person-centered care with communications and actions related to "palliative" vs. "hospice" care. Pair this with other posts in our newsletter today, namely "Improving post-hospital care of older cancer patients."
His sick wife asked him to kill her. Now that she's gone, he says the loneliness is worse.
06/12/25 at 03:00 AMHis sick wife asked him to kill her. Now that she's gone, he says the loneliness is worse. USA Today; by Madeline Mitchell; 6/11/25 Ever since his wife died in December, David Cook feels like a stranger in his own home. ... The loneliness “is a problem,” Cook said, and sometimes he slips into dark, depressive episodes he can only shake with sleep. He avoids the living room, with the framed photos of the two of them smiling together, the new plush carpet, the television where they'd watch tennis and golf and the ghost of the recliner she used to sit in. Patricia Cook died there, so for now − maybe forever − it's off limits. ... When she went into hospice in their living room, adamant that she’d die in her own home, the pain was excruciating. “She actually, several times, asked me to kill her," Cook said. "And I didn’t even have to think about it, I just said, ‘I’m sorry.’ I said, 'I just can’t do that.’” “Do you know how hard that is?” Cook said. “When someone asks you to kill them?” ... Editor's note: Spoiler alert. David Cook did not kill his wife. Still, he asks, "What more could I have done?" Read this story to develop your understanding of the profound depths of loss for spouses/partners, especially when they have served as caregiver through challenging needs.
[New York] State Senate passes Medical Aid in Dying Act, bill heads to governor’s desk
06/11/25 at 03:00 AM[New York] State Senate passes Medical Aid in Dying Act, bill heads to governor’s desk Finger Lakes Daily News; by Lucas Day; 6/10/25 The New York State Senate passed the Medical Aid in Dying Act late Monday night, paving the way for New York to become the 11th state in the nation to legalize medical aid in dying. The vote followed hours of contentious debate and passed largely along party lines, 35-27. Six Democrats broke ranks to oppose the measure. The State Assembly had already approved the legislation in April by a vote of 81-67, meaning the bill now heads to Governor Kathy Hochul, who has the final say on whether it becomes law.
National group, Oregon Death with Dignity leader says ‘modernization’ bill strips safeguards
06/09/25 at 03:00 AMNational group, Oregon Death with Dignity leader says ‘modernization’ bill strips safeguards The Lund Report; by Nick Budnick; 6/5/25 Barbara Coombs Lee, co-author of Oregon’s first-in-the-nation Death with Dignity law, as well as the national assisted-dying group Compassion & Choices, oppose parts of a state Senate bill that they say would remove key safeguards from the law. ,,, [The] group is “very much opposed” to some changes the bill makes, such as eliminating the “fail-safe” of requiring a second doctor vouch for the patient’s state of mind. The group does not support the bill unless it restores needed safeguards, she said. ... The bill makes the most significant changes yet to the law. It would shorten the mandatory waiting period to seven days from the current 15. It also streamlines requirements for institutions to notify patients of their Death With Dignity policies by allowing them to post notices on their websites, and permits electronic transmission of lethal prescriptions.
Sister Grace spent her life helping the homeless. Now in hospice, she reflects on legacy and lessons
06/09/25 at 03:00 AMSister Grace spent her life helping the homeless. Now in hospice, she reflects on legacy and lessons WXXI News NPR, Rochester, NY; by Gino Fanelli; 6/6/25Sister Grace Miller smiles as she props herself up in her hospice bed and gently teases her strands of chestnut brown hair. “How does my hair look?” she asks. It’s the type of remark one would expect from Miller. Sister Grace is many things: a radical compassionate, a devout follower of the Catholic faith, a civil disruptor, and a wielder of a sharp, slightly sardonic wit. ... The 89-year-old champion for the homeless and destitute is dying, in hospice care at a congregation home on Carter Street. But her spirit is alive and well. “I would fight with them over whatever, whatever the people needed,” Miller said, referring to the county and city administrations she often tangled with over the years. “I would fight for the people. ... She said it was, ultimately, an undying, uncompromising commitment to the work she does as a fierce and fearless advocate for the poor.
Q&A with Jim Obergefell on the future of Supreme Court's gay marriage ruling, LGBTQ rights
06/03/25 at 03:00 AMQ&A with Jim Obergefell on the future of Supreme Court's gay marriage ruling, LGBTQ rights Fremont News Messenger; by Laura A. Bischoff; 6/1/25 In 2013, Ohioans Jim Obergefell and John Arthur flew on a medical jet to exchange vows in Maryland where same-sex marriage was legal at the time. With Arthur in hospice care for amyotrophic lateral sclerosis, time was slipping away for the Cincinnati couple and their home state of Ohio prohibited same-sex marriage. Days after their tarmac wedding, civil rights attorney Al Gerhardstein showed them a blank Ohio death certificate. "Do you guys understand that when John dies, his last record as a person will be wrong here, where it says marital status at the time of death?" Gerhardstein told them. "Ohio will say John was unmarried. And Jim, your name will not be here, where it says surviving spouse name." Brokenhearted and angry at the idea of not being recognized by Ohio, Arthur and Obergefell told Gerhardstein, yes, they wanted to do something about it. Arthur didn't live to see the fruits of that decision: On June 26, 2015, in a 5-4 decision in Obergefell v. Hodges, the U.S. Supreme Court decided states must allow for same-sex marriages and must recognize those solemnized in other states. Arthur died in October 2013 at the age of 48.
Saugus nurse arrested in FBI raid for alleged part in $2.5 million Medicare [hospice] fraud
06/03/25 at 02:15 AMSaugus nurse arrested in FBI raid for alleged part in $2.5 million Medicare [hospice] fraud KHTS - Santa Clarita News, Santa Clarita, CA; by Jade Aubuchon; 5/30/25 Jessa Zayas, aka Jessa Contreras, a vocational nurse, is believed to have committed medicare fraud through two different hospice providers, submitting more than $2,500,000 in fraudulent claims to Medicare. Zayas is the Chief Executive Officer of two hospice providers, Healing Hands Hospice Inc. and Humane Love Hospice. From June 2023 through February 2025, she caused Healing Hands and Humane Love to bill Medicare for millions of dollars’ worth of hospice services that were not medically necessary, not authorized by a physician, and were not actually provided to the patients. ...
Assisted living facility where woman was fatally beaten operated out of 'pure greed:' Suit
05/29/25 at 03:00 AMAssisted living facility where woman was fatally beaten operated out of 'pure greed:' Suit Delaware New Journal; by Isabel Hughes; 5/20/25 The family of an 83-year-old woman who was fatally beaten by another resident at The Summit assisted living in North Star has accused the facility and its parent company of "pure greed," claiming in a recently filed lawsuit that the previously violent assailant was not removed from the facility because he brought in nearly $400,000 for the company. The family of Shyuan Hsia who was attacked and left to suffer in her room for hours on the night of Aug. 5, 2024 filed the 84-page suit in New Castle County Superior Court in late April. ... Discovery Senior Living, the lawsuit says, "recklessly failed to remove" him, "because if they did so, they stood to lose approximately $370,000 in revenue." That number was derived from:
[Australia] What voluntary assisted dying options are available for those with dementia?
05/28/25 at 03:00 AM[Australia] What voluntary assisted dying options are available for those with dementia? ABC News Melbourne, Australia; by Emily JB Smith; 5/24/25 John Griffiths suspects his mind is starting to fail. It is a horrifying prospect for the father-of-three, former Monash University engineering lecturer and CSIRO research scientist. The Melbourne man spends much of his time with his wife Rachel, who lives in residential aged care, reading her poems and short stories. While doctors say he is all clear at the moment, he will be assessed for dementia in the next year. If he does develop the condition, he would rather die than let it take hold. But his options are limited. Although voluntary assisted dying (VAD) will be legal in every Australian jurisdiction except the Northern Territory by the end of this year, it remains entirely off-limits for people with dementia. ...
Hospice nurse fired after granddaughter shares video of alleged misconduct
05/22/25 at 03:00 AMHospice nurse fired after granddaughter shares video of alleged misconduct NBC WJAR-10, Providence, RI; by Leanna Faulk; 5/16/25 A hospice nurse has been fired after a Facebook video posted by the granddaughter of a terminally ill man allegedly caught the nurse verbally abusing him inside HopeHealth Hospice & Palliative Care on Main Street in Providence. Aryanna Pecoraro said she was visiting her 69-year-old grandfather, John Carney, during the early morning hours of May 3 when she overheard a nurse speaking aggressively to him through the closed door of his room. Carney had been admitted to the hospice center on April 30 and was in the late stages of emphysema. “I hear her say to my grandfather, ‘I’m not coming back into this room. I don’t care if you fall out of the bed onto the floor. I’m tired of your BS," Pecoraro said in an interview with NBC 10. “She also mocked him while he groaned in pain. I couldn’t believe someone could be that cruel to a person who couldn’t defend himself.” ... HopeHealth issued the following statement in response to the video and allegations: ...
After multi-year battle, Delaware Medical-Aid-in-Dying bill is law
05/21/25 at 03:00 AMAfter multi-year battle, Delaware Medical-Aid-in-Dying bill is law WDEL.com 1150AM and 101.7 FM - Delaware's News Now; by Mark Fowser; 5/20/25, 1:38pm ET Delaware is now the 12th jurisdiction to allow adults who are terminally ill and want to bring an end to their suffering to request and self-administer medication that would end their lives. Governor Matt Meyer Tuesday signed Delaware's Medical Aid in Dying legislation (House Bill 140) into law, which was passed by the General Assembly earlier this year. The measure also passed last year after a ten-year battle, but was vetoed by then-Governor John Carney. "For those with terminal illness who are seeking out more choices at end of life, the signing of this bill provides those in that circumstance one more option than they had just yesterday," Tim Appleton with The Compassion and Choices Action Network said. The legislation will take effect by January 1st, 2026 - or earlier, pending the implementation of regulations. Under the act, several medical professionals would have to agree that a person's prognosis is terminal with six months or less to live, the adult must be able to make clear decisions, and the person would need to be able to self-administer the medication. Appleton also had a message for people who think this may encourage more people to take their lives: "to assure that not one more person will die as a result of this legislation, but far fewer will suffer."
[United Kingdom] For, against, undecided: Three GPs give their views on assisted dying
05/16/25 at 03:00 AM[United Kingdom] For, against, undecided: Three GPs give their views on assisted dying BBC News; by Catherine Burns and Vicki Loader; 5/13/25 If you ask these three doctors about being GPs, their answers are remarkably similar. "It can be the best job in the world," one tells me. It's "a privilege" another says. They all talk about how they love getting to know their patients and their families. But all three have different views on assisted dying. Right now, the law here is clear: medics cannot help patients to take their own lives. But that could change. The Terminally Ill Adults (End of Life) Bill is being debated in Parliament. And if it goes through, it will give some terminally ill patients in England and Wales the option of an assisted death. Here, three doctors - Abdul Farooq, Susi Caesar and Gurpreet Khaira, who all have a different view on assisted dying - tell us how they feel about the proposals.
He was dying, Alabama sent him back to prison anyway
05/14/25 at 03:00 AMHe was dying, Alabama sent him back to prison anyway AdvanceLocal - AL.com - Alabama Media Group; by Renuka Rayasam; 5/12/25 Brian Rigsby was lying with his right wrist shackled to a hospital bed in Montgomery, Alabama, when he learned he didn’t have long to live. ... Rigsby decided to stop efforts to treat his illness and to decline lifesaving care, a decision he made with his parents. And Rigsby’s mother, Pamela Moser, tried to get her son released to hospice care through Alabama’s medical furlough policy, so that their family could manage his end-of-life care as they saw fit. But there wasn’t enough time for the furlough request to be considered. After learning that Rigsby was on palliative care, the staff at YesCare, a private prison health company that has a $1 billion contract with the Alabama Department of Corrections, told the hospital it would stop paying for his stay and then transferred him back to Staton Correctional Facility in Elmore, according to the hospital record his mom provided to KFF Health News. Moser never saw or spoke to her son again. “The last day I went to see him in the hospital, I was hoping he would take his last breath,” said Moser, a former hospice nurse. “That is how bad I didn’t want him to go to the infirmary” at the prison. A week later, Rigsby died ... in the infirmary, according to his autopsy report. Officials at the corrections department and YesCare did not respond to requests for comment.
[United Kingdom] Assisted dying bill: further protections for nurses proposed
05/12/25 at 03:00 AM[United Kingdom] Assisted dying bill: further protections for nurses proposed Nursing Times, London, UK; by Edd Church, source Roger Harris, House of Commons; 5/7/25 No nurse who declines to aid in assisted dying procedures will be at risk of “any detriment” to their careers under a new amendment to the Terminally Ill Adults (End of Life) Bill, the MP behind the draft legislation has claimed. Kim Leadbeater, MP for Spen Valley, announced earlier this week that she would be proposing to extend the “opt-out” provisions in her bill for healthcare workers who work in settings where assisted dying may take place. Ms. Leadbeater said, in a statement released this week, that she understood that “not all people working in and around” healthcare would want to participate in the provision of assisted dying. "Nobody will be at risk of any detriment to their careers if, for any reason at all, they chose not to take part." The bill currently already states that healthcare professionals can conscientiously object to taking part and that employers “must not” subject employees to detriment for exercising this right.
It's time to talk about LGBTQ+ elder care
05/12/25 at 02:15 AMIt's time to talk about LGBTQ+ elder care Psychology Today - Caregiving; by Stephanie Sarazin, M.P.P.; 5/6/25 A once-hidden story is helping us think about queer kinship and caregiving. Key points: