Literature Review

Why reflexivity matters in the literature of suffering, death, and dying in eating disordersJournal of Eating Disorders; by Scout Silverstein; 10/25Current debates on medical aid in dying and treatment futility in longstanding eating disorders emphasize diagnostic frameworks, ethical principles, and legal statutes. What remains underexamined is how an author's own experiences with suffering, death, and dying shape their perspective and conclusions. I argue that every manuscript on end-of-life care, decision-making capacity, or futility in eating disorders should include a reflexivity statement detailing the author's relationship to mortality. By mandating reflexivity disclosures alongside ethics and funding statements, journals can enhance transparency and allow readers to contextualize empirical claims and ethical positions. I propose a template for a reflexivity paragraph in which authors succinctly state their clinical or research focus, experiences with suffering, and forces that shape their views on suffering, futility, and dying.

How clinicians prenatally discuss management options and outcomes for congenital heart disease Journal of Pain and Symptom Management; by Samantha Syme, Kelsey Schweiberger, Judy C Chang, Ann Kavanaugh-McHugh, Nadine A Kasparian, Robert M Arnold, Kelly W Harris; 11/27/25 Online ahead of printA prenatal diagnosis of complex congenital heart disease (cCHD) introduces significant emotional, social, and financial stress for families. ... Fetal cardiology consultations offer an important opportunity to support families navigating uncertainty following a prenatal diagnosis of CHD. Clinicians approached these conversations with empathy and a focus on long-term outcomes, though discussions about management options varied. There is an opportunity for increased presentation and integration of palliative care consultants as a longitudinal, family-centered resource, regardless of mortality risk, which may enhance supports available to families during this highly emotional period.

Ophthalmology considerations in end-of-life careCureus; by Mendel Shloush, Akiva Eleff, Eric Eleff; 10/25Ophthalmologic interventions can significantly impact quality of life, even in the context of end-of-life care. This paper explores the ethical and clinical considerations for ophthalmologic treatments in hospice care, with a focus on cataract surgery, age-related macular degeneration (ARMD) therapy, retinal detachment (RD) repair, glaucoma, painful blind eye (PBE) management, benign and surface ocular tumors, and corneal or anterior segment diseases. Ophthalmologic procedures should be considered viable options in end-of-life care when clinically indicated, with careful ethical review. Restoration of vision contributes meaningfully to the quality of life and deserves thoughtful inclusion in care planning.Assistant Editor's note: When a patient is terminally ill on hospice, we focus on the Big-Bad illness-the one likely to cause death. But often patients suffer from other illnesses as well. For example, when my 95-year-old mom was dying from colon cancer and on hospice, she developed a severe corneal abrasion from an inwardly turned eyelid; a comorbid condition that she had endured for many years called entropion. In this case her inwardly turned eyelashes scraped open her cornea. She was in excruciating pain from her eye. Certainly, this condition was unrelated to colon cancer. But her hospice treated her as a whole person, knowing that her eye pain was contributing to her overall suffering. To their credit, the hospice admitted her to their in-patient hospice house for GIP intervention and care. They had to sedate her deeply for several days until the abrasion began to heal. She was then able to go back home and live comfortably until her death from cancer. There is great variability in what hospices consider "related conditions" and what they believe they are responsible for in terms of payment and treatment. In this case, my mom and us family members experienced only gratitude for the holistic and expert hospice care my mom received.

AI-assisted decision-making for end-stage organ failure: Opportunities and ethical concerns Artificial Organs; by John W Haller, Olga D Brazhnik, Kathleen N Fenton; 11/17/25 ... This paper discusses current applications of AI in healthcare, emphasizing the complex decision-making necessary for patients with organ failure. It outlines how AI can support risk stratification, patient selection, and outcome prediction, particularly in transplantation practices that increasingly rely on robust data to inform care pathways. ... There is a need for standardized, high-quality data, rigorous validation, and transparent algorithms to mitigate biases that could exacerbate disparities in care. Ethical considerations demand attention to equitable access, patient privacy, and the preservation of the human element in patient-clinician relationships. 

Care of the dying patient: Maximizing compassionate care on the battlefield Military Medicine; by Kathryn B Muir, Jeremy Edwards, Rebeccah Dindinger, Benjamin Ingram, Benjamin Baker; 11/9/25... Palliative care has also been employed throughout history on the battlefield and is a vital component of compassionate care for dying patients. Unfortunately, its use on the battlefield is an unpalatable topic with little formal documentation. ... We must prepare now to reduce the pain and suffering of dying patients on the battlefield and potentially mitigate the degree of moral injury sustained by the personnel managing those casualties. Consider ...

AHA responds to OSTP request on AI policies for health care American Hospital Association; by Ashley Thompson, AHA Senior Vice President, Public Policy Analysis and Development; 10/27/25 ... On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, 2 million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) appreciates the opportunity to provide comment on the Office of Science and Technology Policy (OSTP) request for information (RFI) regarding regulatory reform on artificial intelligence (AI). ... [Our] members have urged that policy frameworks strike the appropriate balance of flexibility to enable innovation while ensuring patient safety. The AHA offers four categories of recommendations to maximize the potential for AI to improve care, accelerate innovation and support the health care workforce.

New ACP paper provides ethical guidance amid controversies and changing practices in organ transplantation American College of Physicians (ACP), Philadelphia, PA; Press Release; 10/28/25 The American College of Physicians today issued a position paper on ethical considerations surrounding organ transplantation, saying the needs of the donor patient and family must be prioritized and the process should be trustworthy and transparent. “Ethical Issues in Organ Transplantation: A position paper from the American College of Physicians” was published in Annals of Internal Medicine.  It clarifies the duties and roles of care teams of prospective donor-patients, recipient-patients, and organ procurement teams, reaffirming that end-of-life decision making for prospective donor-patients must center on their best interests independent of organ donation potential. ... “This guidance is relevant to all involved in organ transplantation and particularly to internal medicine physicians who advise their patients about advance care planning and organ donation, caring for them prior to organ transplantation,” said Jason M. Goldman, MD, MACP, President, ACP. 

How to manage financial caregiving for an aging parent AOL.com; by Kerry Hannon; 10/25/25Steering end-of-life financial decisions for an aging parent is not a job many of us would choose. But we do — and feel our way through the messy emotions as best we can. ...[From an interview:] "[Your mom] was rejected for hospice care, which is covered by Medicare. Can you elaborate on that?""That was just such a slap in the face because it's a hard decision to go to hospice. ... My mom made that decision for herself, but my brother, the doctors, and me had to be on board with it in order for her to do it. The only reason they rejected her is because they thought she would be too costly. They do a cost-benefit analysis of how long that person is going to last— how much [in] resources is she going to consume? They decided that her diagnosis was too murky to justify putting her on hospice at that point. I finally found another hospice company to accept her. And she died in two weeks."

Where comfort and nutrition meet: A case series of children with severe neurologic impairment receiving home parenteral nutrition at the end of lifeNutrition in Clinical Practice; by Dana Steien, Erin Alexander, Molissa Hager, Andrea Armellino, Megan Thorvilson; 9/25Increasingly, home parenteral nutrition (HPN) ... is used for intractable feeding intolerance (IFI), which can occur near the end of life (EOL) in children with severe neurological impairment (SNI). [Four cases were retrospectively examined and we] found that the pediatric palliative care team (PPCT) was involved in all cases during HPN decision-making and planning. The pediatric nutrition support team (PNST) and PPCT collaborated to provide individualized, goal-directed care. All [patients] were enrolled in hospice while receiving HPN. HPN at EOL requires careful ethical consideration, particularly of autonomy because families often find comfort in providing nutrition.

Rise in late-stage lung cancer in nonsmokers highlights need for awareness and screening Medscape Medical News; by Evra Taylor; 9/5/25 ... The common thinking is that lung cancer is a smoker’s disease, but that isn’t the full picture, Jessica Moffatt, PhD, vice president of programs and health system partnerships at Lung Health Foundation in Toronto, told Medscape Medical News. ... Moffatt and her colleagues are working to dispel the stigma that smokers “get what they deserve.” Rosalyn Juergens, MD, professor of oncology at McMaster University in Guelph, Ontario, and president of Lung Cancer Canada, said, “If you find out someone has lung cancer, your first question shouldn’t be ‘Did you smoke?’ It should be ‘What can I do to help you along this journey?’ ” 

Wound care marketing can create confusion around hospice relatedness Hospice News; by Jim Parker; 9/16/25 Hospices provide wound care to many patients, but confusion can arise over questions of relatedness to the terminal illness. The goals of palliative wound care include primarily symptom management, comfort and dignity, but it does not always focus on healing the injury, a 2023 study indicated. This differs from general wound care, which does target healing. Palliative wound care is essential for hospice patients and most of the time should be considered related to the patient’s terminal condition, according to Felicia Walz, director of hospice quality for Colorado-based provider HopeWest. “Providing wound care to hospice patients is always appropriate,” Walz told Hospice News.

Hospice care co. can't duck claims it covered up death Law360; by Mike Curley; 8/27/25 A Texas appeals court has thrown out wrongful death and negligence claims against a hospice care provider in a suit alleging its employees are liable for a man's death from fentanyl overdose, but allowed claims that they covered up the cause of death by falsifying patient records to proceed.