Literature Review

Sen. Baldwin demands investigation into veteran care failures at Tomah VAWXOW-19 ABC, Tomah, WI; by Terry Bell; 9/21/26 U.S. Sen. Tammy Baldwin is calling for an immediate investigation into serious allegations about the failure to care for veterans and unacceptable conditions at the Tomah VA Medical Center. Baldwin is asking Department of Veterans Affairs Secretary Doug Collins to conduct a full review of staffing levels, provider coverage, medication delays, hospice care and patient safety at the Tomah VA Hospital. She's also requesting the VA Office of the Inspector General conduct an independent investigation. Baldwin's office heard from several Tomah VA employees who outlined severe lapses in patient care at the hospital. The allegations include inadequate staffing contributing to falls, injuries, food choking incidents and other adverse patient outcomes. [View recent incident:  Former VA nurse charged with intentionally abusing hospice patient]

The dark side of full patient autonomy Medscape; by Lisa O'Mary; 9/14/26 Paternalism is out. Shared decision-making is in. But some communication and ethics experts say medicine is veering far too much toward full patient autonomy. A new review in the journal Health Communication found that clear delivery, active listening, and empathy were associated with patient trust. Obvious? Probably. But here’s the twist: The authors also found that paternalistic styles didn’t always harm trust — and even aided shared decision-making in some situations, particularly in contexts such as emergency care, serious illness, and end-of-life decisions.

Central Illinois nursing home fined $25K by state after resident's death Pekin Daily Times, Perioa, IL; by Zach Roth; 9/6/26 A Canton nursing home was fined $25,000 after a resident died last year after being taken off medication that was prescribed to prevent blood clots. ... On March 31, 2025, a verbal order was given to stop providing Xarelto because the woman began hospice care one month prior. ... The care plan noted that she had a history of strokes and that medication needed to be provided as ordered by her doctor. ... The hospice's owner said that the power of attorney had contacted them after the woman had died asking about the medication situation, noting that they hadn't seen anything to show that her Xarelto had been discontinued. The hospice owner also said that they hadn't received an order from a hospice physician or nurse to discontinue it. Editor's Note: Details are more complex than space allows in the short summary above. A verbal order to stop a medication, without a documented physician directive or clear communications with the family, is a quiet risk hiding in plain sight at hospice transitions — one that can hasten death rather than ease it. Deprescribing has its place in end-of-life care, but only through structured, physician-ordered, shared decision-making. Does your hospice's process protect against this, or could it happen to one of your patients tomorrow? 

Can I get a witness? The ethical dimensions of family presence in patient sufferingThe Hastings Center Report: by Jennifer Blumenthal-Barby, Trevor M Bibler, Holland Kaplan, Adam Omelianchuk, Joanna Smolenski; July-August 2026For patients who are suffering, the bedside presence of a family member can provide comfort, and many people hold that there is moral value in being present with a conscious, suffering patient. Yet what is the moral significance of the absence of family members when a patient is minimally conscious or unconscious and not aware of their absence? Clinicians are often troubled when family members and surrogate decision-makers who are able to spend a significant amount of time at an unconscious, seriously ill patient's bedside do not do so. Clinicians feel frustrated that they must bear the burden of witnessing the patient's actual or perceived suffering while the family escapes this burden and therefore appears to fail to uphold a duty to the patient. Is it morally defensible to request or require family members to be present with an unresponsive patient to bear witness to their actual or perceived suffering?

Dad demands answers after daughter dies of rare cancer: why are so many kids getting sick in this community? (exclusive)People; by Wendy Grossman Kantor; 8/14/26Lilly Dalton grew up a few miles from Ladera Ranch, where at least a dozen young people and children have been diagnosed with Ewing sarcoma. Three days after graduating from college at Loyola University in New Orleans, Lilly Dalton told her parents her stomach hurt. Doctors found a tumor on the 21-year-old’s liver and she was diagnosed with a very rare, one-of-a-kind cancer. Lilly was raised in Laguna Niguel, a city in Orange County, Calif. — just six miles from Ladera Ranch, where 12 children and young adults have been diagnosed with another rare cancer, Ewing sarcoma. “That’s not a coincidence,” says her father, Brian Dalton, 49, who now lives in Meridian, Idaho, with Lilly’s mom, Nicole Dalton, 50. 

Moral distress is the wound behind bedside careKevinMD.com; by Amanda Dean, RN; 8/9/2026A physician I follow on social media is an incredibly talented artist. He turns medical scenarios into cartoon sketches, as if they belong in a Sunday newspaper instead of on a telephone screen. One of his recent renderings depicted the typical ICU patient: intubated, sedated, and surrounded by machines. Standing beside the hospital bed were two individuals with captions over their heads saying, “Look at all of this! This is torture! He is suffering!” An identical image was placed by its side, the only difference being the captions overhead. This time they read, “Look at all of this! What amazing care! He’s getting everything!” The images invited almost 200 comments, ranging far and wide along the opinionated spectrum. ...

At and end-of-life care home, a young cancer survivor finds his calling  The Buffalo News, Buffalo, NY; by Jon Harris; 7/28/26  Seated in the chapel at Sloan Comfort Care Home, 22-year-old Evan Folsom reflected on what working at the end-of-life facility has meant to him. "The Home did come at the right time for me," said Folsom, hours after finishing an overnight shift there, and a day before taking the daylong Medical College Admission Test. Folsom survived a brain tumor as a toddler and spent years recovering. That alone shaped an interest in medicine. ... His work at Sloan Comfort Care Home helped him come to terms with certain issues and fueled his interest in studying the complex moral and ethical questions that arise in medicine. So he took a "shot in the dark" and applied to Harvard Medical School's Master of Science in Bioethics program, along with a few other schools. He got into all of them but chose Harvard because Boston holds a special full-circle meaning for him. Massachusetts General Hospital, the largest teaching hospital of Harvard Medical School, is where he received treatment as a toddler. "Harvard was specifically deep for me, because that's kind of where my journey started," he said. Folsom leaves for Boston on Aug. 1 ...

Ask the expert: Who are hospital ethics consultants? Michigan State University; by Zach Phelps and Dalin Clark; 7/21/26Hospitals are places of incredible hope and healing, but they are also where some of life’s toughest decisions are made. When families and medical teams find themselves at a crossroads with no obvious right answer, trained experts can quietly help evaluate the options. Hospital ethics consultants don’t perform surgery or prescribe medication. Instead, they wield a different kind of superpower: the rare ability to bring insight and clarity to moments of deep uncertainty. When the best path forward isn’t on a medical chart, these guides step up to support families and healthcare teams.

Civility requires the willingness to engage – a dispute with a neighbor revealed how much motivation matters The Conversation; by Deborah Mower, Center for Practical Ethics; 7/2/26 ... Civility research matters for ethics education across every discipline, especially fields such as law or medicine where contentious political and moral disagreements are likely to arise. Consider, for instance, the tense conversations between healthcare professionals who disagree about whether the best course of treatment for a patient is to turn to hospice services. Civility has a role to play in the workplace, too, where people need to navigate disagreements with colleagues and also between potentially conflicting professional and legal obligations, client expectations and ethical beliefs. ... Civility isn’t the absence of disagreement, heated disagreement or even outright anger, but continued engagement in the face of and despite such emotion.

US lawmakers urge stricter monitoring of medically assisted suicide in hospices The Guardian | US healthcare; by Coral Murphy Marcos; 7/9/26 Lawmakers urged the health and human services (HHS) secretary, Robert F Kennedy Jr, on Thursday to establish strict hospice reporting rules to prevent discrimination and coercion in medically assisted suicide. The bipartisan group of members of Congress warned that older adults, people with disabilities, or those with disaffected caregivers face a particular risk of being pressured to end their lives. “Every person has inherent worth and dignity, including those facing their final days,” said the Republican senator James Lankford in a statement. ... Lankford, as well as the Democratic senator Tim Kaine, Republican representative Greg Murphy and Jose Luis Correa, a Democratic representative, signed a joint letter asking HHS and the Centers for Medicare & Medicaid Services (CMS) to monitor the practice.