Literature Review

Hospice fraud is real — but so is ethical hospice care Mountain Democrat, Placerville, CA; by Tim Meadows, CEO of Snowline Health; Molly Corbett, CEO of Livingston Memorial Visiting Nurse Association & Hospice; Deanna Brooks, CEO of Hospice of San Joaquin; Sarah McSpadden, CEO of The Elizabeth Hospice; and Craig Dressang, CEP of YoloCares; 5/20/26 Recent headlines detailing hospice fraud investigations across California are deeply troubling. ... These investigations are necessary, long overdue and effective. ... However, amid this justified scrutiny, it is critical not to lose sight of an equally important truth: Hospice fraud is not hospice care. ... Just as important, there are clear ways to identify ethical hospice providers. Families can protect themselves by taking a few simple, informed steps:

How resolving moral distress unlocks physicians’ potential AMA - American Medical Association; by Bobby Mukkamala, MD, President; 5/20/26 The inability to do what feels right affects physicians to a greater degree and can keep us from delivering the care we know our patients need. ... Across medicine, many physicians are confronting something deeper: moral distress. New research shows it is widespread, distinct from burnout, and carries serious consequences for physicians, patients and the healthcare system itself. 

Ohio nurses help hospice patients navigate end-of-life decisions Public News Service; by Nadia Ramlagan; 5/15/26 On the heels of National Nurses Week, hospice nurses are raising awareness about access to compassionate end-of-life care and medical decisions in the Black community. ... Ottamissiah "Missy" Moore, a longtime hospice nurse and member of the African American Leadership Council for Compassion & Choices, said her personal experience relying on hospice care showed her how important it can be for families. ... A recent study published by the Journal of the American Medical Association found around 34% of Black study participants died while using hospice services compared to more than 46% of their white counterparts. Moore added the disparity echoes other racial inequities in health care, such as nonwhite people being less likely to receive pain medications and higher rates of maternal mortality. 

How do physicians perceive and manage the influence of their personal end-of-life preferences on clinical practice and end-of-life decision-making with patients? An international qualitative study  Health and Medicine Daily | Palliative Care and Social Practice; research portion by Sarah Mroz, Frederick Daenen, and Kenneth Chambaere; 5/5/26 ... Physicians acknowledge the impact of their personal end-of-life preferences on their clinical practice and emphasize the importance of maintaining objectivity and centering decision-making on patient preferences. Physicians adopt strategies to mitigate potential biases. There is a divergence of opinion about whether it is appropriate to share when asked what they would do in the position of their patients. Most believe focusing on patients' values and priorities is essential and others feel sharing is crucial to maintain trust. Physicians struggle with ethical tensions and moral discomfort, particularly when patients' requests conflict with their beliefs. ...

Spokane police arrest hospice caretaker accused of stealing from dying patientsKXLY.com, Spokane, WA; by Kirstin O'Connor; 4/29/26 Spokane police arrested a hospice facility caregiver Wednesday on charges she stole debit cards from dying patients and their visiting family members to buy lottery tickets. Leena Anderson faces charges of second-degree identity theft, possession of stolen property and money laundering in connection with thefts at an unnamed Spokane hospice facility. The Spokane Police Special Investigations Unit launched the investigation several weeks ago after learning of several related thefts from victims at the hospice facility. Investigators determined Anderson was the only employee working during the time frame when all three thefts happened.

Nearly 40% of physicians report high moral distress, which significantly increases burnout Healio; by Josh Friedman; 4/21/26 An AMA survey of more than 9,000 individuals showed nearly 40% of physicians report high levels of moral distress, yet most U.S. adults experience none at their occupation. Physicians who reported high levels of moral distress had a significantly higher likelihood of burnout symptoms and intent to leave the profession. “Physicians want to do what they believe is right for patients. That’s what we want all health care professionals to do, prioritize patient care,” Michael A. Tutty, PhD, MHA, group vice president of professional satisfaction and practice sustainability at AMA, told Healio. “Leaders need to think about how we can reduce or eliminate those ethical challenges that make it harder for physicians to provide high-quality patient care.”

Palliative care for immigrants with cancer in the United States: a roadmap to equitable care Journal of Pain and Symptom Management; by Jessica Zhuo BAc, Cheryl Tolomeo BAc, Anissa Kurani BA, Meaghan Burke BAc, Stephanie Wang BAc, Alice Feng BAc, Yueao Zhang MDc, Edward Christopher Dee MD, Christopher T. Su MD, MPH; 4/8/26 Across the United States, immigrants with cancer, especially those who are undocumented or from low-income backgrounds, encounter significant barriers to accessing quality palliative care. Despite cancer comprising over one-third of global palliative care needs, immigrant patients are often excluded from essential services due to lack of insurance, immigration status, limited English proficiency, and culturally discordant care models. ... This narrative review identifies both patient level and systemic barriers and offers a four-part roadmap to address them. 

Sovereign Hospice: addressing late-stage renal condition care gaps in Fort Worth MyCarrollCountyNews.com, Dallas, TX; by Sovereign Hospice; 4/16/26 End-stage kidney disease affects hundreds of thousands of Americans each year. When kidneys can no longer sustain life without dialysis or a transplant, families are left to make decisions that few feel prepared for. Sovereign Hospice ... is drawing attention to a gap many families face: not knowing that hospice care services exist as a legitimate, fully supported option at this stage of illness. ... For patients with end-stage kidney disease, the shift away from aggressive treatment means that symptom management becomes the priority. Common symptoms at this stage include fatigue, pain, restlessness, and fluid retention. The interdisciplinary team is trained to address all of these through individualized care plans.

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. 

Managing clinical uncertainty Baylor College of Medicine; by Dr. Avni M. Kapadia and Dr. Hannah L. Kirsch; 4/10/26 In the day-to-day routine of critical care physicians, end-of-life care and medical ethics are frequently incorporated into comprehensive care plans. What happens when the laws impede the ability to honor family wishes? ... Recent ethical debates surrounding the care of brain-dead or severely neurologically injured pregnant patients highlight growing tension between clinical ethics and public policy. These cases are medically complex and emotionally devastating for families. But cases involving pregnancy and severe neurological injury also are especially difficult for the medical team. 

Moral distress and occupational burnout in US physicians JAMA Network; by Michael A. Tutty, PhD, MHA, Colin P. West, MD, PhD, Liselotte N. Dyrbye, MD, MHPE, Hanhan Wang, MPS, Lindsey E. Carlasare, MBA, Christine A. Sinsky, MD, Mickey Trockel, MD, PhD, Tait D. Shanafelt, MD; 3/24/26 Question: What is the level of moral distress and the association between burnout, intent to leave (ITL), and intent to reduce work hours (ITR) among physicians and US workers? Conclusion and Relevance:  In this survey study, moral distress was common among physicians and experienced at higher rates than the general US working population. Understanding the differences between moral distress and burnout may allow organizations to more effectively implement interventions to address both concerns among clinicians.