Literature Review

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. 

Language preference is associated with goals-of-care communication and end-of-life care in dementia Journal of General Internal Medicine; by Lauren R. Pollack MD, MS, Lois Downey MA, Ruth A. Engelberg PhD, James Sibley BS, Linda K. Ko PhD, Kimiko Domoto-Reilly MD, MS, Lyndia C. Brumback PhD, Annie T. Chen PhD & Rashmi K. Sharma MD, MHS; 3/30/26 Background: People with dementia and preferred language other than English (PLOE) in the United States may face communication-related barriers to high-quality end-of-life care.Objective: Compare end-of-life care characteristics among people with dementia and PLOE versus those preferring English. ... [Efforts] to improve end-of-life care for those with PLOE might prioritize ED and hospital-based interventions, recognizing their critical safety-net functions, as well as ensure that people with dementia and PLOE and their families have sufficient cultural and linguistic support to engage in high-quality end-of-life communication with their healthcare providers.Editor's Note: Pair this with today's post, "Neenah pastor finds deeper calling after brother’s hospice journey."

The demoralization of America's doctors Straight Arrow News; by Jess Craig; 3/30/26 Key takeaways:

End-of-life care planning for individuals with special needsJD Supra; by Chamblis, Bahner & Stphel, P.C.; 3/23/26 Takeaways

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.

Will Scotland be the first [in the UK] to legalise assisted dying? BBC News; by James Cook, Scotland editor; 3/16/26 For more than a year, Scottish politicians have been grappling with matters of life and death as they debated one of the most contested bills in the history of devolution. Tuesday's (3/10) final Scottish Parliament vote on the Assisted Dying for Terminally Ill Adults (Scotland) Bill is seen as too close to call. But, if it passes, Scotland could become the first nation in the UK to legalise assisted dying. ... Critics of the bill have called it dangerous and say MSPs should focus instead on improving end-of-life care. ... [Supporters of the bill have] said the result was a "bulletproof" bill which amounted to "the toughest and most comprehensively-safeguarded" such legislation in the world.

Nursing's moral agency cannot be outsourced to AI, study warns Medical Xpress; by University of Pennsylvania School of Nursing; 3/10/26 As artificial intelligence (AI) rapidly integrates into clinical settings—from predicting patient outcomes to deploying humanoid "robotic nurses"—an article published in the Hastings Center Report warns that the core of nursing, its moral agency, must remain a human-driven responsibility. The article, What Does Moral Agency Mean for Nurses in the Era of Artificial Intelligence?, explores the growing tension between advanced algorithmic capabilities and the ethical obligations of the world's most trusted profession. While AI systems can now simulate empathy and generate context-aware responses, Penn Nursing's Connie M. Ulrich, Ph.D., RN, FAAN, the Lillian S. Brunner Chair in Medical and Surgical Nursing, Professor of Nursing, and Professor of Medical Ethics and Health Policy, and her co-authors argue that AI lacks sentience, intentionality, and accountability. The authors define a moral agent as a person capable of discerning right from wrong and being held accountable for their actions.

Values considerations in telemedicine: Pause before shiftingJournal of Pain and Symptom Management; by Meaghann S. Weaver, Kenneth A. Berkowitz; 12/25As a contingency standard of care, telemedicine use surged during the COVID-19 pandemic. The Medicare telehealth flexibilities introduced during the COVID-19 pandemic expired in September 2025. Any ongoing sustained pivot to telemedicine warrants purposeful attentiveness to ethical considerations and not just technology use as an end unto itself. Telemedicine has the potential to complement face-to-face care practices and enhance clinical interactions when its use is based on shared values. Values such as access, equity, justice, compassion, autonomy, and dignity warrant thoughtful use of telemedicine. Patients and families need to be able to trust that clinicians and health systems will place patient welfare and shared values above technical convenience. As demonstrated in this case description, upholding values fundamental to the practice of medicine in telemedicine can enhance patient connection and foster trustworthy postpandemic practices.

[Japan] Ethics based educational interventions on end-of-life care for undergraduate nursing students: A scoping reviewInternational Journal of Nursing Studies advances; by Saeko Kutsunugi,Satoko Ono, Misae Ito, Kaho Suda, Siu Ling Chan, John Tai Chun Fung, Claudia Kam Yuk Lai, Kyoko Murakami; 6/26Nurses face various ethical dilemmas and conflicts in end-of-life care; however, there is no evidence of effective undergraduate ethics education on the topic settings to address them. The results suggest that while lectures are effective for acquiring ethical knowledge and attitudes related to EOLC based on ethical competency, simulations are more effective for acquiring practical skills such as communication, self-efficacy, and reflection. Incorporating ethical issues in simulations is hoped to broadly develop ethical practice competencies.