Literature Review

Ethics of artificial intelligence prognostication in palliative care: perspectives from a national survey of palliative care physicians BMJ Supportive Palliative Care; by Ahmed Y Alasmar, Lauren Gunn-Sandell, Stacy M Fischer, Regina M Fink, Elizabeth Juarez-Colunga, Eric G Campbell, Matthew DeCamp; 8/2-/26, online ahead of print ... Although global consensus is emerging about the importance of ethical principles for artificial intelligence (AI), such as respecting autonomous choice, promoting patient well-being, reducing bias, trust, and more, little is known about how palliative care physicians perceive these issues. This study aims to improve understanding of palliative care physicians' perspectives about the ethics of AI-based prognostication. Conclusion: Palliative care physicians see the potential of AI-based prognostication to improve palliative care and also express ethical concerns. Implementation of AI requires context-specific ethical guidance responsive to palliative care, where relationships and communication are paramount.

Pittsburgh Caregivers get federal lifeline as dementia cases swell across Allegheny County hoodline; by Ryan Miller; 8/21/26 Caregivers looking after loved ones with dementia in Pittsburgh now have a new federal tool to lean on, and it is already showing up at a day center in Squirrel Hill. The Anathan Club, run by the Jewish Association on Aging, has begun connecting families to the Guiding an Improved Dementia Experience Model, a Medicare program that can cover up to $2,500 a year in respite care for qualifying beneficiaries. The Guiding an Improved Dementia Experience Model, known as GUIDE, was developed by the Centers for Medicare and Medicaid Services and launched nationwide on July 1, 2024, as an eight-year voluntary pilot running through June 30, 2032, according to CMS. Nearly 390 provider organizations across the country are participating. 

Goal-concordant care for older adults with advanced heart failure: A retrospective cohort studyPalliative Medicine; by Sarah Godfrey, Maryjane Farr; 7/26Older adults with advanced heart failure experience significant morbidity and mortality and face higher complication rates from advanced therapies. Of 212 patients, 91 (42.9%) underwent evaluation for advanced therapies, though few received a heart transplant (16, 7.5%) or left ventricular assist device (32, 15.1%). Most (148, 69.8%) had only one palliative physician visit. One hundred thirty-nine (65.6%) died, often in the hospital (55, 40%) and with life-sustaining therapy in the last 24 h (73, 52.5%). Most (167, 78.8%) received goal-concordant care, with the main reasons for discordance being the desire for advanced therapy (33, 15.6%) and complications post-implantation affecting quality of life (9, 4.2%). Conclusions: Few older adults received advanced therapies, and palliative care was underutilized, with many patients seeing palliative care only once. Most received goal-concordant care, but decisions were often made late, highlighting the need for earlier, longitudinal palliative care for these vulnerable patients.

[Israel] Existential suffering at the end of life in long-term care: A critical essay on recognition, dignity, and witnessPalliative Care & Social Practice; by Anat Romem, Rachel Bardach; 7/26Existential suffering is widely acknowledged in palliative care, but it remains inconsistently recognized and unevenly addressed in long-term care. This critical essay argues that the gap is not caused by clinician indifference, but by a persistent mismatch between whole-person ideals and care systems organized around measurable symptoms, risk management, task completion, and professional uncertainty. [This] ... essay identifies three interrelated shortcomings: the reduction of suffering to medically actionable symptoms; the depersonalizing effects of institutional routines on frail older adults; and the absence of shared existential literacy across interdisciplinary teams. The essay also cautions against romanticizing suffering or treating meaning-making as a clinical expectation. It proposes a practical framework of recognition, dignity, and witness: recognizing biography and identity as clinically relevant; protecting dignity in the ordinary details of care; and enacting witness ... Long-term care cannot resolve every existential wound, but it can reduce existential neglect by treating personhood as a core quality indicator of palliative care.

HHS decertifies Kentucky organ procurement organization Hazard Herald, Hazard, KY; by an Appalachian Newspapers Staff Report; 8/15/26 The U.S. Department of Health and Human Services announced in a statement Aug. 5 that it has decertified Network For Hope, the federally designated organ procurement organization serving Kentucky and parts of Indiana, Ohio and West Virginia. According to the statement, the move comes after multiple federal reviews found "persistent safety failures despite extensive oversight and despite Network for Hope having been provided repeated opportunities to correct them." The failures, according to the statement, put prospective organ donors and patients awaiting lifesaving transplants at risk.

Who should palliative care see? Diane Meier, Bob Arnold, and Justin Sanders GeriPal; by Alex Smith; 8/13/26 As Diane Meier remarks to start today’s podcast, palliative care has come a long way from the days when we were the “brink of death” consult. We’re seeing patients earlier and earlier in the course of illness.  In fact, the evidence base for specialist palliative care is arguably stronger in the outpatient setting than the inpatient setting.  In some ways, as Eric remarked, we are a victim of our own success. We’ve pushed on the boundaries of seeing patients earlier in the course of illness, we’ve demonstrated remarkable value to our colleagues and health systems: now they want us to see more and more patients, with conditions we would not have previously considered core to palliative care practice. Our guests modeled respectful disagreement, and we were somewhat surprised that there was more agreement than we expected.  

[Portugal] Ketamine for cancer-related pain in palliative care: A systematic review of clinical use and safetyJournal of Pain & Palliative Care Pharmacotherapy; by Catarina Vitorino-Afonso, Paulo Reis-Pina; 7/26Ketamine has emerged as an adjuvant for opioid-refractory cancer-related pain in palliative care, but evidence remains limited. [This study found that] ketamine was used mainly as an adjuvant. Many reports described reduced pain and/or lower opioid use, although certainty was very low and attribution was limited by polypharmacy and regimen changes. Intravenous infusions were most common, but subcutaneous, oral, and intranasal routes were also used. Intranasal ketamine showed pragmatic utility for breakthrough pain, while oral ketamine was described in ambulatory palliative care settings.

[Canada] Daughter says elderly father chose MAiD due to 'loss of hope' after not qualifying for hospice LiveAction.org; by Bridge Sielicki; 8/11/26 Colleen De Vos told EWTN News Nightly that her 85-year-old father died in 2023 after being diagnosed with terminal chronic obstructive pulmonary disease (COPD). Though he had initially agreed to hospice or in-home palliative care, he was denied the care he needed. “He was turned down on two occasions, deeming that his diagnosis wasn't enough to warrant hospice care,” De Vos said. “That was a surprise to us because we could see he was deteriorating very quickly.” Nevertheless, he was able to qualify for MAiD. “The irony of the availability of MAiD that could be arranged very quickly... sidelined us very much,” she said. ...

Palliative care consults for the oldest-old: A retrospective study of referral patterns, patient characteristics, and clinical outcomes Geriatric Nursing; by John Cameron, Kalli Stilos, Anita Chakraborty; 8/11/26Objective: This study describes the characteristics and outcomes of patients aged 90 and older (the oldest-old) receiving inpatient palliative care consultation at a tertiary care hospital, to identify gaps and opportunities to improve care. ... Conclusion: Referrals for specialist palliative care in the oldest-old occur late in hospitalization, predominantly among those with non-cancer illnesses and poor functional status. Systemic changes, including the use of prognostication tools and enhanced collaboration between geriatric and palliative care services, are needed. Nurses are pivotal in advocating for earlier advance care planning (ACP) and identifying patients who would benefit from timely palliative integration to ensure goal-concordant care.

52 hospitals closing departments or ending servicesBecker's Hospital Review; by Andrew Cass; 8/7/26A number of healthcare organizations have recently closed medical departments or ended services at facilities to shore up finances, focus on more in-demand services or address staffing shortages. Here are 52 department closures or services that are ending or have been announced, advanced or finalized that Becker’s reported since Jan. 1: ... [#40 names, "Minot, N.D.-based Trinity Health is suspending home health and outpatient hospice services. ...] 

Hospice leaders: palliative care through home health a limited prospect Hospice News; by Jim Parker; 8/6/26 Structuring palliative care payment through the home health benefit is the wrong approach, according to some hospice leaders. The U.S Centers for Medicare & Medicaid Services (CMS) in its proposed 2027 home health rule included language specifying that Medicare would cover community-based palliative care through the Medicare home health benefit. ... CMS indicated in a statement, “Therefore, in this proposed rule, CMS states that skilled palliative care services can be furnished and billed under existing Medicare home health benefits for eligible patients with serious illnesses.” ... But the home health chassis is not built to support the full range of interdisciplinary palliative care, some hospice leaders contend. The benefit also imposes certain limitations. For example, patients would need to be homebound. ...

Mandatory mortality surprise question screening in the ED: Identification and associations with end-of-life care outcomesJournal of Palliative Medicine; by Nancy Kim, Karen Jubanyik, Peiyuan Liu, Giselle O'Connor, Ling Han, Rohit B Sangal, R Lynn Fiellin, Jennifer Kapo, Elizabeth Prsic, Shelli Feder; 7/26Early identification of patients with serious illness remains challenging in the emergency department (ED), where clinical decisions are made under time constraints. The mortality surprise question (MSQ) is a brief prognostic screen that may help identify patients needing end-of-life services. Results: Among 113,397 admissions (74,816 patients), MSQ completion was 100%; 7.8% received a "No" response. A "No" response was strongly associated with increased palliative care consultation ... , ACP documentation ... , hospice referral ... , comfort-measures-only orders ... , hospice disposition ... , higher inpatient mortality ... , and increased 30-day readmission ... Palliative care consultation occurred earlier among MSQ "No" than MSQ "Yes" encounters.