Literature Review

"The best, most difficult thing I've ever done": The complex experiences of palliative and hospice familial caregiversAmerican Journal of Hospice & Palliative Care; by Hannah Rachiele, Kathryn Levy, Gina Schuster, Sheila Conboy, Pei C Grant, Christopher W Kerr; 2/26Caring for chronically or terminally ill individuals comes with unique challenges and circumstances that are specific to each situation and individual involved. The purpose of the current study was to better elucidate the scope of challenges and benefits attributed to caring for a loved one with a serious, life-limiting illness. Four main themes emerged: (1) Burdens on the Caregiver, (2) Navigating Caregiving, (3) The Positives, and (4) Evolution of Relationships. Findings suggest that family caregivers of individuals with terminal or life-limiting illness experience complex, and often contradictory feelings, which may differ from perceptions by those not providing similar care to a loved one. The data suggest that clinicians working with the caregiving population should explore the duality of caregiving beyond just the anticipated negative impacts.

The roboagents are coming!: The promise and challenge of artificial intelligence advance directivesThe Hastings Center Report; by Jacob M Appel; Jan-Feb 2026Advance directives have historically relied upon human agents. But what happens when a patient appoints an artificial intelligence system as an agent? This essay introduces the idea of roboagents-chatbots authorized to make medical decisions when individuals lose capacity. After describing potential models, including a personal AI companion and a chatbot that has not been trained on a patient's values and preferences, the essay explores the ethical tensions these roboagents generate regarding autonomy, bias, consent, family trust, and physician well-being. This essay then calls for legal clarity and ethical guidance regarding the status of roboagents in light of their potential as alternative health care agents.

A qualitative study with patients, care-partners, clinicians, and bioethicists to identify ethical considerations of artificial intelligence tools in palliative carePalliative Medicine; by John Y. Rhee, Paul Miller, Zachary Tentor, Amanda Reich, Alexi A. Wright, Charlotta Lindvall; 1/26The use of artificial intelligence (AI) in medicine has surged. Given the sensitive nature of palliative care, it is crucial to apply AI tools in a patient-centered and ethical manner. From the interviews we extracted five main themes: (1) Primacy of the doctor-patient relationship over AI performance; (2) Humans have intuition and nuance that AI lacks; (3) Agreement about the importance of oversight of AI tools; (4) New AI technologies should include a process for patient education; and (5) AI increases efficiency, scalability, and a more unified approach to serious illness. When building and implementing AI-based tools, we recommend: establishing oversight committees; reflecting on the unique contributions of humans to care; proactively educating patients and contextualizing the tools; and ensuring data use is restricted to clinical care.

Medical Aid in Dying: A narrative review of the recent academic literature in the United States Cureus; by Holland Kaplan, Soraira Pacheco, Keziah M. Thomas, Christopher L. Ulmschneider, Anjiya Sulaiman, Chandni Lotwala, Derek Dawes, Issa A. Hanna, Courtney Nguyen, Caroline G. Snider, Gabriel M. Aisenberg; 2/23/26 ... To assess how academic discourse may shape public opinion and policy in the United States, we conducted a narrative review of the literature published between 2020 and 2024. Articles were categorized as supportive, opposing, or neutral, and patterns were examined across authorship, disciplinary focus, and target populations. ... Authorship discipline strongly influenced position, with legal journals disproportionately supportive and religious journals more frequently opposed. Arguments favoring MAiD emphasized autonomy and relief of suffering, whereas opposing articles highlighted risks to vulnerable populations and potential harm. 

Palliative care and quality outcomes in patients with brain metastases and poor prognosis: A multi-institutional analysis JCO Oncology Practice - An American Society of Clinical Oncology Journal; by Rohit Singh, MD, Camilo E. Fadul, MD, Emily Kopp, MS, Guneet Sarai, MD, Roger Anderson, PhD, Ryan F. Amidon, MD, Samantha Schuetz, MD, Amy Chang, MD, Ausia N. Iqbal, MD, Joseph A. Bovi, MD, and Alissa A. Thomas, MD; 2/23/26 Purpose: To analyze the patterns of palliative care (PC) consultation for patients with brain metastases (BMETs) and its association with treatment, overall survival (OS), and quality metrics (eg, advance directives [ADs], hospice enrollment). Conclusion: The involvement of PC services correlated with higher completion rates of ADs and increased hospice utilization, without compromising survival or significantly altering other treatment options. There is an unmet need for PC among patients with BMETs with poor prognosis.

Co-designing a framework to communicate patient-centred outcomes in palliative care: involving patients and the public to reframe understanding Journal of Patient-Reported Outcomes; by Mevhibe B Hocaoglu, Adejoke Oluyase, Deb Smith, Rashmi Kumar, Sarah Perman, Matthew Maddocks, Sian Best, Chloe Nast, Sabrina Bajwah, Katherine E Sleeman, Irene J Higginson; 2/21/26 online ahead of print Conclusions: This study found that communication of patient-centred outcomes and Patient-Reported outcome (PRO) evidence can be strengthened through meaningful patient and public involvement and engagement (PPIE). This approach helps to reframe public understanding of palliative care, highlighting its broader relevance beyond end-of-life settings. While developed in the context of palliative care, the framework offers transferable strategies for communicating complex outcomes in other often misunderstood or stigmatised areas, such as mental health and dementia care.

Cancer support camps and the measurement of quality of life among children of parents with cancerSupportive Care in Cancer; by Mia K. Price, Marcelo M. Sleiman Jr., Muriel R. Statman, Duye Liu, Rachel Adams, Matthew G. Biel, Alexandra L. Baldwin, Joseph M. Stilwell, Kenneth P. Tercyak; 1/26Children of parents with cancer face elevated risks of anxiety, depression, and impaired social-emotional functioning. This study aimed to develop and evaluate the Kids’ Experience of Summer Enrichment Measure (KESEM), a parent-report tool assessing psychosocial well-being among children attending a cancer support camp due to a parent’s cancer [and] ... the majority of parents (78%) strongly agreed that camp was favorably impactful and would recommend it to others.

GOComm: A team-based communication intervention to improve clinicians' skills and distress tolerance in family meetingsJournal of Hospital Medicine; by Kimberly Bloom-Feshbach, Evgenia Litrivis, Elizabeth Brondolo, Alexandra Spinelli, Thomas Bozzo, Melissa Patterson, Robert Crupi, Cynthia X Pan; 1/26Medical training often omits systematic approaches to prognostication and goals of care (GOC) communication, leading to end-of-life (EOL) hospital care misaligned with patients' values, lower clinician self-efficacy, and greater clinician distress. We developed and implemented GOComm, a 4-h serious illness communication training program across eight campuses of a large health system.  Clinicians had statistically significant gains in GOC knowledge, self-efficacy, and distress tolerance. GOComm had high clinician acceptability: 96.2% indicated they would recommend GOComm to a colleague, and 83.2% credited it with changing how they will manage patients.

Connected care for older adults: A pilot intervention engaging community health workers to advance age-friendly care in rural OregonJournal of the American Geriatrics Society; by Bryanna De Lima, Lindsay Miller, Elizabeth Foster, Jodi Ready, Elizabeth Eckstrom; 1/26Aging in a rural setting presents unique challenges including limited access to in-home care, lack of social support, language and cultural barriers, and the lack of transportation. We conducted a pilot study embedding community health workers (CHWs) into rural primary care teams to assist with implementation of the 4Ms of the Age-Friendly Health System: What Matters, Mentation, Medication, and Mobility. The program made a positive difference for 95% of responding patients (n = 120) and 100% of responding providers (n = 19) were "very satisfied" with the program. Clinicians cited the CHWs' ability to support resource connections, address social isolation and social needs, provide regular check-ins, and help to get patients and families engaged in care as positive components of the model.