Literature Review

First-ever global ranking of palliative care: 2025 World Map under the new WHO framework Journal of Pain and Symptom Management; by Vilma A. Tripodoro, Jesús Fernando López Fidalgo, Juan José Pons, Stephen R. Connor, Eduardo Garralda, MA, Fernanda Bastos, Álvaro Montero, Laura Monzón Llamas, Ana Cristina Béjar, Daniela Suárez, Carlos Centeno; 8/7/25 This is the fourth edition of mapping global palliative care development and the first to introduce a country ranking using the new WHO framework. Covering 201 countries, the findings reveal deep inequities and highlight priority areas for action. The Global Development Score enables the creation of tailored strategies, supporting advocacy, policy, and investment to expand access and reduce serious health-related suffering worldwide. [To view the map, open the source article and scroll down to Figure 3.]

[Netherlands] Voluntarily stopping eating and drinking as a self-chosen path for end of lifeWorld Medical Journal; Gert van Dijk, Veelke Derckx, Alexander de Graeff; 6/25Moving into the future, it is likely that doctors and other healthcare providers will be confronted more often with patients who would like to explore options for controlling their end of life care. They should correctly inform patients about the various clinical care options, including VSED [voluntarily stopping eating and drinking], and carefully guide them in the event of a decision to choose VSED. If healthcare providers have conscientious objections in providing care to people who choose VSED, then care must be transferred to a healthcare provider who is willing to provide the necessary care.

Sex and racial/ethnic differences in end-of-life care in decedents with lung cancer in TexasJournal of Palliative Medicine; by Myrna Katalina Serna, Efstathia Polychronopoulou, Aimee Rodriguez, Anjali Ramachandran, Margaret Goodrich, Sean O'Mahoney, Mukaila Raji, Yong-Fang Kuo; 7/25The lung cancer five-year survival rate is lower for Texans compared with the national average. We assessed sex and racial/ethnic differences in end-of-life care among decedents with lung cancer in Texas [and found that] ... males had more health care utilization and less hospice enrollment. Non-Hispanic Blacks and Hispanics had more health care utilization and less hospice enrollment ... Billed ACP [advance care planning] was low across all groups.

Creating user personas to represent the needs of dementia caregivers who support medication management at home: Persona development and qualitative studyJMIR Aging; by Anna Jolliff, Priya Loganathar, Richard J Holden, Anna Linden, Himalaya Patel, Jessica R Lee, Aaron Ganci, Noll Campbell, Malaz Boustani, Nicole E Werner; 7/25Caregiver-assisted medication management plays a critical role in promoting medication adherence and quality of life for people living with Alzheimer disease or related dementias (ADRD). Caregivers in this study demonstrated a range of characteristics and values that informed their approach to medication management. They used a combination of technology-based strategies and strategies situated in their physical environments to manage medications. The personas created can be used to inform interventions, such as digital tools, that address caregivers' unmet needs.

Working through grief: Exploring the relationship between organizational support on employee engagement, satisfaction, and loyaltyTransdisciplinary Journal of Management; Katie N. Hansen; 7/25For most people, work and grief are unavoidable, meaning the majority of employees will work while grieving. Over the past several decades, employer grief responses have been more strategic than human-focused, leaving the bereaved under-supported. The most significant finding [of this study] is a decline in how engaged, loyal, and satisfied employees feel post-loss. Statistical analysis confirms that bereavement leave, reintegration accommodations, and provided support impact employee engagement, loyalty, and satisfaction, with positive and moderate to high associations existing between several variables. Finally, the results suggest the quality of an employer’s response and support for grieving employees remains insufficient, as the majority of respondents felt the need to take leave in excess of the bereavement leave provided, were not granted flexible work accommodations, and post-loss workloads did not meet their needs.

Demystifying dying in end-of-life-care: A phenomenological perspective Death Studies; by Elisabet Sernbo, Magnus Weber, Charlotta Öhrling, Stina Nyblom; 8/26/25 This article focuses on experiences of the process of dying. The empirical material consists of interviews with patients in palliative care and their significant others. The analysis draws attention to the lived experiences of the participants - embedded in time, identities, social relations, and everyday lives - and to how the possibility of sense-making is conditioned by the lifeworld. ... [This] needs to be understood as reorienting work: supporting people when their lines become disrupted or need to be altered. This requires a display of radical empathy ...

The treatment of chemotherapy-induced peripheral neuropathy: A review of current management options and a potential role for scrambler therapyFrontiers in Pain Research; by Hassan Aboumerhi, Henry Vucetic, Andrew Gruenzel, Bahar Moftakhar, Mona Gupta, Santosh K Rao, Michael D Staudt; 7/25Chemotherapy-induced peripheral neuropathy (CIPN) presents a growing medical and financial burden on patients and the healthcare system alike. This has been treated with conservative and interventional care limited by efficacy, side effects, and lack of coverage. As such, there is an unmet treatment need for effective non-invasive or minimally invasive therapies for the treatment of CIPN. Scrambler therapy (ST) is a peripheral, non-invasive neuromodulation technique, which uses transcutaneous electrical stimulation to modulate pain signals. ST has shown mixed results in clinical trials; while some patients report symptom relief, more robust evidence is required before it can be widely recommended.

Pitfalls of large language models in medical ethics reasoningnpj Digital Medicine; by Shelly Soffer, Vera Sorin, Girish N. Nadkarni, Eyal Klang; 7/25 Large language models (LLMs), such as ChatGPT-o1, display subtle blind spots in complex reasoning tasks. We illustrate these pitfalls with lateral thinking puzzles and medical ethics scenarios. Our observations indicate that patterns in training data may contribute to cognitive biases, limiting the models’ ability to navigate nuanced ethical situations. Recognizing these tendencies is crucial for responsible AI deployment in clinical contexts.

Evaluating the role of palliative care in emergency department opioid use among advanced cancer patientsSupportive Care in Cancer; by Joel Nortey, Shiyun Zhu, Andrew Lynch, Hannah Whitehead, Nirmala Ramalingam, Raymond Liu; 7/25 Patients with advanced cancer often experience severe symptoms that significantly impact their quality of life, leading to frequent emergency department [ED] visits for pain management. These visits not only diminish patient quality of life, but also impose substantial costs on the healthcare system. Our study highlights the significant role that PC can play in reducing ED utilization for pain management needs among advanced cancer patients, improving quality of life and alleviating healthcare burdens.

Effect of a multi-component palliative care intervention on goals of care discussions for critical patients in the emergency departmentInternal & Emergency Medicine; by Julia Murray, Zacharia Grami, Katherine Benson, Christopher Hritz, Samantha Lawson, Corita Reilley Grudzen, Allison Cuthel, Lauren Talanda-Fath Southerland; 7/25Goals of care (GOC) discussions are vital to understanding patients' values and preferences during serious illness, but they occur infrequently during Emergency Department (ED) care. We report a single site sub-study of a stepped wedge pragmatic trial of a multi-component intervention of primary palliative care in the ED (PRIM-ER), focused on GOC conversations. The intervention did not change the proportion of patients receiving a GOC conversation in the ED ... [however patients] presenting with a cancer-related complaint ... or a respiratory emergency ... were associated with increased odds of a GOC conversation occurring. Of the 60 GOC conversations that occurred, 76.7% ... resulted in a change in code status, patient care plans, hospice, or updated advance care planning documents. While the intervention did not increase this secondary outcome of GOC conversations, the discussions that did occur frequently impacted ED care.Assistant Editor's note: This study concluded that the intervention employed in the ED did not increase the proportion of patients receiving GOC conversations. Yet the study also concluded that almost 77% of the patients who DID receive the conversation had a change in code status, care plan, hospice or advance care planning documents. This study clearly reminds us that GOC conversations, employed even in the ED, can help patients embrace a palliative approach to care when faced with serious illness.

The effects of private equity ownership in U.S. nursing homes quality and financial performance: A systematic reviewHealth Policy; by Gregory N. Orewa, Aizhan Karabukayeva, Rohit Pradhan, Itopa Jimoh, Robert Weech-Maldonado; 7/25Private equity (PE) investment in U.S. nursing homes has increased significantly over the past two decades. The emergence of this novel ownership model has prompted concerns regarding its effects on nursing home performance, especially quality... Across studies, PE ownership was linked to higher number of deficiencies, increased hospitalization rates, and higher mortality, although some improvements in care processes were noted. Financial outcomes showed initial financial gains but long-term challenges, primarily due to high debt loads... Findings suggest that PE strategies may prioritize short-term profitability, which may compromise quality of care in some instances. These findings highlight the need for financial transparency, and reimbursement models that incentivize long-term quality.

[India] Challenges and ethical considerations of palliative care in Indian prisonsJournal of Pain and Symptom Management; by Swapnil Kumar Barasker, Pankaj Singhai, Maya Nair, Deepali Kumar; 8/25The landscape of palliative care (PC) in India is still nascent, and when applied to the prison setting, it becomes a terrain fraught with unique challenges. There is a dearth of region-specific perspectives on end-of-life care (EOLC) and PC in Indian prisons. In Indian prisons, EOLC is complicated by issues such as overcrowding, inadequate medical facilities, and the societal neglect of incarcerated individuals, yet the need for it remains largely unrecognized... Prison deaths are frequently associated with brutality or neglect, but statistics reveal that most deaths occur due to natural causes such as ischemic heart disease, pneumonia, cancer, and liver and kidney disorders. Despite many prisoners having chronic illnesses, they often lack regular follow-ups and access to appropriate care due to insufficient medical staff and infrastructure.

System wide goals of care implementation: A podcast with Ira Byock, Chris Dale, and Matt GonzalesGeriPal podcast; by Eric Widera, Alex Smith, Ira Byock, Chris Dale, Matt Gonzales; 7/24/25Most health care providers understand the importance of goals-of-care conversations in aligning treatment plans with patients’ goals, especially for those with serious medical problems. And yet, these discussions often either don’t happen or at least don’t get documented. How can we do better? In today’s podcast, we sit down with Ira Byock, Chris Dale, and Matthew Gonzales to discuss a multi-year healthcare system-wide goals of care implementation project within the Providence Health Care System. Spanning 51 hospitals, this initiative [found] an increase from 7% to 85% in goals of care conversation documentation for patients who were in an ICU for 5 or more days. How did they achieve this? Our guests will share insights into the project’s inception and the strategies that drove its success, including: