Literature Review

What does moral agency mean for nurses in the era of artificial intelligence?Hastings Center Report; by Connie M Ulrich, Oonjee Oh, Sang Bin You, Maxim Topaz, Zahra Rahemi, Liz Stokes, Lisiane Pruinelli, George Demiris, Patricia Flatley Brennan; 2/26Being a moral agent was once thought to be an irreplaceable, uniquely human role for nurses and other health care professionals who care for patients and their families during illness and hospitalization. Today, however, artificial intelligence systems are often referred to as “artificial moral agents,” “agentic,” and “autonomous agents.” As these systems begin to function in various capacities within health care organizations and to perform specialized duties, the question arises as to whether the next step will be to replace nurses and other health care professionals as moral agents. Focusing primarily on nurses, this essay explores the concept of moral agency, asking whether it remains exclusive to humans or can be conferred on AI systems. We argue that AI systems should not supplant nurses’ moral agency, as patients come to hospitals or any other health care setting to be heard, seen, and valued by skilled professionals, not to seek care from machines.

[Australia] The male approach to dementia caregiving: A scoping reviewAustralasian Journal on Ageing; by Vincent O Poisson, Amy E Peden, Roslyn G Poulos, Adrienne L Withall, Helen Jones, Kaele Stokes, Claire M C O'Connor; 3/26The proportion of male caregivers of people living with dementia has been rising since the 1990s.  Four main themes were identified [in this review of the literature]: gender differences in caregiver burden; male caregivers adopt a task-focused approach to gain control over caregiving; sons step into the caregiver role as a last resort; and males have specific caregiver needs. The findings suggest that socially constructed masculinity norms influence how men approach dementia caregiving. The findings also suggest that sons caring for a parent with dementia have a different approach to caregiving compared with husbands.

[Japan] Half of hospice and palliative care unit inpatients' family members are surprised by death Journal of Palliative Medicine; by Satoko Ito, Tatsuya Morita, Masanori Mori, Isseki Maeda, Yutaka Hatano, Takashi Yamaguchi, Hiroyuki Otani, Tetsuya Yamagiwa, Yoshiyuki Kizawa, Satoru Tsuneto, Yasuo Shima, Kento Masukawa, Mitsunori Miyashita; 3/10/26 Background: Sudden unexpected death can occur even among patients with advanced cancer receiving hospice and palliative care. How bereaved families perceive this remains unclear. ... Design/setting/subjects: We analyzed longitudinally linked data from a prospective cohort of advanced cancer patients in 23 palliative care units in Japan and a nationwide survey of bereaved families. Conclusions: Compared with physicians' perspectives, bereaved family members perceive death to be sudden or unexpected more frequently and differently, and their perceptions are associated with postbereavement mental health.

Chronic pain and unrecognized grief: epistemic barriers to personal and social recognition Medicine, Health Care and Philosophy; by Christopher Jude McCarroll, Ying-Tung Lin, Dominik Koesling, and Claudia Bozzaro; 3/29/26 What is it to grieve? What is the nature of grief? ... Importantly, a close examination of the phenomenology of chronic pain helps illuminate the ways in which it also involves the kind of losses that we can grieve over. The losses involved in experiences of chronic pain impact one’s practical identity in ways that can lead to grief. This chronic pain grief remains largely unrecognized, however. We outline four epistemic barriers to recognizing the grief involved in experiences of chronic pain. ...

Oncologist perspectives on timely hospice referral: A qualitative study American Journal of Hospice and Palliative Care; by Andrew Lynch, Andrea Altschuler, Joseph P Cosgrove, Hannah Whitehead, Corey Schwartz, Raymond Liu, Mina Chang; 3/7/26 Background: Late hospice referral rates are on the rise and are associated with negative outcomes at the end of life (EoL). Rates of late hospice referral vary drastically from oncologist to oncologist, and behavioral and psychological factors among individual oncologists have been identified as potential contributors to this variability. ...  Conclusions: Numerous factors independent of hospice eligibility were reported to influence hospice referral practices among oncologists. While some factors represent challenging cultural and social barriers to timely hospice referral, other system- and patient-specific barriers offer opportunities for potential interventions. 

Executive Summary: Society of Critical Care Medicine Clinical Practice Guidelines on Adult End-of-Life Care in the ICUCritical Care Medicine; by Mary Faith Marshall, F Daniel Davis, Patricia A Fogelman, Simon Oczkowski, Julie C Reid, Daniel Arellano, Rebecca A Aslakson, Joshua Campbell, Katherine Courtright, Katarine Egressy, Elizabeth Epstein, Ebonye Green, May Hua, Preeti R John, Erin K Kross, Niels D Martin, Bethany A Melo, Susanne Muehlschlegel, Silvia Perez-Protto, Ben Roberts, Daniel Shalev, Jennifer Wescoe Singley, Shawna L Strickland, Karen A Korzick; 12/25[Recommendations include:]

Use of nebulized tranexamic acid (TA) in combination with nebulized recombinant coagulation factor VIIa to treat hemoptysis in pediatric patients with cancer at end-of-life (EOL)Journal of Pain and Symptom Management; by Santosh Yatam Ganesh, Nelda Itzep, Eduardo Bruera; 2/26Hemoptysis is a distressing symptom for both patients and families at end of life (EOL). In the acute care setting, this can be managed surgically or medically. However, research regarding interventions, such as nebulized tranexamic acid (TA) and nebulized factor VIIa, for palliative management of hemoptysis at EOL is limited. In our case series, we found that combination of nebulized recombinant factor VIIa and nebulized TA relieved hemoptysis in both pediatric cancer patients at the end of life. This case series highlights the potential use of this combination to reduce suffering and distress secondary to hemoptysis in the palliative setting.

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.

Dementia, taboo, and the need for a cultural reckoningJournal of Aging Studies; Kelly Marnfeldt; 3/26Dementia is one of the most feared and misunderstood conditions of our time. Even as public awareness has increased, people living with dementia continue to face exclusion, moral disregard, and systemic neglect. Decades of advocacy, education, and contact-based interventions have sought to reduce stigma. [This study] proposes that dementia becomes stigmatized not only because it is misunderstood, but because it violates cultural expectations of personhood, consistency, and intelligibility. The paper concludes by proposing culturally grounded provocations that imagine what it might look like to reframe how dementia is seen, told, and recognized, both socially and culturally.

Investigating the role of occupational therapy in palliative care a literature review Home Healthcare Now; by Carlie Liseo, OTD, OTR/L and Daniel Martin, D.Sc., MS, OTR/L; March/April 2026 ... Three themes regarding the provision of occupational therapy (OT) services to palliative care (PC) patients were identified: engaging in meaningful activities to increase quality of life (QOL), symptom management and comfort, and supporting caregivers and client environments. OT can play a pivotal role in catering to PC clients’ needs by promoting occupational engagement, alleviating symptoms, and modifying environments. This review offers recommendations for OT service provision in palliative care, clarifying the profession’s role within multidisciplinary home healthcare teams.