Literature Review

What we get wrong about comfort at the end of life: Jennifer Martnick Cleveland.com, Cleveland, OH; by guest columnist Jennifer Martnick; 3/22/26 When people hear the word comfort in the context of serious illness or the end of life, they often picture something passive. A quiet room. Soft blankets. And a sense that medical care has somehow stepped back. That misunderstanding is one of the most persistent myths in health care. Comfort care is not about doing less. In many ways, it requires more skill, more attention and more presence than almost any other kind of medicine. At Reserve Care (formerly Hospice of the Western Reserve), comfort care means active, expert care delivered by clinicians trained to manage pain, ease symptoms and support the emotional and spiritual needs of patients and families facing serious illness.

Identifying key components of neuropalliative care fellowship using nominal group techniqueJournal of Pain & Symptom Management; by Sachi Y Gianchandani, Jocelyn M Jiao, Kwame O Adjepong, Yaowaree L Leavell, Jessica M Besbris, Neha M Kramer, Joel N Phillips, Paul M Vermilion; 2/26There is no standardized curriculum for neurology-focused palliative care training. An adapted nominal group technique (NGT) was used to collect and rank responses to 2 key questions: "In designing the ideal dedicated neuropalliative care clinician training experience, what core components should be included?" and "When a general palliative care fellowship has a neurologist in their program, how could the program/program director potentially tailor the year to their unique needs?" For both key questions, the top-ranked responses included: dedicated outpatient neuropalliative care experience, mentorship from faculty with expertise in neuropalliative care, and a core didactic curriculum that includes neurology-specific content. Additionally, appropriateness for certification in hospice and palliative medicine was identified as crucial.

Centering end-of-life care around what matters most: Goal-of-care discussions drive earlier hospice access Cleveland Clinic; features Laura Hoeksema, MD, MPH, FAAHPM; 3/10/26 Hospice experts help those with incurable disease maintain autonomy, reduce trauma and gain symptom relief. Yet studies show that the median length of stay in hospice before death is roughly 19 days. What can care teams do to ensure that patients and their families have access to this appropriate end-of-life care? As the Medical Director of Cleveland Clinic Hospice, Laura Hoeksema, MD, MPH, FAAHPM, and her team support physicians and patients in navigating this journey. ...

Facing death as a doctor: Knowledge vs natureMedscape; by Sarah Amandolare; 3/12/26 The decision to enroll her father in hospice care came easily for Janet Abrahm, MD. Abrahm, a palliative care doctor and former oncologist, helped her father — an internist who died of prostate cancer at home — understand the program’s benefits, such as family bereavement services, and that he could be readmitted to the hospital if needed. “Most doctors don’t know that,” said Abrahm, who is also a professor of medicine at Harvard Medical School in Boston and the author of Comprehensive Guide to Supportive and Palliative Care for Patients with Cancer. “They think it’s a one-way street, I imagine — that you put somebody in hospice and then that’s it. ... The level of engagement physicians have with death in their practice may inform how they want to die — and how they counsel loved ones facing a serious illness. But a new study suggests even as they face end-of-life decisions through the lens of their expertise, physicians can also be swayed by the same financial, familial, and existential burdens afflicting their patients. 

Hospital workers are revealing the heartbreaking regrets patients had on their deathbeds, and I'm at a loss for words BuzzFeed Staff; by Liz Richardson; 3/16/26 You may have heard about people's last words, but if there's anything even more haunting, it's the regrets they have on their deathbed. And, as you can imagine, those who work closely with dying patients have heard some unforgettable final regrets that stick with them for years. ... Several users shared the striking and heartbreaking regrets their patients shared, and wowww, it will hit you hard. Here's what they had to say: ... Editor's Note: This article reflects a more popularized perspective than we typically feature, but it raises themes that are deeply familiar in serious illness and end-of-life care. Hospice and palliative care teams are trained to meet these moments with presence, skilled communication, and interdisciplinary support—helping patients and families explore reflection, meaning, and connection in ways that extend far beyond the headlines.

Corticosteroid use and risk of adverse events in metastatic hormone-sensitive prostate cancerThe Prostate; by Umang Swami, Qiujun Shao, Tamuno Alfred, Maelys Touya, Frank Cao, Pinal Kamdar, Jasmina Ivanova, Johanna Celli, David Nimke; 2/26Among the approved therapies for metastatic hormone-sensitive prostate cancer (mHSPC), abiraterone and docetaxel are administered concomitantly with corticosteroids. This study evaluated the association between corticosteroid use and risk of adverse events among patients with mHSPC. Our findings suggest that patients exposed to corticosteroids are at increased risk of adverse events, hospitalization, and death. As not all mHSPC treatments require concomitant use of corticosteroids, these findings may help to inform treatment decision-making.

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.

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.

Hospice nurse weekend visit rates, by state Becker's Hospital Review; by Elizabeth Gregerson; 3/11/26 ... CMS collects skilled nursing visit data, submitted directly by hospice providers, from Medicare hospice claims, and from the Hospice Consumer Assessment of Healthcare Providers and Systems survey, through the Hospice Quality Reporting Program. The national percentage of hospice nurse visits provided during the weekend was 9.6%. Here are the percentage of weekend skilled nursing minutes provided between Jan. 1, 2023, and Dec. 31, 2024, by state, according to CMS: ...

[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.

Longer-running state POLST programs improve end-of-life outcomes for SNF patients McKnights Long-Term Care News; by Kimberly Marselas; 3/9/26 Nursing home patients are more likely to die in the facility or in hospice than in a hospital in states with mature POLST programs, according to a new, first-of-its kind study. Physician Orders for Life-Sustaining Treatment, also known as POLST or MOLST, are standing orders meant to assist in decision-making at the end of life to ensure patients’ treatment preferences are documented. ... Researchers behind the new study said results suggest continued implementation and long-term use of POLST programs streamlined advance directives among residents, helped lessen unnecessary hospitalizations and limited aggressive care at the end of life. 

How America’s nursing shortage impacts health care Deseret News; by Lois M. Collins; 3/8/26 America has a nursing shortage, but where it is and who’s affected is not evenly distributed across the country. And even communities with an adequate or near-adequate supply must be vigilant to ensure that shortages don’t creep in. Key Points:

‘Don’t play God’ in end-of-life conversations Medscape; by Medscape's editorial team; 3/5/26 For many clinicians, the most difficult words to utter are not a complex diagnosis but a simple admission: “We have reached the end of what medical care can do to make your loved one better.” An ICU/emergency room (ER) nurse with 30 years of experience says avoiding this reality can “prolong the dying process” rather than an extension of meaningful life — and called “false hope in the next procedure, next drug, next consultation” the “cruelest thing a well-meaning caregiver can do.”