Literature Review

Cultivating interdisciplinary shared wisdom through a structured case conference American Journal of Hospice and Palliative Medicine; by Meredith A. MacMartin, MD MS, Amelia M. Cullinan, MD, and Catherine H. Saunders, PhD MPH; 4/8/26 Objectives: To develop and understand the impact of a structured, case-based, facilitated discussion of communication challenges on the function and wellbeing of an interdisciplinary specialty palliative care team. Conclusions: Embedding a weekly facilitated case discussion in the usual practice fostered a virtuous cycle of individual growth and team connectedness among interdisciplinary palliative care providers. Similar conferences could be implemented in other medical teams to teach practical wisdom and reduce burnout.

Nearly 40% of physicians report high moral distress, which significantly increases burnout Healio; by Josh Friedman; 4/21/26 An AMA survey of more than 9,000 individuals showed nearly 40% of physicians report high levels of moral distress, yet most U.S. adults experience none at their occupation. Physicians who reported high levels of moral distress had a significantly higher likelihood of burnout symptoms and intent to leave the profession. “Physicians want to do what they believe is right for patients. That’s what we want all health care professionals to do, prioritize patient care,” Michael A. Tutty, PhD, MHA, group vice president of professional satisfaction and practice sustainability at AMA, told Healio. “Leaders need to think about how we can reduce or eliminate those ethical challenges that make it harder for physicians to provide high-quality patient care.”

End-of-life guidelines [in the ICU] emphasize unified care American Association of Critical-Care Nurses, in "Clinical Voices April 2026"; 4/21/26 New guidelines for end of life (EOL) care in the ICU call for clearer communication with families, stronger support for decision making and coordinated teamwork across disciplines to align treatments with what patients can realistically achieve and reduce suffering. “Society of Critical Care Medicine Clinical Practice Guidelines on Adult End-of-Life Care in the ICU ,” in Critical Care Medicine, highlights the need for standardized processes, including identifying legal surrogates, using shared decision making tools and adopting protocolized withdrawal pathways. Additional priorities include early palliative care involvement, spiritual support and focused education to reduce conflict. Recommendations are summarized in three major areas:

Medical ethics unpacked: clinical ethics consultation in practice Consultant LIve; by Dominic Sisti, PhD and Aliza Narva, JD, BSN, MS; 4/20/26 In this episode of Medical Ethics Unpacked, Dominic Sisti, PhD, a bioethicist from Penn Medicine, speaks with Aliza Narva, JD, BSN, MSN, director of ethics at the Hospital of the University of Pennsylvania, about the practical realities of clinical ethics consultation. ... Common consult themes include end-of-life decision-making, surrogate disputes, and clinician moral distress. She emphasizes that ethics consultants are often called when clinicians feel constrained or uncertain about next steps.

Local filmmaker releases new movie "Winter Hymns" shot in Menomonie WQOQ-18 ABC News, Eau Claire, WI; by Sam Fristed; 4/16/26 A Chippewa Valley filmmaker is excited about a new movie that is now on the silver screen. Nathan Deming's new film "Winter Hymns" recently premiered at the Wisconsin Film Festival. ... The plot centers around a doctor who visits multiple dying patients in one day. While helping the families, she struggles with balancing the compassion of her profession with the American health care system that prioritizes profits and efficiency. Deming was inspired to write the film because his father was a palliative care physician in Eau Claire for about ten years. 

Engaging bereaved parent educators in pediatric end-of-life workshops: A trauma-informed onboardingJournal of Pain & Symptom Management; by Kayla Solstad, Dannell Shu, Kelly McManimon, Stacy Remke, Susan O'Conner-Von, Anne Woll, Joseph M Miller, Miriam C Shapiro, Johannah M Scheurer; 3/26Recognizing that pediatric end-of-life (EOL) scenarios occur infrequently and are distressing for trainees and other healthcare team members, our group created pediatric end-of-life care skills (PECS) simulation-based workshops to improve trainee competence for these skills. We  ... provide interprofessional workshops, including trainees from the pediatric residency program, graduate school of nursing, and graduate school of social work. Since creation of the workshops, the group and curricula have benefited immensely from including the expertise of bereaved parent educators (BPEs), who have experienced the death of their own infant or child and have been integral team members ... from workshop creation through facilitation. Research shows that families who have experienced the death of a child appreciate an interdisciplinary approach to their care and communication at the EOL. When parents of pediatric patients were asked about priorities in EOL care, they highlighted the importance of communication, emotional expression and support by staff, and ready access to multi-disciplinary staff.

Owner opened restaurant on day off to fulfill dying man's last wish to feed hospice nurses who cared for him People; by Erin Clack; 4/11/26 "To me, it means the world to see that kindness, that greatness spread," the dying man's brother said of the restaurant owner.  Tommy Milani didn't hesitate to step up and help when he received a request from a grieving family. Before his death, Frank Ozimek — who spent six weeks at Niagara Hospice in Lockport, N.Y., bonding with and being cared for by the dedicated staff there — asked his younger brother, Ken Ozimek, to make sure the nurses were treated to a meal on Easter Sunday, per local outlet WKBW.

Your wishes, your voice: Ochsner doctors encourage families to plan ahead for National Healthcare Decisions Day NOLA.com; by Amanda McElfresh; 4/12/26 Every year on April 16, National Healthcare Decisions Day serves as a reminder that medical emergencies rarely arrive with warning. When they occur, the decisions surrounding treatment often must be made within minutes. For healthcare providers, including those in Ochsner emergency departments, the day highlights a simple yet powerful message: Conversations about medical wishes should happen long before a crisis unfolds.

Expanding access to palliative care for patients with advanced liver diseaseAAAS - EurekAlerts!, Philadelphia, PA; describes JAMA Internal Medicine at doi: 10.1001/jamainternmed.2026.0571; 4/13/26 A new multicenter trial led by Manisha Verma, MD, and Victor Navarro, MD, at Jefferson Einstein Philadelphi Hospital demonstrates a new approach that could potentially transform access to palliative care for patients with ALD and address a major care gap. In the PAL LIVER trial, a large cluster-randomized study conducted across 19 U.S. centers, researchers evaluated whether hepatologists trained in primary palliative care could match the effectiveness of palliative care specialists in delivering quality-of-life benefits to patients with ALD, including those with decompensated cirrhosis and liver cancer. With 935 patients enrolled, this is one of the largest trials to date in liver disease palliative care.

Managing clinical uncertainty Baylor College of Medicine; by Dr. Avni M. Kapadia and Dr. Hannah L. Kirsch; 4/10/26 In the day-to-day routine of critical care physicians, end-of-life care and medical ethics are frequently incorporated into comprehensive care plans. What happens when the laws impede the ability to honor family wishes? ... Recent ethical debates surrounding the care of brain-dead or severely neurologically injured pregnant patients highlight growing tension between clinical ethics and public policy. These cases are medically complex and emotionally devastating for families. But cases involving pregnancy and severe neurological injury also are especially difficult for the medical team. 

A scoping review of breakthrough cancer pain: Mapping the evidence landscapeSupportive Care in Cancer; Mellar Davis, Russell Portenoy, Andrew Davies, Sebastiano Mercadante, Akhila Reddy, M R Rajagopal, Eduardo Bruera; 3/26Breakthrough pain (BTP) in cancer populations is characterized by heterogeneous definitions, assessment approaches, and management strategies. This scoping review mapped the available evidence to characterize BTP concepts, describe the evidence base, and identify knowledge gaps. This scoping review maps heterogeneous evidence characterized by inconsistent definitions, selected populations, short-term outcomes, and geographic concentration. Key knowledge gaps include: standardized operational definitions, patient-centered functional outcomes, long-term efficacy and safety data, evidence from diverse settings and populations, and integration of pharmacological and non-pharmacological approaches. The review provides a descriptive landscape but does not assess evidence quality or support treatment recommendations.