Literature Review

Donate Life Ceremony celebrates organ donors and their families Vanderbilt University Medical Center; by Matt Batcheldor; 5/6/25 In addition to honoring organ donors and their families, the ceremony salutes hospital staff who care for donors and transplant recipients. Seventy-one individuals donated their organs at Vanderbilt University Medical Center in 2024, and they and their families were saluted on April 30 at the annual Donate Life Ceremony. “Those 71 donors resulted in 235 lives that were saved,” said C. Wright Pinson, MBA, MD, Deputy Chief Executive Officer and Chief Health System Officer for VUMC. ...  In addition to that, there were another 191 individuals who made the remarkable gift of tissue donation … which restored sight to the blind, enhanced the lives of burn victims, and gave mobility to those with bone and joint injuries.” ... The ceremony, held in the lobby of Langford Auditorium, was part of a national effort to raise awareness about the need for organ and tissue donors.

It's time to talk about LGBTQ+ elder care Psychology Today - Caregiving; by Stephanie Sarazin, M.P.P.; 5/6/25 A once-hidden story is helping us think about queer kinship and caregiving. Key points:

New York State Department of Health announces revision of Medical Orders for Life-Sustaining Treatment (MOLST) form New York State Department of Health, Albany, NY; 5/2/25 The New York State Department of Health announced the revision of the Medical Orders for Life-Sustaining Treatment (MOLST) Form, a form that records a patient's preferences for life-sustaining treatments, such as CPR, ventilation, and other interventions, to ensure all patients are considered. The comprehensive revision was a collaboration of the Department, New York State Office for People with Developmental Disabilities (OPWDD), the New York State Office of Mental Health (OMH), and the MOLST Statewide Implementation Committee. ... All information regarding the MOLST, including the form, supporting checklists, glossary, and instructions are available on the NYSDOH Center for Hospice & Palliative Care's webpage.

Pharmacist-led care in palliative settings: Using anticholinergics thoughtfully and compassionately Pharmacy times; by Diana Violanti, PharmD, Pamela S. Moore, PharmD, BCGP, and Alana Hippensteele; 5/5/25 The use of anticholinergic agents to manage terminal secretions, often referred to as the death rattle, remains a nuanced and evolving area of end-of-life care. While these medications are frequently used in hospice and palliative care settings to reduce secretion-related sounds that may be distressing to caregivers, their efficacy in improving patient comfort is less clear and often debated. ... Diana Violanti, PharmD, and Pamela S. Moore, PharmD, BCGP, discuss the nuanced use of anticholinergic agents for managing terminal secretions at end of life, highlighting practical considerations, timing, safety concerns such as delirium, and the limited yet evolving evidence supporting their role in palliative care.

A powerful film chronicles one man’s last days within a loving community for all to witness. Monterey County Now, Seaside, CA; by Pam Marino; 5/1/25 Facing certain death from a brain tumor, Ethan “E3” Sisser adopted a mantra. “I am embodied. I am empowered. I am ecstatic,” the 36-year-old would tell himself, in order to ward off oncoming seizures, carry himself through pain or recite for his many followers on social media. “E3” became his nickname. We see Sisser, looking into the camera, recite the mantra early in the documentary, The Last Ecstatic Days, released in 2024. We also meet his hospice and palliative care physician, Aditi Sethi, who leaves her position to become his death doula and friend. She fulfills his wishes for a peaceful death surrounded by a caring community, filmed for others to learn from. Director Scott Kirschenbaum – who made one of the definitive documentaries about birth, These Are My Hours – spent the last two weeks of Sisser’s life near his side with a camera, capturing each moment.

Hospice use by cause of death: A cohort study using Utah population database American Journal of Hospice and Palliative Medicine - Sage Journals; by Rebecca L. Utz, PhD, Michael Hollingshaus, PhD, Attrayee Bandyopadhyay, MS, Kathie Supiano, PhD, Margaret Clayton, PhD, Katherine A. Ornstein, PhD, Djin Tay, PhD, Eli Iacob, Ken Smith, PhD, and Caroline Stephens, PhD; first published online 4/29/25 Illnesses such as cancer often follow a predictable trajectory of decline, while others, such as Alzheimer’s Disease and Related Dementias (ADRD) and Chronic Obstructive Pulmonary Disease (COPD), follow a more dwindling and protracted decline. ... This study assesses whether hospice use differs by the underlying cause of death and whether current hospice eligibility and practices provide optimal EOL to all causes of death. Major Findings: Non-cancer decedents were more likely to have sub-optimal patterns of hospice care, including minimal use, lasting less than a week, and extended use, lasting more than 6 months. Stroke decedents were the most likely to have minimal-use patterns of hospice, whereas dementia and COPD decedents were most likely to have extended use. Conclusion: New models of hospice-like EOL care that can accommodate both short-term and long-term palliative care needs may help meet the diverse needs of patients and families facing different EOL trajectories associated with common causes of death.Editor's note: Compare this data with your own data of disease-related Length of Stay (LOS), live discharges, disease-related accuity needs, and more. How can we improve disease-related patient care, across the different trajectories of palliative/hospice care?

CMS releases HOPE Guidance Manual (V. 1.01) and TablesCenters for Medicare and Medicaid Services (CMS); by CMS; 4/22/25On April 22, 2025, CMS released the HOPE Guidance Manual (V. 1.01) and connected tables. Providers can use v1.01 for HOPE planning, as this is considered final before HOPE implementation. Also note that earlier this month, the final HOPE data specs have also been released, helping software developers to finalize their HOPE software for testing in the coming months.

“It’s an homage”: Noah Wyle quietly sneaked in a tribute in one of the best episodes of ‘The Pitt’ FandomWire; by Arian Cruz; 4/18/25 In the fourth episode of The Pitt titled 10:00 A.M., Noah Wyle’s Dr. Michael ‘Robby’ Robinavitch monitored Mr. Spencer during his final hours while dealing with his own thoughts about the death of his beloved mentor, Dr. Adamson. He remembers the advice he received from him and shared it with the children of the dying patient as they waited for their father to pass. The phrases ‘I love you,’ ‘Thank you,’ ‘I forgive you,’ and ‘Please forgive me’ are words that need to be heard when someone is at the end of their life. Wyle revealed that he took these lessons from palliative care physician and author Ira Byock when he was writing the screenplay. Wyle said these short phrases are profound and hold deep meanings beyond their simplicity. He made sure to weave them in on the show while taking inspiration from his own mother for the emotional scenes. He shared via USA Today: "A very similar event had played out with my mother and her brother when saying goodbye to my grandfather. After she shared this with me, I just said ‘Thank you,’ went right back to my typewriter and wrote the scene. It’s an homage to my mother, my uncle and my grandfather.Editor's and Publisher's note: And we thank you, Dr. Ira Byock, for your profound, immeasurable influence for so many of us--professionally with those we serve, and personally with our own families and friends.

TIEC, trauma capacity, and the moral priority of surrogate decision makers in futility disputesThe Journal of Clinical Ethics; Autumn Fiester; Spring 2025In the past 15 years, trauma-informed care (TIC) has evolved as a new paradigm in healthcare that recognizes the impact of past traumas on patients' and families' healthcare experience while seeking to avoid inducing new trauma during clinical care. A recent paper by Lanphier and Anani extends TIC principles to healthcare ethics consultation (HEC) in what they label "trauma-informed ethics consultation" (TIEC), which calls for the "addition of trauma informed awareness, training, and skill in clinical ethics consultation." While Lanphier and Anani claim that TIEC is "novel, but not radical" because it builds on the approach to HEC endorsed by the American Society for Bioethics and Humanities, I believe that TIEC has radical implications, particularly regarding ethical obligations to surrogate decision makers (SDMs). Given what I call the SDM's "trauma capacity," I argue that TIEC accords moral priority to SDMs over patients in certain types of end-of-life cases, particularly futility disputes, which is a radical departure from the conventional HEC approach to SDMs.

Palliative care and advanced cardiovascular disease in adults: Not just end-of-life care: A scientific statement from the American Heart Association AHAIASA Journals - American Heart Association; by Lucinda J. Graven, PhD, APRN, FAHA, Lisa Kitko, PhD, RN, FAHA, Martha Abshire Saylor, PhD, MSN, BA, RN, Larry Allen, MD, MHS, FAHA, Angela Durante, PhD, RN, Lorraine S. Evangelista, PhD, RN, CNS, WAN, FAHA, Amy Fiedler, MD, James Kirkpatrick, MD, Lakeisha Mixon, MSW, and Rachel Wells, PhD, MSN, BA on behalf of the American Heart Association Complex Cardiovascular Nursing Care Science Committee of the Council on Cardiovascular and Stroke Nursing; and Council on Cardiovascular Surgery and Anesthesia; 4/17/25  ... This scientific statement (1) discusses the application of effective communication, shared decision-making, age-friendly care, and advance care planning in advanced cardiovascular disease palliative care; (2) provides a summary of recent evidence related to palliative care and symptom management, quality of life, spiritual and psychological support, and bereavement support in individuals with advanced cardiovascular disease and their care partners; (3) discusses issues involving diversity, equity, and inclusion in cardiovascular disease palliative care; (4) highlights the ethical and legal concerns surrounding palliative care and implanted cardiac devices; and (5) provides strategies for palliative care engagement in adults with advanced cardiovascular disease for the care team.

Why good palliative care clinicians get fired JAMA Network - Viewpoint; by Abby R. Rosenberg, MD, MS, MA; Elliot Rabinowitz, MD; and Robert M. Arnold; 4/14/25 Even the most seasoned palliative care clinician gets fired. In the past year, one of us was fired after asking whether a patient endorsing suicidal ideation had access to a gun; the patient requested not to see the palliative care team because we asked intrusive questions and documented the encounter. One of us was fired after supporting a family’s decision to discontinue life-sustaining therapies for their loved one with multisystem organ failure; the primary intensivist suggested palliative care overstepped in discussing options for which the family (and clinical teams) was not ready. And one of us was fired after sharing the impression that a patient with cancer was dying; the family suggested they preferred the oncologist’s version of a more hopeful future.

For AYAs with advanced cancer, study finds serious communication gaps about their care National Cancer Institute; by Daryl McGrath; 4/15/25 Many adolescents and young adults (AYAs) with advanced cancer don’t have discussions with their clinicians about how they want to approach palliative care until the final weeks of life, a study of medical records of nearly 2,000 young patients showed. ... Talking about care and treatment near the end of life is one of the most challenging aspects of caring for AYAs with advanced cancer, said Ashley Wilder Smith, Ph.D., M.P.H., of NCI’s Healthcare Delivery Research Program and co-leader of NCI’s Adolescent and Young Adult Oncology Working Group. ... “When a young person is faced with a disease that may lead to an early death, it’s vitally important to give them the opportunity to think about what’s most important to them and what happens to them in terms of care in the time they have left,” she said.