Literature Review

Consciousness and meaning at life’s end: How the study of dying deepens our understanding of everyday presencePsychology Today; by Alexander Batthyany, PhD; 11/15/25Sergei Rachmaninoff lies dying in his Beverly Hills home. Family and friends surround him, the room suffused with that particular stillness that often accompanies life's final hours. Then something unexpected occurs. The composer opens his eyes and asks those present: "Can you hear this beautiful melody? The enormously beautiful music?" The response from those at his bedside is immediate: "No, there's no music here." ... I share this story with all those who wish to participate in our work as mandatory reading, simply because I want to prevent us from making the same error—saying "No, there's no music" instead of asking "What do you hear?" ...

AI-assisted decision-making for end-stage organ failure: Opportunities and ethical concerns Artificial Organs; by John W Haller, Olga D Brazhnik, Kathleen N Fenton; 11/17/25 ... This paper discusses current applications of AI in healthcare, emphasizing the complex decision-making necessary for patients with organ failure. It outlines how AI can support risk stratification, patient selection, and outcome prediction, particularly in transplantation practices that increasingly rely on robust data to inform care pathways. ... There is a need for standardized, high-quality data, rigorous validation, and transparent algorithms to mitigate biases that could exacerbate disparities in care. Ethical considerations demand attention to equitable access, patient privacy, and the preservation of the human element in patient-clinician relationships. 

Meet Oscar: The cat who could predict death and comfort patients in a Rhode Island hospice doggodigest - Cats, DD Animal News; by Andrew Alpin, MSc; 11/17/25 ... Oscar, a seemingly ordinary therapy cat, possessed what appeared to be an uncanny gift, the ability to predict when patients were nearing their final moments. It is still a matter of scientific research and debate as to whether animals especially cats and dogs can predict death. ...

Navigating choice: Eating, drinking and decision-making at end of life for individuals with cognitive impairmentJournal of Clinical Practice in Speech-Language Pathology; by Laura Chahdaa, Druvni Pererab, Darcy Longc, Laura Knauerb, Sanora Yonand; 10/25Current clinical guidelines offer limited direction for speech-language pathologists (SLPs) supporting eating and drinking decisions in palliative care (PC), particularly for individuals with dysphagia and co-occurring cognitive impairment. This population presents unique clinical, ethical and interpersonal challenges that often fall outside existing frameworks such as ‘Eating and Drinking with Acknowledged Risk’. This scoping review explores the key considerations for SLPs involved in end-of-life decisionmaking in these complex cases. A qualitative scoping review was conducted and analysed thematically [and] ... six overarching themes were identified: person-centred care; emotional and relational dynamics; ethical decision-making complexity; medical risk; barriers to effective clinical practice; and legal considerations. Findings reveal inconsistencies in practice and limited guidance for SLPs navigating care for individuals with cognitive impairment at the end of life.

Understanding challenges and barriers to quality end-of-life care for patients with hematologic malignancies: A GIMEMA surveyAnnals of Hematology; by Leonardo Potenza, Fabio Efficace, Eleonora Borelli, Paola Fazi, Thomas Baldi, Francesca Tartaglia, Francesco Sparano, Claudio Cartoni, Pasquale Niscola, Claudia Mucciarini, Oreofe Odejide, Eduardo Bruera, Camilla Zimmermann, Marco Vignetti, Mario Luppi, Elena Bandieri; 10/25Patients with hematologic malignancies often receive aggressive end-of-life (EOL) care, which may be partly related to hematologists' discomfort with discontinuing aggressive treatments at EOL. We assessed a cohort of Italian hematological oncologists through a GIMEMA online survey to explore their attitudes toward standard measures of quality EOL care, their opinions on barriers to providing this care, and potential interventions. In conclusion, Italian hematologists find most standard EOL quality measures acceptable, they identify barriers to quality care, and are open to interventions, including early integration of palliative care, to improve patients' EOL care. However, they lack familiarity with GOC [goals of care] and ACP [advance care planning] discussions, highlighting the need for communication skills training.

[Australia] Defining the symptoms of personality and behaviour changes in brain tumour patients and their impact on caregiversSupportive Care in Cancer; by Emma McDougall, Haryana M Dhillon, Karin Piil, Lauren J Breen, Anna K Nowak, Sara Nordentoft, Sine Kjærgaard, Georgia K B Halkett; 10/25This study highlights the nuances and complexity in conceptualising personality changes in patients with a brain tumour and the grief, isolation, and safety concerns experienced by carers. Brain tumour-related aggression was identified as a significant concern by both healthcare professionals and carers, lacking clinical guidelines internationally for managing violence and aggression in this population. Future research is required to test interventions and support for safeguarding and risk management for patients and their family members.

[France] End-of-life sedation and spousal grief: Exploring bereavement narratives with and without continuous deep sedationPalliative Care & Social Practice; by Livia Sani, Yasmine Chemrouk, Marthe Ducos, Pascal Gauthier, Marie-Frédérique Bacqué; 10/25This study explored how bereavement experiences differ based on the use of CDSUD [Continuous Deep Sedation Until Death]. Spouses whose partners received CDSUD often reported emotional disruption and unresolved grief, while those without CDSUD described greater relational continuity and a more gradual farewell. Across both groups, the quality of communication, emotional preparedness, and involvement in end-of-life decisions shaped the grieving process. These findings emphasize the emotional complexity of CDSUD, particularly when implemented suddenly or without sufficient explanation. Palliative care teams should prioritize transparent, timely discussions about sedation options and provide tailored emotional support throughout the dying process.

31 shocking confessions people made to their doctors and nurses on their deathbed BussFeed; by Hannah Marder; 11/12/25 Being on your deathbed puts everything into perspective, and sometimes, the dying have something big to get off their chests. No one knows this better than those who work with the dying, who bear witness to these disturbing confessions. ...Editor's Note: This BuzzFeed feature compiles unverified, anonymous accounts of “deathbed confessions” shared by clinicians online. While written for popular appeal, it touches a truth familiar to hospice and palliative professionals: dying patients often reveal deeply held truths when facing the end. We share it as a reminder that such moments call for clinical steadiness, ethical awareness, and the presence of board-certified chaplains—those uniquely trained to meet these revelations with compassion and care.

10 common sibling clashes while caring for parents—and how to resolve them AOL.com; 11/10/25 Sibling conflicts over the care of elderly parents are quite common, along with disputes over estates and inheritance. ... 

ID# 1904730 Peripheral nerve stimulation, a minimally invasive option for end of life pain managementNeuromodulation: Technology at the Neural Interface; by Jeffrey Cao; 10/25Peripheral nerve stimulation (PNS) works by delivering targeted electrical pulses to peripheral nerves, which transmit sensory and motor signals between the central nervous system and the body. Integrating peripheral nerve stimulation (PNS) into hospice care for cancer patients marks a significant advancement in pain management, focusing on personalized and comprehensive approaches to enhance the quality of life. The reported cases highlight the effectiveness of PNS in targeting specific nerves for pain relief, complementing pharmacological therapies and improving overall patient outcomes. As research continues, PNS holds promise as a key intervention in palliative care ...

Establishing a health system policy for proportionate palliative sedationJournal of Pain & Palliative Care Pharmacotherapy; by Alec Rutherford, Trinh Bui, Jaya Gupta, Alex Choi, Leah Tenenbaum, Benjamin Tolchin, Laura Morrison, Karen Jubanyik, Richard Gelb, Allison Pinney, L. Scott Sussman, Rohit B. Sangal, Elizabeth Prsic; 10/25Proportionate palliative sedation (PPS) is an important therapeutic option for patients at the end of life who experience intractable suffering despite use of all conventional interventions. In this article, we present two cases from Yale New Haven Hospital, and explore the associated practical and ethical challenges, in the absence of clear institutional guidelines. We then describe the policy development process that followed these cases and discuss how defined PPS guidelines not only ensure patient comfort and autonomy but also mitigate decisional fatigue and moral distress among clinicians. As further guidance, we offer an ethical analysis and our own institution’s PPS policy. We encourage other institutions that are similarly committed to patient-centered care and the moral support of clinicians and caregivers to develop PPS guidelines.

Living with dementia report emphasizes that even those with advanced disease have stories to share JAMA Medical News; by Rita Rubin, MA; 10/31/25 As the average age of the US population has risen, so has the number of people living with Alzheimer disease and related dementias. And yet, dementia is still a highly stigmatized condition, a new collection of essays published by the Hastings Center for Bioethics points out. Clinicians, caregivers, and loved ones could improve the lives of the more than 7 million people in the US who are living with dementia if they only recognized that such individuals still have their own stories to tell, even when they can’t express themselves the same way they did before their symptoms appeared. 

HBO’s ‘The Pitt’ inspires viewers to consider organ donation, end-of-life planning WBOG Country 101.3; by Ozzy; 10/28/25 A University of Southern California study reveals HBO’s Emmy-winning The Pitt motivates viewers toward organ donation and end-of-life preparations. Research examining two multi-episode storylines shows 26.9% of surveyed audiences sought organ donation information while 17.2% shared donation details with others. The organ donation narrative particularly resonated with Black viewers, a demographic overrepresented on transplant waiting lists yet underrepresented as donors. Editor's Note: The Pitt's storyline involving organ donation is from Season 1, Episode 6, titled' 12:00 P.M."