Literature Review

Communication processes and priorities in Medical Aid in Dying conversations: A cross-sectional qualitative study of multidisciplinary cancer cliniciansCancer Medicine; by Meghan McDarby, Alix Youngblood, Megan Miller, William E Rosa, Haley Buller, Betty R Ferrell; 4/26Medical aid in dying (MAiD) is a practice that enables eligible individuals with a terminal, life-limiting illness to end their lives in a self-directed way. Multidisciplinary care teams play a vital role in facilitating discussions and patient decision making about MAiD in cancer care settings. Four themes were identified as communication priorities and processes critical for multidisciplinary teams when discussing MAiD with cancer patients: (1) addressing complexity of MAiD ... ; (2) thorough palliative care assessment; (3) strategies for clinicians and healthcare systems to optimize MAiD discussions; and (4) person-centered care that de-stigmatizes MAiD. Findings underscore the distinct complexity of MAiD discussions in oncology and highlight the need for tailored, person-centered approaches that go beyond standard end-of-life communication.

A musical about hospice? Yes, and it actually works Baltimore Fishbowl, Baltimore, MD; by Aliza Worthington; 4/21/26 ... The hospice experience may not initially evoke thoughts of “musical theater,” but if music expresses that which cannot be put into words, the subject matter put to music makes a lot of sense. Benjamin Kintisch is a trained cantor and former chaplain from Columbia, Maryland. He created “Life Review: The Hospice Musical” from real hospice patient stories over more than a decade, turning those conversations into songs. ... It is a 2025 Maryland State Arts Council Creativity Grant recipient. “Life Review: The Hospice Musical” is set in “Hopeful Hospice” – the final home for a group of hospice patients. The audience is witness to private conversations between the patients and their chaplain, a rabbi, transformed into song. Each patient’s story invites reflection on one’s own life, relationships, and memories.

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:

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.

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. 

Spiritual distress screening by nurses to increase comprehensive spiritual support of patientsJournal of Hospice & Palliative Nursing; by Nair, Archana; Patterson, Dorothy; Hauver, Bethany; Labadie, Chelsey; 4/26This project aimed to address a gap in nurses’ awareness of spiritual care and comprehensive spiritual support of patients in a breast oncology clinic at a National Cancer Institute (NCI)-designated Comprehensive Cancer Center through interdisciplinary collaboration with chaplaincy. Following education, nurses screened patients during their initial visit to the breast surgical oncology clinic who were experiencing moderate to severe distress for related existential themes of distress using an assessment tool and referred them to chaplaincy or social work based on the screening results. Nurse-initiated chaplain referrals increased significantly during the study period, with the most common distress themes being stress, hopes/fears, and assistance/help. Patient acceptance of referrals averaged 18.7% for chaplaincy and 33.1% for social work. By enhancing nurses’ understanding of spiritual care and the role of chaplaincy, the clinic was able to improve the provision of comprehensive spiritual support, contributing to holistic patient care. 

How to navigate a multigenerational team in health careHomeCare; by Kimberly Skehan & Jennifer Kennedy; 4/2/26 For the first time in history, five generations are working side by side in today’s organizations. Each cohort brings distinct experiences, values, communication styles and expectations. In health care, these differences influence not only workplace culture but also how care is delivered, received and supported. Understanding generational differences is no longer a soft skill. It is a strategic competency tied directly to quality, compliance, workforce sustainability and patient experience. The 5 Generations:

“I just feel alone and by myself”: how adolescents experience loneliness when their parent has cancer BMC Public Health; by Lydia Mckeown, Martin Dempster, Jenny Groarke & Lisa Graham-Wisener; 3/31/26... Adolescents experiencing parental cancer report intrapersonal loneliness and interpersonal loneliness across their peer group and family life. Healthcare professionals should identify if patients have young dependent children early on so they can support parents to provide age-appropriate information about cancer to their young people and signpost parents to relevant support for their children. Editor's Note: This need becomes even more urgent when a parent is dying. The Centers for Medicare & Medicaid Services Hospice Conditions of Participation reference “family” 423 times—an intentional reminder that hospcie care extends beyond the patient. Supporting parents as they support their children is both essential and expected.

Integrating palliative care: The power of silence in oncology Oncology Nursing News; by Angela Thomas, MSN, APRN, AGPCNP-C, ACHPN; 3/31/26Integrating palliative care principles into oncology requires the ability to allow silence to create a space where patients can process difficult news and feel truly seen. According to Angela Thomas, MSN, APRN, AGPCNP-C, ACHPN, these intentional pauses validate the patient’s experience and provide a necessary emotional release. By sitting in silence, providers acknowledge the gravity of the patient’s situation, which Thomas identifies as a core “heart issue” learned from palliative care and successfully integrated into the oncology setting. In a recent interview with Oncology Nursing News, Thomas, of Texas Oncology, discusses how practitioners can incorporate these techniques into their daily practice. 

Neenah pastor finds deeper calling after brother’s hospice journey WFRV Green Bay, WI; by Breanna Reinhart; 3/30/26 For the Reverend Niveen Ibrahim Sarras, walking with people through their final moments of life is more than a calling. It’s deeply personal. ... For years, Sarras has guided families through grief, offering prayers and presence at the end of life. But last summer, she found herself navigating that journey from a different perspective. Her brother, Odeh, traveled from Palestine to visit after a long battle with cancer. Just days later, doctors delivered devastating news. “The doctor, after having a CT scan, told me my brother was dying, and I shouldn’t let my brother go back,” Sarras said. Her family turned to hospice care, ... Through language barriers, cultural differences and grief, a team of local caregivers stepped in to help. What followed was a shared experience of compassion and learning. “I just want people to know that with hospice we are there to support you wherever you are at, no matter the cultural background,” said ThedaCare hospice nurse Briana Eggert.Editor's Note: To what extent does your hospice put this into action—supporting persons “no matter the cultural background”? Whatever your strengths, where are your cultural gaps, and how can you better align commitments with action through training, access to translated materials, interpreters, and community partnerships?

Mike Schramm: 'The Pitt' and the doctrine of double effect 1819 News, Birmingham, AL; by Mike Schramm; 3/27/26 ... In season two [of The Pitt], episode eight, Drs. “Robby” and McKay begin a conversation about a patient with terminal cancer in agonizing pain who is nearing death. “Where are we with the morphine?” Robby asks, suggesting they raise the dosage. After being told (surely for the viewers) “she could stop breathing,” he gestures and asks, “Are you familiar with the doctrine of double effect?” ... “We treat pain,” Robby explains. “And if, in doing so, there’s a negative side effect, we accept it.” “Even if the negative side effect is death?” McKay asks. While this might seem intuitive to some, its history and reasonability cannot be taken for granted. This doctrine of double-effect basically affirms that a good or neutral action may be morally undertaken in good conscience, even if one knows that a secondary bad result will occur from that action.