Letter: A strategic path forward for hospice and palliative care must focus on equity: A response to Byock

Letter: A strategic path forward for hospice and palliative care must focus on equity: A response to Byock
Palliative Medicine Reports; by Karen Bullock, Ramona L. Rhodes, Marisette Hansan, Kimberly S. Johnson; 8/21/25
In a letter to the editor critiquing Ira Byock’s recent white paper, the authors say: “one of the most urgent uncomfortable truths is briefly and incompletely acknowledged in the article. That is, not only do historically marginalized communities face unequal access to the benefits and progress of our field; they endure a disproportionate share of practices that lead to poor quality care, including many of the challenges that Byock highlights.” While applauding the article’s call to action, they caution that:

1. Standards must embed cultural and structural competence.
2. Data must expose disparities and drive accountability.
3. Quality-based competition must not deepen disparities.
4. Rebranding the field must include building trust.

Guest Editor Note, Ira Byock, MD: The authors’ perspectives and insights amplify and expand the approach outlined in the Strategic Path Forward white paper. I am grateful to them for calling on me – and us all – to keep equity as a core value and priority in strategic planning.