Dementia, taboo, and the need for a cultural reckoning
Journal of Aging Studies; by Kelly Marnfeldt; 3/26
Dementia is one of the most feared and misunderstood conditions of our time. Even as public awareness has increased, people living with dementia continue to face exclusion, moral disregard, and systemic neglect. Decades of advocacy, education, and contact-based interventions have sought to reduce stigma. [This study] proposes that dementia becomes stigmatized not only because it is misunderstood, but because it violates cultural expectations of personhood, consistency, and intelligibility. The paper concludes by proposing culturally grounded provocations that imagine what it might look like to reframe how dementia is seen, told, and recognized, both socially and culturally.

Values considerations in telemedicine: Pause before shifting
Journal of Pain and Symptom Management; by Meaghann S. Weaver, Kenneth A. Berkowitz; 12/25
As a contingency standard of care, telemedicine use surged during the COVID-19 pandemic. The Medicare telehealth flexibilities introduced during the COVID-19 pandemic expired in September 2025. Any ongoing sustained pivot to telemedicine warrants purposeful attentiveness to ethical considerations and not just technology use as an end unto itself. Telemedicine has the potential to complement face-to-face care practices and enhance clinical interactions when its use is based on shared values. Values such as access, equity, justice, compassion, autonomy, and dignity warrant thoughtful use of telemedicine. Patients and families need to be able to trust that clinicians and health systems will place patient welfare and shared values above technical convenience. As demonstrated in this case description, upholding values fundamental to the practice of medicine in telemedicine can enhance patient connection and foster trustworthy postpandemic practices.

Home health nurses’ perceptions of safety
Home Health Care Management & Practice; by Kiernan Riley, Kalei Crimi, Michael M. Evans, Natalie Faybisovich, Judith E. Hupcey; 2/26
The purpose of this qualitative analysis was to evaluate perceived safety threats and the impact of these treats on home health nurses. Findings included overarching themes of fear and safety. Fear within practicing nurses was a consequence of impaired safety in the home setting. The theme of safety had 2 sub-themes: risks to safety, and nursing actions to enhance safety. Effective training and awareness for nuanced safety concerns, such as when caring for persons with SPMIs in a home setting, are required to enhance nurse safety and retention as well as optimize patient care.

Diversity in health care institutions—Well worth the effort
JAMA Network Open; by Marshall Fleurant, Jada C. Bussey-Jones; 2/26
The Institute of Medicine’s report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care, a comprehensive examination of racial disparities in health care, called for interventions and policy changes to ensure equitable access and quality of care. In this systematic review and meta-analysis, Fremont et al noted that programs that promoted equity, diversity, and inclusion (EDI) were associated with diversifying training programs and academic institutions while enhancing professional development among underrepresented minority groups (eg, Black or Latino/a), including in the fields of midwifery, nursing, and dentistry. These programs also were associated with improving the workforce by increasing staff and trainee retention, improving employee and patient satisfaction, and enhancing trainee self-efficacy. Continuing these initiatives are not only worthwhile but essential to truly improve the nation’s health.

Use of nebulized tranexamic acid (TA) in combination with nebulized recombinant coagulation factor VIIa to treat hemoptysis in pediatric patients with cancer at end-of-life (EOL)
Journal of Pain and Symptom Management; by Santosh Yatam Ganesh, Nelda Itzep, Eduardo Bruera; 2/26
Hemoptysis is a distressing symptom for both patients and families at end of life (EOL). In the acute care setting, this can be managed surgically or medically. However, research regarding interventions, such as nebulized tranexamic acid (TA) and nebulized factor VIIa, for palliative management of hemoptysis at EOL is limited. In our case series, we found that combination of nebulized recombinant factor VIIa and nebulized TA relieved hemoptysis in both pediatric cancer patients at the end of life. This case series highlights the potential use of this combination to reduce suffering and distress secondary to hemoptysis in the palliative setting.

Executive Summary: Society of Critical Care Medicine Clinical Practice Guidelines on Adult End-of-Life Care in the ICU
Critical Care Medicine; by Mary Faith Marshall, F Daniel Davis, Patricia A Fogelman, Simon Oczkowski, Julie C Reid, Daniel Arellano, Rebecca A Aslakson, Joshua Campbell, Katherine Courtright, Katarine Egressy, Elizabeth Epstein, Ebonye Green, May Hua, Preeti R John, Erin K Kross, Niels D Martin, Bethany A Melo, Susanne Muehlschlegel, Silvia Perez-Protto, Ben Roberts, Daniel Shalev, Jennifer Wescoe Singley, Shawna L Strickland, Karen A Korzick; 12/25
[Recommendations include:]

• 1.1) We suggest using structured tools to facilitate shared decision-making for EOL treatment decisions in the ICU (Conditional recommendation, moderate certainty evidence).
• 1.2a) We suggest ICUs develop resources for educating substitute decision-makers on their role in making decisions on behalf of decisionally incapable patients (Conditional recommendation, low certainty evidence).
• 1.2b) ICUs should have a standardized process for identifying and documenting the legal surrogate decision-maker for decisionally incapable patients, including for those for whom a surrogate cannot be identified, in accordance with local laws and organizational policy (Good Practice Statement).

[Click here to read all recommendations.]

[Canada] What about the family? A content analysis of international legislative frameworks and guidelines on assisted dying
Policy, Politics & Nursing Practice; by Charlotte Boven, Gilla K Shapiro, Liesbeth Van Humbeeck, Let Dillen, Nele Van Den Noortgate, Gary Rodin; 2/26
When a person chooses assisted dying, the impact on their family can be profound. Legislation and professional guidelines not only regulate and standardize practice, but also support the delivery of high-quality care. Within this framework, bereavement care plays a vital role by helping families prepare for the death and potentially reducing the risk of prolonged grief. To improve quality care, there is a clear need to better integrate family support into assisted dying guidelines by establishing best practices for bereavement care. Future research should focus on family members' perspectives and needs.

[Japan] Ethics based educational interventions on end-of-life care for undergraduate nursing students: A scoping review
International Journal of Nursing Studies advances; by Saeko Kutsunugi,Satoko Ono, Misae Ito, Kaho Suda, Siu Ling Chan, John Tai Chun Fung, Claudia Kam Yuk Lai, Kyoko Murakami; 6/26
Nurses face various ethical dilemmas and conflicts in end-of-life care; however, there is no evidence of effective undergraduate ethics education on the topic settings to address them. The results suggest that while lectures are effective for acquiring ethical knowledge and attitudes related to EOLC based on ethical competency, simulations are more effective for acquiring practical skills such as communication, self-efficacy, and reflection. Incorporating ethical issues in simulations is hoped to broadly develop ethical practice competencies.

You're only given a little spark of madness. You mustn't lose it. ~Robin Williams