Where hospice fails us: A qualitative study of facilitators and barriers in transitions to hospice according to palliative care clinicians
Journal of Palliative Medicine; by Morgan M Nakatani, Julia G Cohn, Kris W Herring, Thomas W LeBlanc; 7/26
Transitions to hospice are challenging for patients, caregivers, and health care teams, yet few studies have examined gaps in care from the perspectives of referring palliative care (PC) clinicians. PC clinicians identify substantial barriers to hospice transitions, underscoring the need to improve access to comprehensive end-of-life care. Clinicians emphasized the value of hospice and the Medicare benefit, while identifying barriers to hospice transitions [including] ... inadequate caregiving support, limited reimbursement, uncertainty around eligibility and prognostication, and differences between for-profit and non-profit hospice agencies. These barriers contributed to inequitable access to hospice and gaps in care.

Medical aid in dying: Bridging ethical guidance and bedside communication in nursing practice
Journal of Hospice & Palliative Nursing; by Jeanna Ford, Phyllis Whitehead; 7/26
As MAiD [Medical aid in dying] becomes more integrated into serious illness care, nurses, particularly those in hospice and palliative care, are increasingly the first clinicians to receive patient questions about this option. These inquiries are often embedded in broader concerns related to suffering, loss of autonomy, fear of prolonged dying, and desire for control rather than solely requests for hastened death. The Hospice and Palliative Nurses Association’s recent position statement on medical aid in dying emphasizes compassionate, nonjudgmental care, respect for autonomy, professional integrity, and the ethical obligation of nonabandonment while recognizing the complexities of conscientious objection. This manuscript examines the evolving legal and ethical landscape of MAiD, explores the professional implications for nursing practice, and introduces the EXPLORE (Elicit, Explore, Probe Suffering, Learn Values, Observe Pressures, Review Support, Evaluate Next Steps) communication framework, a practice-based model developed to provide nurses with a structured, evidence-informed approach for responding to patient-initiated MAiD discussions.

[Portugal] The ethical and psychosocial dimensions of palliative care in prison: A scoping review
Journal of Bioethical Inquiry; by Ana Gehl-Costa, P. Reis-Pina; 7/26
With prison populations expanding and aging, palliative care (PC) is an urgent concern. People in prison (PIP) face chronic illness, mental health conditions, and social vulnerabilities, creating ethical and psychosocial challenges to dignified end-of-life (EOL) care... Ethical domains included structural neglect of PIP with life-limiting illness, barriers to compassionate release, compromised autonomy, denial of death in prison culture, and inadequacies in care quality and access. Psychosocial domains encompassed stigma, mistrust, isolation, existential suffering, and fractured social bonds. PIP-led hospice models offered companionship but raised tensions around labour, confidentiality, and the normalization of death in custody... Prison-based PC requires systemic reforms, staff training, family and advocacy involvement, and legal safeguards to ensure equitable, compassionate, and dignified EOL care.
Publisher's note: This article was included in the August 2026 issue of End-of-Life Care Behind Bars - Current Thinking, by Barry R. Ashpole.

[Portugal] Ketamine for cancer-related pain in palliative care: A systematic review of clinical use and safety
Journal of Pain & Palliative Care Pharmacotherapy; by Catarina Vitorino-Afonso, Paulo Reis-Pina; 7/26
Ketamine has emerged as an adjuvant for opioid-refractory cancer-related pain in palliative care, but evidence remains limited. [This study found that] ketamine was used mainly as an adjuvant. Many reports described reduced pain and/or lower opioid use, although certainty was very low and attribution was limited by polypharmacy and regimen changes. Intravenous infusions were most common, but subcutaneous, oral, and intranasal routes were also used. Intranasal ketamine showed pragmatic utility for breakthrough pain, while oral ketamine was described in ambulatory palliative care settings.

[Sweden] Effects and user-reported experiences of a self-management mobile health app for grieving adolescents: Randomized controlled trial
Journal of Medical Internet Research; by Rebecca Rhodin, Rakel Eklund, Anneli Silvén Hagström, Rolf Gjestad, Atle Dyregrov, Josefin Sveen; 7/26
Adolescents who experience the loss of a family member are at increased risk of adverse mental health outcomes, yet many face barriers or may be reluctant to access in-person or group-based support. This study evaluated the short- and long-term mental health effects of Alba - Youth in Grief, a preventive self-management mobile app for bereaved adolescents. Intention-to-treat analyses showed moderate reductions in prolonged grief symptoms at 12 months among adolescents randomized to Alba compared with the control group, with no significant effects at the 2- and 6-month follow-ups. The app group also demonstrated greater reductions in grief reactions, posttraumatic stress symptoms, and depressive symptoms compared with controls, with the strongest effects observed at long-term follow-up.

Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that.  ~Martin Luther King Jr.