Literature Review

Study explores Native Hawaiian end-of-life careNational Indigenous Times; by Joseph Guenzler; 2/4/25A study by the University of Hawaiʻi at Mānoa's Hā Kūpuna – National Resource Center for Native Hawaiian Elders has examined the end-of-life care preferences of Native Hawaiian kūpuna (Elders). Led by Laguna Pueblo and Quechan woman, Assistant Professor Miquela Ibrao, researchers from UH and ALU LIKE, Inc. identified culturally specific approaches to support kūpuna values in healthcare. "Death is not an end but a transition that honors relationality, ancestors and the land,' Assistant Professor Ibrao said. "Decolonizing end-of-life care means respecting cultural beliefs and embracing Indigenous wisdom about healing and living well." The study, published in the Journal of Palliative Medicine, is based on interviews with 20 kūpuna aged 60 and over from rural areas across Hawaiʻi. It highlights four key themes.

Truth-telling, and ethical considerations in terminal care: an Eastern perspectiveNursing Ethics; Qing Ma; Yi Wu; Ronghua Fang; 1/25 Truth-telling for terminally ill patients is a challenging ethical and social issue for Chinese health care professionals. However, despite the existence of ethical and moral standards for nurses, they frequently encounter moral dilemmas when making decisions about truth-telling to patients with end-stage diseases in China. This article focuses on nursing morality, ethics, norms, and philosophy in health care and discusses countermeasures taken by nurses in truth-telling decision-making in combination with Chinese Confucian culture. The analysis identifies key ethical strategies tailored to Chinese nurses’ practices, emphasizing individual autonomy, cultural sensitivity, and family dynamics in truth-telling decisions.

Well-being and choosing the best job for youJAMA Internal Medicine; Jamile A. Ashmore, PhD; J. Michael DiMaio, MD; 1/25Well-being is emerging as the catch-all term describing the field dedicated to understanding and addressing the way in which the health care system, work environment, and individual interact to influence the fulfillment and meaning that health care workers derive from their work. Clinician well-being is often led by a chief wellness officer (CWO) or other executive leader who is compensated to focus on well-being. In addition to strategic planning and oversight, the CWO’s role is to ensure that well-being is considered in administrative and operational decisions including in those related to governance, rewards systems, and culture. Health care systems’ moving from the triple to the quadruple aim are signaling that they are committed to taking care of those that care for the patients. Indeed, health care systems cannot have optimal patient care without a healthy and fulfilled workforce. 

Digital meditation to target employee stress-A randomized clinical trialJAMA Network Open; Rachel M. Radin, PhD; Julie Vacarro, MA; Elena Fromer, BA; Sarah E. Ahmadi, BA; Joanna Y. Guan, BA; Sarah M. Fisher, MS; Sarah D. Pressman, PhD; John F. Hunter, PhD; Kate Sweeny, PhD; A. Janet Tomiyama, PhD; Lauren Tiongco Hofschneider, PhD; Matthew J. Zawadzki, PhD; Larisa Gavrilova, PhD; Elissa S. Epel, PhD; Aric A. Prather, PhD; 1/25Mental health is at an historic low in the US, and work stress may be a primary contributor. Work stress is associated with poorer emotional and physical well-being, as well as high absenteeism and low presenteeism. Participants were randomized 1:1 to a digital meditation program or the waiting list control condition. Participants in the intervention group were instructed to complete 10 minutes of meditation per day for 8 weeks. The findings suggest that participating in a brief digital mindfulness-based program is an effective method for reducing general and work-related stress in employees. 

Nurses' perspectives on end-of-life care for Black/African American patientsJournal of Hospice & Palliative Nursing; Aaron, Siobhan P. PhD, RN, FNP-BC; Supiano, Katherine PhD, LCSW, FT, FGSA, APHSW-C; DeSimio, Samantha BS; 2/25In this qualitative examination of health care disparities based on race and ethnicity, the accounts of Black/African American nurses shed light on a range of critical issues within the health care system. These issues encompass stereotyping, bias, and a notable absence of cultural competence among health care providers, which often result in unequitable treatment for patients of color. Socioeconomic factors, including insurance and income disparities, further exacerbate these inequalities. Discrimination, whether implicit or explicit, continues to affect diagnosis and treatment, with a particular focus on disparities in pain management. Furthermore, the cultural perspectives and historical context surrounding treatment preferences were explored, emphasizing the profound impact of health care literacy, cultural viewpoints, and historical mistrust, especially within the Black/African American community.

Defining spine cancer pain syndromes: A systematic review and proposed terminologyGlobal Spine Journal; Markian Pahuta, MD, PhD, FRCSC; Ilya Laufer, MD; Sheng-fu Larry Lo, MD; Stefano Boriani, MD; Charles Fisher, MD, MHSC, FRCSC; Nicolas Dea, MD, MSc, FRCSC; Michael H. Weber, MD, MSc, PhD, FRCSC; Dean Chou, MD; Arjun Sahgal, MD, FRCPC; Laurence Rhines, MD; Jeremy Reynolds, MB.ChB, BSc (Hons), FRCS; Aron Lazary, MD, PhD; Alessandro Gasbarrinni, MD; Jorrit-Jan Verlaan, MD, PhD; Ziya Gokaslan, MD, FACS; Chetan Bettegowda, MD, PhD; Mohamed Sarraj, MD; Ori Barzilai, MD; AO Spine Knowledge Forum Tumor; 1/25The spine is the most common site of osseous metastasis, and over one-third of patients with carcinoma or hematological malignancy will develop spinal metastases. Vertebral metastases have a negative impact on patient function and heath related quality of life (HRQoL). We consolidate the terminology used in the literature and consolidated into clinically relevant nomenclature of biologic tumor pain, mechanical pain, radicular pain, neuropathic pain, and treatment related pain. This review helps standardize terminology for cancer-related pain which may help clinicians identify pain generators.

Outpatient palliative care and end-of-life care intensity: Linking Massachusetts Cancer Registry with all-payer claimsJNCI Cancer Spectrum; Nancy L Keating, Joel S Weissman, Alexi A Wright, Robert Wolf, Susan Gershman, Richard Knowlton, John Z Ayanian; 1/25Early palliative care is associated with better outcomes for patients with advanced-stage cancers. Using a novel data linkage, we assessed outpatient palliative care use before death and its association with end-of-life care intensity and variation across eight provider networks. End-of-life care intensity varied across provider networks. Patients with palliative care visits had lower adjusted odds of receiving intensive end-of-life care ... 

The iatrogenic consequences of medicalising grief: Resetting the research agenda Sociology of Health & Illness: by Sarah Gurley-Green, Lisa Cosgrove, Milutin Kostic, Lauren Koa, and Susan McPherson; published 11/28/25, distributed via Evermore 1/28/25When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, there was a firestorm of controversy about the elimination of the bereavement exclusion. Proponents of this change and of the proposed “complicated grief” designation believed that this change would help clinicians recognise major depression in the context of recent bereavement. Other researchers and clinicians have raised concerns about medicalising grief. In 2022 “prolonged grief disorder” (PGD) was officially included in the DSM-5-TR in the trauma- and stressor-related disorders section. ... As human rights activists have argued, bereavement support is an inalienable human right, one that is centered on the right to health and well-being, for “bereavement health is as intrinsic to our humanity as any other aspect of health and citizenship” (Macaskill 2022). That is why there are increasing calls for investing in bereavement as a public good and for “cultivat[ing] a bereavement-conscious workforce.” (Lichtenthal et al. 2024, e273). As Lichtenthal notes, it is not only clinicians but also institutions and systems that must “shift bereavement care from an afterthought to a public health priority.”Editor's note: "Iatrogenic" refers to unintentional consequences/condition from a medical intervention. In the hospice context, this means bereavement/grief from the hospice death. How many patients do you serve? The CMS Hospice Conditions of Participation identify "bereavement" and/or "grief" 155 times. What priority do you give to bereavement care before, at and after your patients' deaths?

Stories of bereavement: Examining medical students’ reflections on loss and griefOmega-Journal of Death and Dying; Johanna Shapiro, Nicholas Freeman, Alexis Nguyen, Nancy Dang, Yasaman Lorkalantari; 12/24Medical students in this study reported similar reactions to personal and professional loss, with some expected differences, such as students who experienced professional loss more often noting compassion for others and more frequently discussing managing the feelings of others, the importance of skill acquisition, processing personal emotions and team support. Students experiencing personal loss understandably appeared more focused on their own grief and more often commented about feelings of helplessness and numbness. Students in both groups reported little about how they coped with their grief or about receiving either informal or institutional support. The similarity of the essays, while due to many factors, may suggest internalizing pressures to conform to socially desirable narratives. Medical educators and clinical supervisors should help students develop effective coping skills in response to loss, provide better institutional support, and encourage students to tell authentic stories about their experiences of loss and grief. 

The 2024 election and potential battle for the social safety netJAMA Health Forum; Sara N. Bleich, PhD; Benjamin D. Sommers, MD, PhD; Rita Hamad, MD, PhD; 1/25Federal safety net programs play a major role in providing nutrition assistance, health insurance, income support, and much more to tens of millions of people with low incomes, including children, parents, and adults with disabilities or chronic conditions. Trump’s return to office for a second term with a Republican-controlled Senate and House leaves the future of the US social safety net unclear. Clinicians and public health professionals should elevate and advance strong evidence about the positive effects of the social safety net and the likely harms that would ensue if access or benefits are reduced.

Medical professionals’ perceptions of and experiences with terminally ill Orthodox Jewish patientsAmerican Journal of Hospice and Palliative Medicine; Moshe C. Ornstein, MD, MA; David Harris, MD; 1/25Orthodox Jewish patients with terminal illnesses have unique goals and desires, often driven by halakha (Jewish law and ethics) and cultural norms. Compared to the general population, Orthodox Jewish patients with terminal illnesses are more likely to request aggressive measures at end-of-life and are less likely to have completed advanced directives and health care power of attorney documentation. They also do not always have a rabbinic authority involved in decision-making. Health care professionals highlighted strong religious and community support as positive elements of caring for this population and recommend that medical teams establish early and direct communication with rabbinic authorities for those patients for whom a rabbi’s involvement is desired.

Disproportionate use of aid in dying among people with ALS: Why ALS aid-in-dying requests are common while ALS is rareJournal of Aid-in-Dying Medicine; Carolyn Rennels, MD; Steven Z. Pantilat, MD FAAHPM, MHM; Ambereen K. Mehta, MD, MPH, FAAHPM; Allison Kestenbaum, MA, MPA, BCC-PCHAC, ACPE; Kelsey Noble, DO; Jessica Besbris, MD; Ali Mendelson, MD; Kara Bischoff, MD; 12/24People with amyotrophic lateral sclerosis (ALS) disproportionately use aid in dying. We explore aspects of the ALS experience that may help explain the higher rates of aid-in-dying requests in this disease relative to others. In particular, the desire to maintain control is prominent in the face of a relentlessly progressive disease that results in substantial disability. We also describe how the requirement for self-administration of aid-in-dying medications impacts people with ALS.

Requests for medical assistance in dying by young Dutch people with psychiatric disordersJAMA Psychiatry; Lizanne J.S. Schweren, PhD; Sanne P.A. Rasing, PhD; Monique Kammeraat, BSc; Leah A. Middelkoop, MSc; Ruthie Werner, MSc; Saskia Y.M. Mérelle, PhD; Julian M. Garcia, MD; Daan H.M. Creemers, PhD; Sisco M.P. van Veen, MD, PhD; 1/25This cohort study found that the number of young psychiatric patients in the Netherlands who requested MAID-PS [medical assistance in dying based on psychiatric suffering] increased between 2012 and 2021 and that applications were retracted or rejected for most. Those who died by MAID or suicide were mostly female and had long treatment histories and prominent suicidality. These findings suggest that there is an urgent need for more knowledge about persistent death wishes and effective suicide prevention strategies for this high-risk group.