Literature Review

Calibrating AI reliance—A physician’s superhuman dilemmaJAMA Health Forum; Shefali V. Patil, PhD; Christopher G. Myers, PhD; Yemeng Lu-Myers, MD, MPH; 3/25Assistive artificial intelligence (AI) technologies hold significant promise for transforming health care by aiding physicians in diagnosing, managing, and treating patients. Leveraging AI’s superior diagnostic accuracy in certain specialties, these assistive AI systems aim to reduce medical errors, while also promising to address physician fatigue by alleviating cognitive load and time pressures. Because human operators are perceived as having control over the technology’s use, responsibility unduly shifts to the human operator, even when clear evidence shows that the AI system produces erroneous outputs. Consequently, although scholars have proposed recommendations for shaping AI regulations, the reality is that in the absence of clear policies or established legal standards, future liability will largely hinge on societal perceptions of blameworthiness. This regulatory gap imposes an immense, almost superhuman, burden on physicians: they are expected to rely on AI to minimize medical errors, yet bear responsibility for determining when to override or defer to these systems.

Opening the door to wholistic patient care: Results from a nationally representative database on the use of spiritual and religious counselingHealth Services Insights; Peter J. Mallow, Pierson Savarino; 4/25The introduction of the International Classification of Diseases 10th Revision (ICD-10) code Z71.81 in 2015 enabled the systematic documentation of spiritual and religious counseling (SRC) in hospital settings, opening avenues for research into its effect on patient outcomes and healthcare resource utilization. Religion and spirituality are integral to many patients’ lives, influencing their well-being, recovery and health outcomes. SRC is primarily utilized in complex, high-mortality cases, underscoring its role in holistic care for severely ill patients. The disparities observed highlight the need for standardized SRC documentation and equitable access to SRC. Future research should investigate the clinical and economic impacts of SRC to enhance patient-centered care in alignment with value-based care practices.

Assuring the provision of palliative care as an ethical duty for all physiciansJournal of Pain and Symptom Management; Amber R Comer,Daniel Sulmasy; 4/25Although palliative care is an evidence-based, essential component of care for patients with serious or critical illness and at the end-of-life, access to palliative care continues to be limited by inaccurate definitions, misrepresentation, stigma, and neglect. To help physicians and patients to overcome barriers limiting the provision of palliative care, the American Medical Association (AMA) has recently adopted policy and a new opinion in the Code of Medical Ethics which establishes an ethical duty for all physicians, in all specialties, to assure the provision of palliative care to patients who stand to benefit. Additionally, the new policy and Code opinion expand the depth and breadth of what palliative care access and delivery entail and address misconceptions that have resulted in barriers to the delivery of palliative care.

Disparities in end-of-life care: A retrospective study on intensive care utilization and advance care planning in the Colorado all-payer claims databaseAmerican Journal of Hospice and Palliative Medicine; Darcy Holladay Ford, PsyD, MA, LPC, RDN; Kimberly Landry, MPH; Megha Jha, MPH; Martha Meyer, PhD; 3/25Intensive end-of-life (EOL) care is emotionally and financially burdensome, disproportionally negatively impacting racial and ethnic minorities, rural residents, and lower socioeconomic seniors. ICU Stays: Hispanic/Latino, Asian, and Black members had increased ICU stays compared to Whites ... However, members without ACP [advance care planning] and rural residents had lower ICU stays ... ED Visits: Hispanic/Latino, Asian, Black members, non-dually eligible members (Medicare Fee for Service (MFFS) + Medicaid), and rural residents had increased ED visits ... Meanwhile, members without ACP or hospice care had lower ED visits ... 30-day Readmissions: Asian members and rural residents had increased 30-day readmissions ... In contrast, those on MFFS and not on Medicaid, members without ACP, and those not in hospice care had decreased 30-day readmissions ...

Research study participation: Have you been an unpaid caregiver to a hospice patient?Press release, Northern Illinois University and Seattle University; M. Courtney Hughes, Erin Vernon; 4/23/25You may be eligible to participate in a new survey. Help us understand which services (e.g., meals, transportation) most positively impact hospice patients and their families.

Advance care planning in the inpatient setting: The role of the hospitalistAmerican Journal of Hospice and Palliative Medicine; Nikhil Sood, MD; Rohini Garg, MBBS; Anthony D. Slonim, MD, DrPH, FCCM; 3/25Advance care planning (ACP) is critical to patient-centered health care, particularly in hospital settings where acute and end-of-life decisions often occur. As frontline providers, hospitalists are uniquely positioned to initiate and guide ACP discussions. This article explores the role of hospitalists in ACP, identifies barriers to its implementation, and highlights strategies to overcome these challenges. Key barriers include time constraints, lack of formal training, and uncertainty regarding the appropriate timing of discussions. To address these issues, hospitalists can benefit from structured communication training, integration of ACP prompts into electronic health records, and collaboration with multidisciplinary teams. While ACP has demonstrated benefits, including the alignment of care with patient preferences, reduced unnecessary interventions, and improved satisfaction for patients and families, challenges remain in ensuring consistent and culturally sensitive implementation.

The physical side of grief: Physical symptoms in bereavementIllness, Crisis and Loss; Crystal L. Weeden, Nora P. Reilly; 3/25Both emotional and physiological responses to loss are normal reactions to bereavement. The aim of the study was to examine if the type of loss someone experienced was related to the magnitude of their expressed symptomology in a nonwidowed specific sample. Specifically, to determine if there is a difference in physical symptoms between participants who experienced grief due to an out-of-order loss (a death before the age of 55) versus those who experienced grief after a natural life progression loss (a death that occurs after the age of 80). Results confirmed that those who bereaved an out-of-order loss experienced significantly more symptomology, both emotional and physiological, than those who lost a loved one aged 55 or older. This study highlights the importance of identifying those at the highest risk for increased grief-related symptomology.

Prevention of opioid misuse and abuse through effective pain management in patients with chronic pain: An umbrella systematic reviewCureus: Sana Sultana, Safeera Khan; 3/25Chronic pain is a condition that affects physical well-being as well as emotional well-being, has mental impacts on patients, and diminishes their quality of life. There is also growing evidence that opioids have only limited effectiveness in the management of CNCP [chronic non-cancer pain], and the increased availability of prescription opioids has contributed to an increase in opioid addiction cases and overdose deaths. This review was conducted to determine if adequate pain management would decrease opioid use and prevent misuse. We discussed the different pain management methods in the paper, including the different pharmacotherapy options, nerve blocks, and spinal cord stimulation. We also talk about multidisciplinary treatment with the involvement of various departments (physician, pharmacy for pill counting, physical therapy, psychological care, etc.) in managing pain; good outcomes were observed with improvement in function.

Access to outpatient palliative care: Insights from MichiganAmerican Journal of Hospice & Palliative Care; by Andrew E Russell, Maria J Silveira; 4/25Outpatient palliative care provides supportive care to community-dwelling patients with serious illness who are not eligible or ready for hospice. Little is known about the services these clinics offer and the populations they serve. We conducted a cross-sectional study of outpatient palliative care clinics in Michigan to describe their services and identify gaps in care... There is limited access to outpatient palliative care in Michigan, especially in rural communities. Many clinics do not accept non-cancer or pediatric patients. Additionally, many clinics lack the full interdisciplinary team that is required to provide robust palliative care.

Quality of nonprofit hospice affiliated with integrated healthcare systemsJournal of Pain & Symptom Management; Gulmeena Khan, Emmanuelle Belanger, Joan Teno; 4/25Research shows hospice primary caregivers report better quality of care at Nonprofit (NP) than For-Profit (FP) hospices, but there is variation in quality across NP hospices. CAHPs hospice scores did not differ if a hospice was part of integrated healthcare system or not. Further research is needed on variation in quality in NP hospices.

Hiding in plain sight: A narrative review of non-parental relatives' perinatal griefJournal of Social Work in End-of-Life and Palliative Care; Rennie Bimman, Nancy Graham; 3/25Perinatal loss frequently leads to disenfranchised grief, and members of family systems less proximate to the loss are at risk for additional disenfranchisement. Grandparents and siblings are especially vulnerable to complications in perinatal grief due to intersecting and disenfranchising factors of identity, including age, role within family, and type of loss. Evidence found attested to the uniquely complex grief experiences these populations face as a result of their confluent disenfranchisement, and their overwhelming lack of support and recognition. New insights uncovered may inform clinicians as they assess needs and provide support to these oft-ignored grievers. Significant research gaps remain in this subtopic, such as firsthand perspectives of nonparental grievers, data on other extended family members, and the effect of additional psychosocial stressors on nonparental perinatal grief.

Interventions for prolonged grief disorder in children and adolescents: A systematic reviewJournal of Child & Adolescent Trauma; Sarah Bondy, Haleigh Scott; 3/25 Prolonged Grief Disorder (PGD) was added as a new diagnosis to the Diagnostic and Statistical Manual of Mental Disorders 5 Text Revision (DSM-5-TR). There is a need to tailor interventions to children and adolescent populations, but there is a lack of consensus on best practices for treating PGD in these populations. Interventions were grouped by modality including group treatments, hybrid treatments (combined group or individual therapy with family therapy), family treatment, and individual treatment. Cognitive Behavior Therapy (CBT), Attachment Theory and Multidimensional Grief Theory were common theoretical bases for interventions and all shared elements of psychoeducation and integrating knowledge about the loss with existing knowledge. Results for each intervention were found to be generally positive in reducing PGD symptoms.

“I Don’t Know What to Say”-A multimodal educational and environmental intervention to improve bedside nursing communication at end of lifeJournal of Hospice & Palliative Nursing; Wolownik, Gregory DNP, AGPCNP-BC, ACHPN; Wholihan, Dorothy DNP, AGPCNP-BC, ACHPN, FPCN, FAAN; 4/25... research shows inpatient medical-surgical nurses are not adequately trained to deliver end-of-life (EOL) care. This lack of foundational learning leads to gaps when communicating with patients and families and negatively impacts quality of care. A literature review and staff interviews identified barriers to communication, such as lack of formal education and experience; personal, cultural, and emotional challenges; and high workload. A multimodal intervention focusing on improving staff nurse communication skills was designed ...[including] environmental cues, engaging pocket cards, and an education module on communication techniques. Nurses demonstrated increased confidence and competence immediately following the education session, enduring at 4 weeks. Innovative, clinically relevant interventions can positively impact communication skills without requiring increased time commitments or high cost.