Palliative Care

End-of-life decision-making is never a solo act

Chinmeri Nwuba

Health Policy

June 5, 2026

Technological and biomedical advancements are undeniable blessings in today’s health sector. These advancements have improved life-prolonging technologies. So, clinicians can often sustain biological life long after meaningful recovery is unlikely. Consequently, there is a subtle shift happening in modern medicine, where we are no longer asking whether we can keep people alive but who gets to decide when not to.

This shift becomes clearer when viewed through Ronald Dworkin’s distinction between …

Why physicians need to learn cannabis medicine now

Janice Makela, MD

Medications

May 31, 2026

I am a geriatrics and hospice and palliative medicine physician with over 20 years of experience. Over the years, I have seen how cannabis has helped my patients, and I am very comfortable with my patients using cannabis.

But like many physicians, I was not formally trained in cannabis medicine. In fact, for the longest time I thought people smoked the leaves. It was only much later that I learned that …

Continuity of care in HIV/AIDS lives in the people who stay

Gus W. Krucke, MD

Physician

May 15, 2026

There are moments in medicine when the entire architecture of modern health care reveals both its brilliance and its limitations at the same time.

Years ago, a familiar face appeared quietly in our treatment room, though diminished enough that several people did not recognize him immediately. He had once been the life of every room he entered, effortlessly social, funny, alive in the particular way some people seem born carrying light …

Death certificate errors expose flawed medical history

Karen Glover, MD

Physician

May 14, 2026

My mother died recently. I received the death certificate. I disagree with her cause of death. The doctor who completed her worksheet did not know her well. The death certificate has a diagnosis that she never had that was handed down from her previous doctor. It omitted a long-standing, chronic disease. Why am I bothered? Because I would complete death certificates on a routine basis, for I am a hospice …

Clinician grief is a hidden crisis in modern hospice care

Linda Ellington, RN

Conditions and Diseases

May 12, 2026

I stood knocking at the door of my hospice patient like I did every Monday for the past eight months. A musically talented man in his early 40s was always waiting for my weekly nursing visit, more so for the aspect of socialization. He was diagnosed with colon cancer two years prior and had a colostomy bag, leaving this once vibrant, social, even handsome man a shell of what he …

Why I would never compromise on withdrawing care until I saw it firsthand [PODCAST]

The Podcast by KevinMD

Podcast

April 16, 2026

Subscribe to The Podcast by KevinMD. Watch on YouTube. Catch up on old episodes!

What happens when your deepest religious convictions collide with a patient suffering from metastatic cancer and no miracle in sight? Medical student Jonah Rocheeld shares the raw tension between …

A physician’s poem on burnout and end-of-life care

Nisha Punatar, MD

Physician

April 6, 2026

They tell us doctors
to practice self-care,
as if grief were a muscle
that loosens with stretching.
But no one teaches
how to set down
a conversation about dying
and pick up
the rhythm of living.

At the end of the work day,
the questions still echo,
How much time do I have?
What would you do, doc?
The charts are closed,
but the questions remain open.

Burnout does not arrive
as flames.
It seeps,
through the small cracks
between hope and reality,
between doing everything possible
and knowing we have …

The serpent and the staff: the ancient origins of the medical symbol

Neal Taub, MD

Physician

March 27, 2026

Every physician recognizes the serpent and the staff. It appears on hospital logos, medical schools, and ambulance doors, so familiar that few of us stop to ask what it actually means.

Many assume the symbol of medicine is the caduceus: two snakes, wings, and a staff. It is not. That emblem belonged to Hermes, the Greek god of commerce, negotiation, and speed. Its twin serpents represent exchange and trade, apt for …

Caregiver end-of-life decisions: Moving beyond advance directives

Kevin Haselhorst, MD

Physician

March 27, 2026

Advance directives pale in comparison to the real-time medical decisions caregivers make every day, whether to encourage medication, contact a specialist, call 911, or continue treatment for a loved one. National Healthcare Decisions Day (NHDD), observed each year on April 16, encourages individuals to complete an advance directive. But when the true day of reckoning arrives, when death seems imminent, disfigurement is likely, or mental capacity is lost, this document …

Why symptom variability in chronic illness is not failure

Donald Kushner, MD

Physician

March 26, 2026

Every clinician has encountered this moment. A patient leans forward and says, “But doctor, I was fine yesterday.” The statement carries confusion, frustration, and sometimes quiet alarm. It also reveals an assumption deeply embedded in both medical culture and human cognition, that stability should look like consistency.

In clinical medicine, predictability is often mistaken for stability. We feel reassured when symptoms follow familiar patterns. Patients feel encouraged when treatments produce repeatable …

Ignored DNR hospital policy: a family’s tragic end-of-life story

Amanda Cutshall

Conditions and Diseases

March 25, 2026

On the morning of May 19, 2024, my 74-year-old mother was struggling to breathe at her home in Bastrop, Texas. I called 911, an ambulance arrived, and my mother was transported to a hospital.

What followed was a devastating series of miscommunications and ignored directives that led to unnecessary suffering for her and profound trauma for our family.

A clear directive

My mother’s end-of-life wishes had been clear for a long time: She …

Demedicalize dying: Why end-of-life care needs a spiritual reset

Kevin Haselhorst, MD

Physician

February 6, 2026

If life is what we make it, then the end of life can be understood as a spiritual journey rather than a medical pursuit. We demedicalize dying by distancing ourselves from practices that use hope as consent (prolonging life through reflexive hospitalizations, procedures, or antibiotics that offer little dignity to those already living with serious illness).

Every medical decision poses a fundamental question: Is this the beginning of the end, or …

End-of-life care cost substance use: When compassion meets economic reality

Brian Hudes, MD

Physician

February 4, 2026

At two o’clock in the morning, the emergency department doors open to a familiar story. A middle-aged man arrives with massive gastrointestinal bleeding, severe jaundice, and advanced cirrhosis from decades of alcohol use. He has no insurance, no primary care provider, no stable home, and no ongoing addiction treatment. The next 10 days bring mechanical ventilation, endoscopic procedures, dialysis, and intensive care. The total bill will exceed $100,000, nearly all …

Why every physician needs a sabbatical (and how to take one)

Christie Mulholland, MD

Physician

January 16, 2026

In the first episode of The Pitt season 2, Dr. Robby reveals he’s taking a three-month sabbatical, his last shift before heading to a UNESCO World Heritage Site in Canada. For a primetime medical drama to feature a physician stepping away for three months signals something important: Sabbaticals are entering the cultural conversation about how doctors survive in modern medicine.

But here’s what the show doesn’t tell you: Most physicians can’t …

What is palliative medicine and why is it so misunderstood?

Patricia M. Fogelman, DNP

Conditions and Diseases

January 16, 2026

After years of leading palliative medicine departments, as a Fellow of the American Academy of Hospice and Palliative Medicine, I’ve had countless conversations that start the same way. A colleague in the hallway says, “Oh, palliative care—that’s so important. You all are so nice.” Or a hospital administrator tells me, “We wish we could give you more, but resources are tight right now.” Or my personal favorite: “Palliative care is …

Physicians’ end-of-life choices: a surprising study

M. Bennet Broner, PhD

Conditions and Diseases

January 3, 2026

In July, I wrote about the importance of end-of-life planning (EOL). Shortly after, I read a study that examined physicians’ EOL plans with advanced cancer and Alzheimer’s disease (stage unspecified). The study encompassed nations with different forms of aid in dying, from the U.S., where a terminal coma is the only option most states allow, to Belgium, where physician-assisted dying (PAD) and euthanasia are available. Although the term suicide …

How end-of-life planning can be a gift

Dustin Grinnell

Conditions and Diseases

December 25, 2025

This is a work of fiction.

I directed Mrs. Powell to sit and make herself comfortable. She lowered herself into the chair at the round table in the lobby of my office slowly, her frail, 90-year-old frame eventually settling into it.

“How’s your health, Mrs. Powell?” I asked. This is how I approached most conversations in which a client asked if they could meet suddenly. Usually, it meant they had gotten some …

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How end-of-life planning can be a gift

A doctor’s ritual: Reading obituaries

Emma Jones, MD

Physician

December 5, 2025

I live across the street from a funeral home. Each day as I see the cars begin to line up and the people in dark clothes gather to say goodbye, I can’t help but wonder about the stories inside. Who were they coming to honor? What kind of life had just ended? So, most mornings, before I check my email or the hospital census, I read the obituaries.

As a child, …

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A doctor’s ritual: Reading obituaries

The role of meaning in modern medicine

Neal Taub, MD

Physician

November 17, 2025

For the past century, physicians have practiced within the framework of materialism: the belief that everything real can be measured, and everything measurable is real. But that worldview has been quietly eroded by physics itself. In the double-slit experiment, particles behave as waves of probability until observed, at which point they collapse into definite form. Later variations (such as Wheeler’s delayed-choice experiments) demonstrated that observation seems to determine not only …

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The role of meaning in modern medicine

Advance directives not honored: a wife’s story

Susan Hatch

Conditions and Diseases

November 14, 2025

For nearly a decade, almost every time my husband, Teddy, went into the hospital, they asked if he had an advance directive. And he did: It was notarized and given to any doctor he saw and any hospital he visited, including the one he died in.

But on the last day of Teddy’s life, the interventions he received were explicitly against his wishes as documented in his advance directive: no resuscitation, …

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