End of Life and Bereavement
In this difficult area, we offer clues to help patients and families understand their grief, ways to support them in that grief, along with ways to enhance the possibility that their dying will be a comfortable one. We also recognize your grief as a clinician and directly address burnout, how you can tell if you’re on the way, if you’re there, and what you can do about it.
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Introduction
Compassion Fatigue and Burnout
Grief’s Hidden Role in Oncologist Compassion Fatigue and Burnout
Targeted Oncology, October 2024
Empowering care teams: redefining message management to enhance care delivery and alleviate oncologist burnout.
JNCCN 2024;22:664-669
Palliative Care Professionals’ Inner Life: Exploring the Mediating Role of Self-compassion in the Prediction of Compassion Satisfaction, Compassion Fatigue, Burnout and Wellbeing
J Pain Symptom Manage 2022; 63:112-123.
Disenfranchised Grief and Countertransference: Hidden Contributors to Oncologist Compassion Fatigue and Burnout
accc-cancer.org, Vol. 40, No 3, 2025
Key strategies to promote professional wellness and reduce burnout in oncology clinicians.
JCO Oncol Pract 2025;21:936-941 (see also editorial by Speers).
Psychological well-being in clinical research coordinators.
JAMA Network Open 2025;8:e2523985 doi:10.1001/jamanetworkopen.2025.23985
The meaning of together: exploring transference and countertransference in palliative care settings.
J Palliat Med 2021;24:1598-1602
Academic medical centers and ASCO recommendations: starting a difficult discussion.
J Clin Oncol 43:1939-1941 (editorial on Winer 2025 article)
Ten-year trends in clinician well-being and burnout among oncology fellows in training: an ASCO state of the cancer care in America study.
JCO Oncol Pract 2025;21:1039-1044
State of professional well-being, satisfaction, and career plans among US oncologists in 2023.
JCO Oncology Adv 2025;2:e2400010
Rx for resilience: curing burnout in oncology through smarter workflows and supportive practices.
JCO Oncol Practice 2025;21:903-905 (see Paper by Lapen).
Promoting reasonable career expectations and maximizing professional fulfillment for academic oncologists: ASCO recommendations for academic medical centers.
J Clin Oncol 2025;43:2017-2023 (see also Ryan editorial)
Trauma Stewardship: An Everyday Guide to Caring for Self While Caring for Others
Berrett-Koehler Publishers, Inc., Oakland, CA. 2009.
Managing Burnout: Diagnosis and Treatment
End of Life Conversations
Psychological Issues in End-of-Life Care
J Palliat Med. 2006 Jun; 9(3):751-72. DOI: 10.1089/jpm.2006.9.751. PMID: 16752981.
Life After Death: a Practical Approach to Grief and Bereavement
Ann Intern Med 2001; 134:208-215.
Addressing Spirituality Within the Care of Patients at the End of Life: Perspectives of Patients with Advanced Cancer, Oncologists, and Oncology Nurses
Version 2. J Clin Oncol 2012; 30:2538–2544.
The Four Things That Matter Most: 10th Anniversary Edition. A Book About Living
Atria Books – Simon and Shuster. 2014.
Dying Well: Peace and Possibilities at the End of Life
New York: Rivershead/Putnam books. 1997.
Handbook for Mortals: Guidance for People Facing Serious Illness , 2nd Edition
New York, Oxford University Press. 2011.
What to Do and Say When Time is Very Short… with Dr. Molly Collins, FACP, FAAHPM
May 2024
VitalTalk.org
Learn to communicate effectively with seriously ill patients.
Grieving
Grief’s Hidden Role in Oncologist Compassion Fatigue and Burnout
Targeted Oncology, October 2024
The paradox: guilt as an antidote to helplessness among oncologists.
Support Care Cancer 2022;30:7545-7551. Note: Only abstract content is available
Oncology and suffering: strategies on coping with grief for health care professionals.
Am Soc Clin Oncol Educ Book 45:e482244
At a Loss: Patient Deaths and Clinical Research Coordinators
J Clin Oncol 2023;41:3072-4.
Development, feasibility, and acceptability of an oncologist group peer support program from ASCO’s clinician well-being task force.
JCO Onc Pract 2023;19:669-676.
A call to action: ethics committee roundtable recommendations for addressing burnout and moral distress in oncology.
JCO Oncol Pract 2020;16:191-199.
Caring for people we know: a recognized risk for burnout?
J Palliat Med 2023;26:472-480.
Understanding disenfranchised grief in a post-COVID-19 world—a pilot study of advanced practice registered nurses in palliative care.
J Hospice Palliat Nurs 2025;27: E7-26. DOI 10:1097. Note: Only abstract content is available.
State of professional well-being, satisfaction, and career plans among US oncologists in 2023.
JCO Oncology Adv 2025;2:e2400010
Improving outcomes for ICU family members: the role of spiritual care.
J Palliat Med 2025;28:538-548
Grieving Beyond Gender: Understanding the Ways Men and Women Mourn
Rev. ed., Death, Dying, and Bereavement series, Neimeyer R (ed.). New York: Routledge. 2010.
An introduction to Coping with Grief, 2nd Edition
2019, Robinson, (Little Brown Book Group).
Overcoming Grief 2nd edition: A Self-Help Guide Using Cognitive Behavioral Techniques
Robinson (Little Brown Book Group). 2018.
Hospice
Medical Aid in Dying (MAID)
Is Medical Assistance in Dying Part of Palliative Care?
JAMA. 2024;332:1137–1138. Note: Article only available to JAMA subscribers.
The pharmacology of aid in dying: from database analyses to evidence-based best practices.
J Palliat Med 2025; 28:492-498
Medical Aid in Dying Laws: More Accessible in More States
JAMA. 2024;332:1139–1140. Note: Article only available to JAMA subscribers.
Responding to patient requests for hastened death: physician aid in dying and the clinical oncologist.
J Onc Pract 2017;13:693-700.
MOLST/POLST ACP Forms
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MOLST Form
The MOLST form is a set of medical orders for patients with advanced illness who might die within 1-2 years; require long-term care services; or wish to avoid and/or receive specific life-sustaining treatments now. Best practice is to offer MOLST. Completion of MOLST is voluntary. The physician, nurse practitioner (NP) or physician assistant (PA), beginning June 17, 2020, reviews the patient’s current health status, prognosis, the patient’s goals for care, risks and benefits of each life-sustaining treatment with the patient if they have capacity, or the health care agent or surrogate if the patient lacks capacity. All ethical and legal requirements must be followed, including special procedures when a patient has an intellectual or developmental disability and lacks capacity. If the patient is unable to make medical decisions, the medical orders should reflect patient wishes, as best understood by the health care agent or surrogate and based on the patient’s values, beliefs and goals.
POLST Form
A POLST form is generally only appropriate for people who are in the final year of life, or suffering from an advanced stage terminal illness or an illness from which they are not expected to recover. It is complementary to an Advance Directive. (To find your state’s advance directive form, use our resource State-by-State Advance Directive Forms.)
Moral Distress
Grief’s Hidden Role in Oncologist Compassion Fatigue and Burnout
Targeted Oncology, October 2024
A call to action: ethics committee roundtable recommendations for addressing burnout and moral distress in oncology.
JCO Oncol Pract 2020;16:191-199.
Compassion: The Essence of Palliative and End-of-Life Care
New York: Oxford University Press. 2016
Promoting Comfort
High flow nasal cannula oxygen withdrawal at the end of life. Fast Facts #503.
J Palliat Med 2025;28;849-850
Top ten tips palliative care clinicians should know about end-of-life doulas.
J Palliat Med 2025;28:808-814
MASCC expert opinion/guidance on the use of clinically assisted hydration in patients with advanced cancer.
Support Care Cancer 2024;32:228.
“The Last Days,” in Abrahm J, Collins M, Daubman B-R. Comprehensive Guide to Supportive and Palliative Care for Patients with Cancer, 4th ed.
Johns Hopkins University Press, 2022, pp.531-561.
nia.nih.gov/health/end-life/providing-care-and-comfort-end-life
Providing care and comfort at the end of life
pallmed.net
Miscellaneous
A taxonomy of the factors contributing to the overtreatment of cancer patients at the end of life. What is the problem? Why does it happen? How can it be addressed?
2025;10:1- 16.