This is unpublished


Clinical Faculty
Palliative Care
Associate Professor
Medical Director, Palliative Care & Hospice Service, VA Puget Sound HCS
Program Co-Director, Palliative Medicine Fellowship Program
Sites of Practice
VA Puget Sound Health Care System

Philosophy of Care

Dr. Gruenewald is Medical Director of the Palliative Care and Hospice Service at VA Puget Sound Health Care System. He is Associate Director of the Palliative Medicine Fellowship and Associate Professor of Medicine in the Division of Gerontology and Geriatric Medicine.
His varied clinical interests in patient care near the end of life include the management of symptoms, especially difficult pain management problems; palliative treatments of “last resort” including palliative sedation and voluntarily stopping eating and drinking; conducting goals of care conversations; and communication skills. His palliative care program development work includes his founding role in building the Palliative Care & Hospice Service at VA Puget Sound HCS in 2004 and the UW Palliative Medicine Fellowship in 2008; and project leadership for a Dept. of Veterans Affairs initiative to improve family meetings in intensive care units. Through his work with the VA Palliative Care Leadership Centers program, he assisted several VA medical centers to develop, expand or improve their palliative care programs.
His published work includes systematic reviews examining the illness experience of older adults near the end of life and the evaluation of quality of life in people severely affected by multiple sclerosis; development of a curriculum to improve family meetings in intensive care units; management of requests to stop eating and drinking by residents of long term care facilities; review of palliative treatments of last resort; review of barriers and facilitators of end-of-life care for Veterans without secure housing; reviews of aging and the endocrine system; and assessment of the merits of rationing health care based on age.

Education and Training

  • Fellowship, University of Washington, VAPSHCS, Seattle WA (1987-1991)
  • Residency, University of Washington, Seattle WA (1983-1987)
  • MD, University of Chicago Pritzker School of Medicine (1983)
  • College, Reed College, Portland OR (1978)


  • Dept of Veterans Affairs Certificate of Appreciation: Transition to Cerner Electronic Health Record (2019)
  • Dept of Veterans Affairs Certificate of Appreciation: Integrating Palliative Care in Intensive Care (2013)
  • Geriatric Academic Program Award (1991)
  • Alpha Omega Alpha (1982)
  • Phi Beta Kappa (1978)