consider creative, economical ways of incorporating questions on end-of-life issues in a wider range of studies. (One example is a study sponsored by the National Heart, Lung, and Blood Institute that looked at risk factors and prognoses for cardiovascular diseases for people over age 65 and included an ancillary study that looked at behaviors and burdens of caregivers for those with severe disease (Schulz et al., 1997). Other longer-term objectives would be to encourage interdisciplinary research and to develop career tracks for researchers interested in these topics and to attract researchers to areas not previously identified as being "interesting." The committee recognized that these kinds of initiatives are difficult to create and sustain but believed that policymakers and research leaders can devise creative ways to support focused biomedical research that will ultimately help people have a better quality of life while dying.

Conclusion

Progress in a clinical field is dependent on its research base. Deficiencies in basic scientific and clinical knowledge affect both the availability of effective palliative therapies and the reimbursement of palliative services. The recruitment of excellent young professionals to an area of medical care depends in some part on the opportunities in the field for posing and resolving stimulating questions. This chapter has highlighted a number of exciting areas of inquiry that could build on findings that are accumulating in fields such as pain and immunology research. A major challenge to the field of palliative medicine is to work with colleagues in other fields to generate and conduct research in these and related areas. A broader task is to cultivate understanding of the potential benefits of such research among government and industry sponsors of research, to develop stronger ties with patient advocacy groups, and to promote public demand for knowledge that will improve the quality of life for people who are dying.



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