Clinical trials in palliative care: an ethical evaluation

On first sight, clinical trials do not seem to fit well within the concept of palliative care. Tn palliative care, the needs and wishes of the patient set the norm while participation in experimental trials is potentially har mful for the patient. The dilemma seems hard to solve as optimal care for t he dying and improvement of treatment for future patients are both imperati ve. Yet, the one seems to exclude the other. however, on closer examination it becomes less evident that clinical trials in palliative care confront: us with an unsolvable dilemma. Some patients' lives may gain meaning throug h participation in trials out of solidarity with future patients. In order to clarify this, the notions of authenticity and hope can be illuminative. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.