Placebo-controlled trials in palliative care: the argument for

A survey of the views of palliative care healthcare professionals towards referring cancer patients to participate in randomized controlled trials in palliative care

“…The results of this survey suggest that some HCPs may deny them this opportunity. There has been much debate in the literature as to the ethics of RCT-specific issues in palliative care research [15,20]. However, in this survey, more than two thirds of doctors were willing to refer to trials involving blinding, placebo or randomisation, perhaps reflecting an understanding that RCTs are the best way to minimise bias.…”

“…Evidence-based practice forms an essential part of modern medicine, yet many treatments and interventions used in palliative care have not been demonstrated to be efficacious, and their use is based on audit, case report, anecdote or physician preference alone [15]. A few of the many examples of this include the use of benzodiazepines for terminal agitation, antihistamines for opioid induced nausea and anticholinergics in "death rattle".…”

“…The literature is littered with poor studies, failed studies or studies that have failed to accrue sufficient numbers of patients [30,31]. Specific challenges include difficulties in recruiting patients [15], small samples [8], high attrition rates [22], rapidly changing clinical situations, limited survival times and gatekeeping by healthcare professionals [1].…”

What do palliative care patients and their relatives think about research in palliative care?—a systematic review

“…Despite the current need in medical practise for evidencebased medicine, many treatments that are widely used in palliative care have never been proven to be effective, and their use is based on anecdote and physician preference alone [1]. It is widely acknowledged that research in this patient group is difficult and therefore is often not attempted.…”

Réflexion sur la recherche clinique en soins palliatifs à travers un essai thérapeutique sur l’effet antalgique de l’association kétamine–morphine

“…La littérature reste ainsi partagée. Selon Hardy, l'effet placebo paraît influencer significativement une étude en fin de vie [10]. Pour Kirkham et Abel, le recours à un produit placebo doit cependant se faire avec circonspection [11].…”