As more Americans spend their final days in hospices, drug makers and doctors are asking patients there to take part in tests of new medicines.
But the research faces considerable logistical and ethical challenges, this morning’s WSJ reports.
For starters, there’s the danger the studies will give people false hope. “People are really vulnerable when they’re coming to the end of life,” the executive vice president of the American Academy of Hospice and Palliative Medicine told the paper. “They’re willing to sign up for anything.” Earlier this year, the group issued this position paper that recognized the vulnerability of hospice patients but said there’s an “urgent need for further palliative care research.”
Another problem is that hospices, geared to offering physical and emotional suppport, often don’t have the staff or culture suited to the rigors of clinical trials, the WSJ says.
Still, the research is gaining ground. A small company called Progenics Pharmaceuticals has partnered with Wyeth on a drug called methylnaltrexone, used to treat constipation caused by opioids such as morphine. The drug’s late-stage clinical trial took place in hospices, because Progenics believes a great need for the drug is among patients who received regular doses of opioids to manage pain as the near the end of life. Many of the hospices were unaware of how much additional work would be required to conduct the trial, however. And some hospice nurses were reluctant to enroll dying patients in a drug trial.
But the trial went on, and the drug has been submitted for approval to the FDA. A decision is expected by late January.