Hospice Patients in Clinical Cancer Treatment Trials

Patients with cancer and practitioners face a confl ict when no known curative treatments exist because Medicare and other insurers do not allow clinical trial participation and hospice care to occur concurrently. Patients may not fully benefi t from hospice care because of late enrollment. Barriers to hospice referrals exist in the form of clinician attitudes and insurance limitations. Patients with advanced cancer may be prevented from enrolling in clinical trials, and trial participation may limit hospice care. Factors related to this situation are discussed.