Gatekeeping from palliative care research trials

Evidence-based practice forms an essential part of modern medicine, but many treatments widely used in palliative care have never been proven to be effective. Attempts at performing research in palliative care to improve the evidence base have often failed due to poor trial accrual. Many researchers perceive gatekeeping by professionals (i.e. a reluctance to contribute patients for research studies) to be a major reason for this poor accrual. This review considers the problem of gatekeeping from palliative care research trials, determines if this is a problem exclusive to palliative care, and identifies potential methods to reduce gatekeeping.