ABCD Exchange : February 1999 : President's Letter - Turning a Corner

Upfront - Barriers to Effective Pain Management
QuickScan - News in Brief
In the Sates - Media Briefing
Public Policy - Pain as a Fifth Vital Sign
Lunch Bunch - Legal Assisted Suicide in Oregon

Sometimes, the World Turns a Corner
by Joanne Lynn, M.D.

If you haven’t already done so, set your browser to the website of the Agency for Health Care Policy and Research at There, you will find a remarkable document—the National Institutes for Health request for applications for "Research on the End of Life." NIH will commit at least $2.7 million for up to one dozen new grants for end-of-life research.

The background statement could have come ABCD! Enough people in enough key spots have finally come together on the seriousness of the problems and the prospects for valuable research. They have generated an initiative that frames and funds important research for advanced illness. Some research items build upon solid traditions of research, such as pain mechanisms and targeted drugs. Others point to relatively novel arenas of inquiry—prevention of symptoms, patient education strategies, interventions to enhance social or spiritual well-being, and cultural variations in end-of-life preferences.

What an opportunity! Pass it along to colleagues! Those interested in end-of-life care should submit as many high-quality research proposals as possible. The deadline is May 21, 1999, with awards to be made by late September.

Funded projects promise to launch substantial new lines of research and to build a cadre of well-established researchers. Our field needs new drugs, new modes of service delivery, and new research methods. This could be the start of major growth and learning. If there are few good proposals, there will be less enthusiasm for building this field. So, think on it—and share the good news.

Even those not involved in research can encourage this program by writing to Congress and noting how important and worthy this funding opportunity is. Applaud NIH for taking an initiative—and, if you can, thank especially the National Institute for Nursing Research, which helped to anchor the work behind the scenes.

On another note, visit ABCD on-line via the Inter-Institutional Collaborative Network on End-of-Life Care. In addition to the ABCD discussion board, you will find many others. The boards, organized by Growth House, offer unlimited opportunities for exchanges and conversations on end-of-life care. Try it out by going to, and following the sign-up process. Through this service, you can let others know of recent developments in your organization or community and offer links to other sites.

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This content is provided by Americans for Better Care of the Dying. For more information, visit