Retrieving and applying the best available evidence, by means of controlled clinical studies, should be the basis of clinical decision making in palliative medicine. Evidence based medicine should ideally be based upon systematic reviews and randomised studies. Expert group opinions have been helpful in palliative medicine so far, however one should be aware of all possible biases related to this methodology.
There is a lack of extended programs addressing basic biological mechanisms of patients with advanced disease and short life expectancy. Nationally and internationally it is an increasing voice for promoting research in palliative care. However, there are several obstacles and challenges, such as: ethical, establishment of a research agenda, a critical number of experienced researchers in the group at the university level, lack of national and international leadership and finally, earmarked funding for palliative care research.
Through individual obligations and enthusiasms, combined with professional leadership, research groups in palliative medicine can possibly compete in the long run about national and international fundings. However, in order to establish a broad basis for research, earmarked programs are necessary, which have been acknowledged in some countries. There is now a need for an international move towards establishment of such programs in all countries who see the needs of improving palliative medicine.