Abstract
1which presents its own difficulties for scientific research despite its manifest achievements. Clinical research in particular has to be done in a culture that is continually seeking ways to meet growing and at times unrealistic demands. While lip service may be paid within that culture to longterm strategy, the reality is far from this. The needs are pressing and immediate, but it is not intrinsically attractive to invest in pursuit of objectives that do not help a hard-pressed service to cope with such powerful forces. Yet research rarely produces short-term gains. In many cases the prospect of patients’ benefit is speculative, and most scientific projects can at best be justified only by less tangible returns such as additions to the body of knowledge or to the development of scientific skills.
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