This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC's Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

Susan Dale Block, Dana Farber Cancer Institute

Eduardo Bruera, University of Texas, M.D. Anderson Cancer Center

LaVera M. Crawley, Stanford University Center for Biomedical Ethics

Betty R. Ferrell, City of Hope National Medical Center

Priscilla Kissick, Philadelphia, Pennsylvania

Joseph S. Pagano, University of North Carolina at Chapel Hill

Thomas Smith, Medical College of Virginia

T. Declan Walsh, The Cleveland Clinic Foundation

George Wetherill, Carnegie Institution of Washington

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by Harold Sox of the Dartmouth-Hitchcock Medical Center, appointed by the NRC's Report Review Committee, who was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the National Cancer Policy Board, the Institute of Medicine, and the National Research Council.