Ethics and pain management: respecting patient wishes.

The fear of pain is common among cancer patients. The management of cancer pain can raise troubling ethical issues for medicine and society. Medical caregivers have an ethical duty to provide therapy that benefits patients by achieving one or more goals of medicine at all points. Pain and symptom relief may be the only achievable goal when curative therapy has failed. Relief of pain can restore decision-making capacity and enhance the patient's right to self-determination. The underpinning ethical principles and extensions of these principles in the medical context of pain control with varying medical goals in cancer care, including dying patients, is explored.