Relieving pain: what are today's ethical and legal risks?

Many physicians have poor understanding about the symptoms of terminal illness. There is also surprisingly little data about treating symptoms compared to treating disease. Subsequently pain and other forms of suffering are often under-treated, despite the availability of effective interventions. Fear of retribution is often coupled with the moral notion that aggressive pain treatment may cause premature death. Legal and ethical obligations may compete but an appreciation of both is needed to inform effective palliative care.