Over 50 000 people die per year in England and Wales from lung cancer and chronic obstructive pulmonary disease (COPD). Current National Institute for Clinical Evidence guidelines for lung cancer and COPD recommend provision of palliative care for those that need it. Palliative care historically has accepted patients with cancer, but access to patients with non-malignant disease has been more sporadic. This paper aims to highlight the many ethical dilemmas faced when treating both these groups of patients. These include issues surrounding the form of treatment or treatment with drawal, the burden on the patient or on the health service; or conducting research in terminally ill patients.
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