No single person should make decisions about for whom or according to which criteria palliative surgery is clinically and ethically appropriate.

Word usage and intentional clarity will influence how patients feel about that Whipple pancreaticoduodenectomy surgery.

Seeming incongruity between surgery and palliation reiterates patients’ needs for clinicians to be able to identify when and how they should coexist.

A surgeon’s duty is to identify goals of care, including those about quality of life, from a patient’s perspective and to consider how to achieve them.

Guidance about sedation to unconsciousness and medically ineffective interventions can be applied to surgical palliation.

Differentiating between best palliative care options and the curative and palliative potential of surgery is key to developing dual intentional clarity.

Calls to expand palliative care education have been explicit since the 1990s, but palliative care training in surgery remains too narrowly focused on end of life.

Some clinicians offering image-guided procedures have little training in palliative medicine, which is both a clinical and an ethical problem.

Palliative care—medically or surgically intervening to relieve suffering and support quality of life for seriously ill patients—is now an independent, growing specialty.

Breast implant-associated anaplastic large cell lymphoma and breast implant illness have prompted recalls of implants.