Palliative surgery: when should we stop?

Palliative surgery plays a crucial role in alleviating distressing symptoms in patients with advanced oncologic disease.However, disproportionate interventions risk compromising dignity and extending suffering without meaningful benefit.This argumentative review critically examines bioethical principles guiding surgical decision-making in palliative care, drawing on international clinical guidelines and Mexican legal frameworks.By analyzing autonomy, beneficence, nonmaleficence, and justice, we highlight the ethical challenges in balancing symptom relief with therapeutic proportionality.A clinical case illustrates the importance of shared decision-making, interdisciplinary collaboration, and respecting advance directives.Our findings emphasize that surgical interventions should be guided not by procedural reflex but by ethical discernment, ensuring patient dignity and equitable care in resource-limited contexts.