To practice surgical oncology is to practice applied ethics. This chapter aims to explain why the practice of surgical oncology is inseparable from the practice of applied ethics and it seeks to provide an orientation to some of the key ethical issues that are relevant to the daily practice of surgical oncology. Ethics are important because every clinical decision, no matter how mundane, is invested with moral content. Good surgeons must have practical wisdom to discern the best course of action in each clinical situation. Early and frequent discussions about the goals of care with patients and their families should inform clinical decision making and can often mitigate difficulties posed by questions of futility and overly-aggressive treatment. Palliative care is an interdisciplinary effort that aims to relieve suffering and improve quality of life for patients and their families in the context of serious illness. It should not be confused with non-curative treatment of the dying. Cancer affects the whole patient, physically, psychologically, socially and spiritually. The FICA is one way to explore how a patient’s spirituality may be relevant to their cancer care. Encourage all patients to have some form of advance directive. Medical and surgical errors are not uncommon and a full and honest disclosure should be made when an error causes harm to a patient. Familiarity with current guidelines regarding surgical innovations can streamline innovation while also protecting patients and surgeons.