There was no real analgesia, only sedation and side effects. Why? It is a question that has plagued me ever since. Here she was being cared for by a good palliative care service in London, experts in WHO’s "analgesic ladder." Yet, if you now ask any member of the family whether she had a good, pain free death, the answer will be a categorical "no." Pain is multifactorial. It is impossible for relatives of patients-even when doctors-to objectively assess their pain.