She was 29 years old, with metastatic breast cancer. She was from Russia and had been trafficked to the UK and worked in the sex industry. She didn’t disclose much information about her social circumstances but seemed socially isolated without family support. She had severe pain and existential distress.

Attitudes from several staff members were judgmental about her appearance and priorities – she was concerned about how she looked and what clothes she would wear. Unhelpful assertions were made about her returning to work in the sex industry and the effect this had on her chemotherapy treatment, without any attempt to ensure or consider her safety in terms of infection or to offer her financial assistance.

She was understandably suspicious of subsequent encounters with health care staff. I tried to negotiate a pain management plan and get her community support. I tried to gain her trust and give her back some element of control.

She died several weeks later in an acute medical ward with poorly controlled symptoms.