Sex workers share with other members of the urban poor, a deep distrust of the medical profession. Interviews with women in prostitution in three cities — Bombay, Calcutta and Delhi — and parts of Maharashtra — Kohlapur, Ahmednagar and Yavatmal simultaneously bring out aspects of what are uniquely their experience. This article will look at some of the ethical issues involved in health care and sex work. The first part focuses on the perceived needs of the primary actors, the second on attitudes of health care professionals. Finally, it looks at laws and policies that attempt to redress the situation, often unsuccessfully.