This chapter considers two plausible scenarios: the individual is a patient and an athlete in which an individual is seeking treatment with gene transfer tools to cope better with pain. It describes the comparative strategy to highlight the similarities and dissimilarities between the ethical frameworks used to evaluate the two scenarios. The chapter focuses on the existence of a fundamental difference between a medical and an elite athletic context of vascular endothelial growth factor (VEGF) gene transfer to tolerate pain. Indeed, angiogenic gene transfer strategies such as VEGF gene transfer are by no means the only ones being explored in the treatment of chronic pain but appear to be among the most advanced at the clinical level, while other strategies are still at the level of animal studies. In endurance sports, the use of VEGF gene transfer as an endurance enhancement technology is not merely ethically unjustifiable; it compromises an element essential to the activity itself.