Using a case study approach this article explores two critical ethical-emotional issues that arise in the nursing care of imperiled infants. The questions concerning who should decide and what should be decided about the care of these infants are discussed. Roles of the parents, physician, and nurse are examined in relation to decision-making. An emphasis is placed on the role of the nurse with three criteria supporting nursing involvement being identified. Ethical theories, ethics by committee, and guidelines for decision-making are briefly discussed.