“Ethical dilemmas…are rarely simple and stark but are, instead, multifaceted, complex, and gut wrenching for parents and care givers alike.” This is never more the case than when one must treat vulnerable babies who are not, nor ever can be competent to offer us some guidance about that treatment. The ethical problems are heightened when the parents, or the single mother, are incompetent to make decisions themselves, for example, because of drug addiction. In such cases, when the baby is premature and suffering the effects of the drugs the mother has taken, and the mother herself is either no longer available for consultation or so damaged by her own addiction that she is not a reliable decisionmaker, the usual trend In the United States is to initiate treatment and continue until it is virtually certain that the infant will die.