In this chapter of Complex Ethics Consultations: Cases that Haunt Us, the authors describe a baby born at 25 weeks gestational age (at a time when survival at that stage was tenuous) to an adolescent mother. The fragile preemie developed necrotizing enterocolitis that was so extensive that definitive surgical resection was impossible. With no definitive treatment and inevitable suffering without it, the recommendation to shift to comfort care was declined and ethics consultants helped to negotiate the conflict.