Trauma changes a life forever. Trauma professionals’ decisions can, too. High-stakes clinical decisions—whether to give blood, go to the operating room, amputate or try to salvage a mangled extremity—are often made quickly and without knowledge of a patient’s name, age, or history. Such decisions are also almost always made without knowledge of a patient’s goals, values, or advanced directives. Not always, but commonly and of necessity, action must outpace deliberation. The May 2018 issue of the AMA Journal of Ethics explores the ethics of urgent decision making in trauma care settings, what it means for clinicians to approach these kinds of decisions responsibly, and what it means for patients and their loved ones to have the aftermaths of those decisions communicated with clarity and compassion. This issue will also explore what trauma care policies can mean for public health, community planning, and resource allocation.