Pediatricians should not opt out of caring for children of same-sex couples due to anti-gay beliefs or bias.

In referring transgender patients for medical transition, clinicians should be guided by harm reduction, respect for autonomy, and continuity of care.

Although patients’ medical gender transition can be facilitated by counseling, as a matter of medical ethics, informed consent must be obtained for treatment.

Physicians new to a case might object to an established care plan. Practice variation, clinical momentum, and how value is assigned by different parties to acute care and comfort measures can each contribute to conflict in these cases.

Physicians must express compassion when discussing risk and success rates of palliative surgery.

Physicians need to help surrogate decision makers to make treatment and end-of-life decisions for those with severe neurological damage by proving a realistic prognosis and maintain strong lines of communication.

Recommendation for induced lactation in nonbiological mothers is widespread in the medical literature. To resist offering the service for nongestating lesbian mothers bespeaks potential discrimination.

Moral distress can be reduced by approaching the patient-physician relationship with empathy and humility, which foster trust and good communication.

An exploration of what could have been done to help the immigrant family of a severely ill child with his care.

For some patients whose survival is extended by disease-modifying interventions, little guidance about clinical and ethical complexities exist.