The decision-making capacity and autonomy of burn patients and medical paternalism is examined through the cases of Dax Cowart and Andrea Rubin.

Although identical twin-to-twin skin grafting has resulted in excellent survival rates in burn patients, the nature and scope of ethical decision making in monozygotic sibling skin grafting needs further examination.

Withdrawing care for cosmetic reasons in cases of severe burns is examined in light of ethical principles guiding surrogates’ and clinicians’ roles.

After the infant’s birth, the neonatologist’s first duty is to his or her patient—the newly born infant. If clinical circumstances are different than anticipated, the physician must first consider the best interests of the baby.

Goals-of-care conversations in the trauma setting are rendered complex by patient, physician, surrogate, and system-specific factors.

Off-label prescribing of drugs is appropriate when their use is in the patient’s best interest on the basis of credible, published scientific data.

Overriding a proxy decision maker’s refusal of medication for a psychotic patient is justified when the patient poses a danger to himself or others.

This commentary on a case considers moral reasons to adopt a palliative approach to the care of some psychiatric patients.