The case of Baby M: nursing care in an ethical wilderness

This is a reflective case study of an infant with Down Syndrome and a potentially fatal cardiac defect. It is a story of hope and loss, of silence and learning to speak, and of relinquishing space and standing ground. The purpose of this article is to explore the conflicting claims a neonatal intensive care (NICU) nurse faces in caring for critically ill infants. The questions of "Who speaks?" and "Who listens?" are addressed. The concepts of women's moral development and a nursing definition of voice are included. It is proposed that the conventional feminine voice and the embodied knowledge so integral to expert nursing actually draw strength away from the voice that needs to be permitted into the circle of decision makers when ethical issues are raised in the NICU.