Clinical ethics consultation was requested by the intensive care unit regarding a young woman with a near full-term pregnancy on the brink of COVID respiratory failure. She refused lifesaving mechanical ventilation, as she embraced the religious instruction of her upbringing to distrust religious outsiders and instead allow God to personally direct her choices. A psychiatrist determined that her beliefs were atypical, but she had medical decision-making capacity to refuse ventilation. Without it, her intensivist team anticipated her death along with the fetus within hours. Ethical consultation weighed the following: rights to bodily autonomy; standards of informed refusal; religious coping; nonabandonment and trust; moral distress and sympathetic regret. With her permission, the ethics consultant contacted her family, who were dismayed by her choices and reached out to persuade her otherwise. Within hours, she provided consent for ventilation and cesarean section; despite these, she required extracorporeal membrane oxygenation for ten days. Ultimately, she and her healthy newborn were discharged home. In follow up, she described no regrets over her care nor distrust of her providers. The clinical ethicist is haunted by the uncertainties of the practice of medicine and ethics, as well as by missteps in the consultation process