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Pediatric healthcare providers must understand the social, cultural, and religious context in which their patients and their patient's families live or they will not be able to provide effective care. For example, the dilemma of a 17-year-old Jehovah's witness who refused a needed transfusion but said that he wanted to live could not be resolved until his caregivers addressed the cultural and social meaning of his conflicting wishes. Accepting transfusion would mean social ostracization. Caregivers could not understand a young Muslim boy's episodes of failure to thrive until they understood that they coincided with an annual month-long religious observance in which adults fasted during daylight hours. They could then work with the family to overcome the problem. To deliver the best care, caregivers should explore their own ethics and values around health care, care seeking, and illness and come prepared to address those same issues in their patients in an open-minded and non-judgmental fashion.