In addition to hundreds of thousands of newborns, who thanks to modern medicine have chances of unimpaired development, there is also a group of severely damaged children who survived for the same reason. Many of them are incapable of independent living with lot of pain and other problems of low quality of life. The potential of modern medicine to preserve life of the sickest newborns should not be overestimated, because it raises many ethical, legal, psychological, emotional and other issues, which are compared to technical possibilities, still waiting to be solved. During pregnancy the prospective parents anticipate a normal child, although many have lingering fear that the infant may be malformed. In many cases diagnosis of severe congenital malformation is made prenatally. It seems that the problem could be more understandable if the answers to some substantial ethical questions could be answered. Is the value of human life dependent on its quality? Who deserves access to neonatal intensive care? Are some babies too sick or too premature for newborn intensive care? Is it possible to abandon lifesaving procedure in newborns if it is futile? Who decides whether an infant receives care and how are these decisions made? How can this care be assured and equitably distributed? Who pays for this care? Appropriate management plan for the malformed child and sincere care for the family and counseling are the most important for the parents and the family, which has been often very exhausting for the medical staff. Appropriate medical knowledge and effective, empathic communication is an essential skill of medical staff caring for infants with life threatening congenital malformations and their families.