This book takes us beneath the banality of business as usual where technoscientific professionals routinely make judgments that impact the lives of others. Be it the safety of engineered systems, the speed and accuracy of medical diagnoses, or the wellbeing of animals subject to genetic modification, mindful, ethical choices contribute to the society we want to live in. In these decision making moments, professionals working in laboratories, clinics, offices and data centers weigh what constitutes ethical action in the face of ambiguity and uncertainty. This navigation is highly social and messy. The impact may be distant in time and geography and, as our cases show, professionals don’t always get it right. Making ethical choices in a given context is not readily codified, which is a critical observation in the context of escalating trends to automate decision making. We show how engineers, doctors, nurses, synthetic biologists, and other technoscientific professionals work through conflicting values, complex social organization, and societal expectations, grasping always for a hold on the potentially big consequences of everyday decisions.