The vulnerability of the young child with a developmental delay ralses specific concerns regarding the provision of medical care to this population. Specific areas of concern include the means and standards by which a valid consent for intervention is obtained and exercised, as well as the issue of justice that refers, in this context, to the distribution of what are increasingly perceived as scarce medical and economic resources. Furthermore, future advances in providing care to this population will need to be predicated on clinical research that needs to be ethically sound. This article highlights basic ethical principles and their application to these specific issues with respect to children with developmental delay.