This article explores ethical challenges in qualitative research by bringing forward examples from the literature and from IN•GAUGE^®, a research program spanning over 15 years and focusing on the significance of multiple perspectives and the value of gauging the health needs of young people and their families. In addition to exploring the ethical challenges in working with children and youth in research, we make the case that ethical considerations need to extend beyond research ethics boards protocols and present “sustaining mindful presence” as a conceptual frame practical guide for working through ethical challenges in qualitative research. We contend that greater participation of research subjects, including children and youth, is the way forward for developing more holistic and effective approaches to ethics within research institutions.