In the complex decisions involved in foster care, the needs of adult caregivers and the needs of children may sometimes reflect competing priorities. Foster children can be negatively impacted by adult-centered decisions that cause trauma beyond that which led to their entrance into the system. Though dictated by laws and policies meant to increase a child's well-being, foster care decisions often prioritize adult-centered concerns over a child's attachment needs. Utilizing case examples, this discussion paper examines foster care decisions that disrupt important child-caregiver relationships. Considerations for child-centered decision-making may help to reduce emotional trauma in foster children.