This paper explores how the educational and career paths of Indigenous people in STEMM have been impacted by ethical, cultural, and/or spiritual issues. Based on a survey of over 400 Indigenous students and professionals in STEMM fields, plus over 30 follow up interviews, we find that these issues cause some Indigenous people to leave particular fields altogether, others to avoid certain tasks within their chosen field, and still others to intentionally select particular fields. Ethical, cultural, and/or spiritual issues also are the reason some Indigenous people choose certain career paths, because of their desire to help their communities. By understanding these pathway impacts, STEMM leaders and educators can ensure more equitable pathways and can prepare, recruit, and retain Indigenous people in STEMM fields.