Abstract Background: Contemporary pediatric oncology confronts medical staff with challenges that are not only clinical but also ethical and existential in nature. The aim of this study was to identify the cognitive and affective factors associated with medical professionals’ attitudes toward fertility preservation procedures (oncofertility) in pediatric patients. In particular, the association of “existential vacuum” (lack of life goals, sense of meaninglessness), value systems, and religiosity on the level of competence and emotional acceptance of these procedures was examined. Methods: A cross-sectional observational study was conducted between January and September 2024 in pediatric oncology centers in Poland (Gdańsk, Lublin, Łódź, and Poznań). The study group consisted of 62 medical professionals (62.9% physicians and 37.1% nurses) selected using purposive sampling. The research protocol included an Author-Designed Questionnaire, the Scheler Value Scale (SVS), the Life Attitude Profile—Revised (LAP-R), and the Centrality of Religiosity Scale (CRS-15). Statistical analyses comprised Pearson’s r correlations, multiple regression analysis, and cluster analysis using the k-means method. Results: Participants demonstrated a moderate level of substantive competence in oncofertility (M = 2.31 on a 5-point scale). Regression analysis revealed that “existential vacuum” was the strongest negative predictor of competence (B = −0.34; p = 0.001), which was found to be a significant negative correlate of professional development in this area. In the affective domain, a pronounced normative conflict was observed: religiosity was negatively correlated with emotional acceptance of the procedures (r = −0.42; p < 0.001), indicating tension between medical imperatives and worldview-based beliefs. At the same time, the regression model showed that internalized religiosity and moral values might theoretically function as an “axiological buffer”; however, due to the severe psychometric limitations of the emotional acceptance measure (α = 0.268), these affective associations are highly tentative and unstable. Alternative measurement strategies are required to validate this hypothesis. Exploratory cluster analysis suggested the potential existence of two professional profiles: “Axiologically Integrated” staff members and a larger group of “Existential Skeptics”, who exhibited higher “existential vacuum” and lower psychosocial resources. Conclusions: Viewed through a dual-process interpretative lens, a theoretical phenomenon of cognitive–affective dissociation was explored. The highly tentative data suggest that “existential vacuum” might represent a hypothesized barrier to competence acquisition. Furthermore, findings regarding the affective domain—limited by the low reliability of the emotional measure—suggest religiosity could act as a potential source of normative tension. These exploratory profiles serve as hypotheses for future intervention designs rather than definitive clinical mechanisms. Keywords: oncofertility; pediatric; attitudes; medical staff