Prouty Garden, long a refuge at Boston Children’s Hospital for ailing youngsters and their families, can be bulldozed to make way for an expansion that includes a new neonatal intensive-care unit after a key city commission voted Tuesday night to reject pleas to protect the space as a landmark.
After an emotional hour of public comment, the Boston Landmarks Commission voted 7 to 1 to deny landmark status, effectively allowing the hospital expansion to proceed. Commissioners acknowledged they had grappled to find the greater good in a dispute in which the goal of both sides was to heal and comfort sick children.
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Testimony included the accounts of parents whose sick children recovered and others whose youngsters died. Nurses and doctors spoke about the healing power of the garden and the undeniable need for a new facility to cure more disease.
One speaker who testified in favor of preserving the garden was a high school junior from Cambridge named Sara Curtis, who described herself as a longtime patient at Children’s Hospital who suffers from an abdominal disorder.
“I might be too young to look back into the past and say this garden was or was not made by some famous people,” Curtis told the commission. “But I do see the present and the future, and I did see over the winter that children were [there] building snowmen.”
The commission could have voted to initiate a formal study of the garden, which could have taken months and delayed construction. Administrators testified that after years of planning and permitting, a delay would be detrimental to the $1.2 billion project.
“Our clinical building cannot be built without the removal of the garden,” said Charles Weinstein, chief of real estate at Children’s Hospital. “I want you to honestly consider the real-life health care consequences of not being able to expand our inpatient care to meet the needs of sick kids.”
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Prouty Garden is a half-acre of green space that has brightened the heart of the hospital for more than a half century. On their most difficult days, sick children and their families have found strength in the meandering paths, colorful azaleas, and a stately dawn redwood tree that stands sentry 65 feet over the garden.
While advocates held out hope, the vote was not a surprise. The Landmarks Commission recently rejected a petition to protect a notable building at Children’s that will be torn down as part of the expansion, recognizing the space constraints and needs at the hospital. The city has never granted landmark status to an interior courtyard such as Prouty Garden.
To become a landmark, the garden would have also needed approval by the City Council and Mayor Martin J. Walsh, who told the Globe last week that he did not believe it should be a landmark.
The garden was paid for and endowed by Olive Higgins Prouty, a novelist who mentored Sylvia Plath. It was designed by the firm founded by the sons of famed landscape architect Frederick Law Olmsted.
Prouty Garden was honored with a gold medal from the Massachusetts Horticultural Society and described as “one of the most successful hospital gardens in the country” by Clare Cooper Marcus, a landscape architecture authority at the University of California, Berkeley.
At the hearing, one nurse, Karen Rapallo, told the commission that Prouty Garden means much more than another building.
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“People are heartbroken over that garden, staff and patients alike,” said Rapallo, who has worked 21 years at Children’s Hospital. “A lot of the staff are afraid to come forward and say how bad they feel about it.”
Another longtime nurse, Cheryl Toole, had a daughter born with a rare heart defect who underwent repeated surgeries. Toole described the limitations of the aging facility that houses the neonatal intensive-care unit.
“Children’s is a place that parents come when no other place can help,” Toole told the commission. “Please don’t delay this critically needed building.”
The effort to save the garden has been spearheaded by Anne Gamble, a longtime volunteer at Children’s Hospital whose husband, Walter, served there for three decades as a pediatric cardiologist. After the vote, Anne Gamble said she needed time to consider the next course of action.
“We knew we were up against a big institution,” Gamble said. “We just hope they could hear what we were really trying to say.”
Andrew Ryan can be reached at andrew.ryan@globe.com .