A recent study was done in Canada to identify what clinical ethicists felt were the top 10 clinical ethical challenges facing Canadians in healthcare. (Breslin et al., 2005; Table VII.1).

What is clear from this list is that many of these ethical issues are core to challenges of healthcare more broadly today. While this study was conducted in Canada, it is likely these same challenges may be similar in other healthcare systems, at least in the developed world.

Clinical ethics is a comparatively recent endeavor in healthcare, but despite its relative newness it provides an ideal model for initiatives that can impact healthcare because of its inherent interdisciplinary make-up and its unique capacity to impact care across the healthcare spectrum from “boardroom to bedside.” While clinical ethics offers this unique perspective to address healthcare problems, it is often missing from the meetings where significant system-wide decisions are made. Many decision makers miss the key point that much of healthcare is grounded in values and many of the solutions may be found in the ethical field of inquiry. The most likely reason for this absence of clinical ethics at the decision tables in healthcare is related to the still developing nature of this work. What the chapters in this section show, however, is that perhaps clinical ethics is “coming of age” and is beginning to make serious arguments to the healthcare community about how its activities and frameworks can offer useful, real-world contributions to help to guide system decision makers, healthcare professionals, and the public.