Ethical decisions in health care. A seven-step ethical discernment process can help organizational leaders make wise choices.

Dr. Slosar is director, ethics, Ascension Health, St. Louis. I t is sometimes said that health care ethics as a profession is in an early stage of its maturation process. If this is true, it can also be said that organizational ethics in health care is just now beginning to emerge from its earliest stage of development. In its infancy, organizational ethics was generally viewed as synonymous with "corporate compliance," in part because a primary impetus for the development of organizational ethics programs has been governmental pressure. Although governmental compliance pressure continues to be a factor, organizational ethics in Catholic health care has been evolving independently of that pressure.