Ethical challenges persist throughout healthcare and, over the last 40 years, more organizations have hired ethicists or teams of ethicists to help identify and address them. Strategies and tools used by healthcare ethicists have evolved over this time. Most commonly capacity-building (education) and ethical frameworks are used to support ethical decision-making within organizations. In this article, we argue that traditional, technical tools (like frameworks and education) are insufficient for addressing ethical issues in healthcare and supporting the changes in behaviour that are required to make sustainable, widespread improvement. We maintain that many ethical issues in healthcare are inherently adaptive (rather than solely technical) issues and advocate for an ethics approach that uses adaptive leadership skills and strategies to help ethicists, clinicians, staff, and organizations to navigate complex ethical challenges and make sustainable behavioural and organizational change.
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