In these essays, discussing clinical ethics consultation, three sorts of reflective writing are presented. The first is a description of a clinical ethics consultation, obviously limited as a documentation of the experiences at its source. It is followed by three examples of a second kind in the probing commentaries by figures in biomedical and clinical ethics - Francois Baylis, Tom Tomlinson, and Barry Hoffmaster. Finally, these are followed by a third variety of reflection in the form of responses to those three commentaries, by Bilton and Stuart G. Finder, and an Afterword - a further reflection on some of the issues and questions intrinsic to clinical ethics consultation and to these various essays. assisted at one point (he is the colleague mentioned in Bliton's manuscript) but frequently participated in the discussions that are invariably part of the clinical ethics consultative practice in the Center for Clinical and Research Ethics at Vanderbilt University Medical Center. It was thus natural for Finder to participate in the response.