© 2018 The National Catholic Bioethics Center 29 Abstract. The authors work in a variety of clinical ethics consultation services (CECSs) that employ a range of methods and approaches. This article discusses the approach to ethics consultation at the Center for Medical Ethics and Health Policy at Baylor College of Medicine and describes the development and transformation of the authors’ CECSs. It discusses how one CECS shifted from a nascent program with only ffty consultations a year to a vibrant, heavily staffed service with fve hundred ethics consultations a year. National Catholic Bioethics Quarterly 18.1 (Spring 2018): 29–38. Clinical ethics consultation services (CECSs) have expanded considerably over the past three decades to address ethical uncertainties and problems. 1 There is general agreement that clinical ethics consultation adds value to hospital operations. 2 At Courtenay R. Bruce, JD, MA, works in business practices and hospital operations in the Houston Methodist health system, in Houston, Texas. Jocelyn Lapointe, MPA, is a project leader in clinical ethics and graduate medical education at Baylor College of Medicine in Houston. Peter Koch, PhD, is an assistant professor of philosophy at Villanova University, in Villanova, Pennsylvania. Katarina Lee, JD, MA, is a clinical ethics fellow at Baylor College of Medicine. Savitri Fedson, MD, is an associate professor at Baylor College of Medicine. The views expressed in the NCBQ do not necessarily represent those of the editor, the editorial board, the ethicists, or the staff of The National Catholic Bioethics Center. 1. Glenn McGee et al., “A National Study of Ethics Committees,” American Journal of Bioethics 1.4 (2001): 60–64, doi: 10.1162/152651601317139531. 2. Ellen Fox, Sarah Myers, and Robert A. Pearlman, “Ethics Consultation in United States Hospitals: A National Survey,” American Journal of Bioethics 7.2 (2007): 13–25, Building a Vibrant Clinical Ethics Consultation Service Courtenay R. Bruce, Jocelyn Lapointe, Peter Koch, Katarina Lee, and Savitri Fedson, MD