The discipline of clinical medical ethics guides both the moral stance of the total institution as well as the specific ethical decisions of physicians, nurses, and other health care providers. None would quarrel with the fact that a health care institution as a caring entity must have an ethical stance. This is made necessary by the obvious distinction between the pragmatic question of what can be done to patients within modern health care and the ethical question of what should be done for patients. The notion that an institution’s ethical stance might be determined by a set of ideas rather than the needs of a particular vested interest is not always so obvious. It is nonetheless true that ideas drove the formation both of this great institution and the institutional ethics committee (IEC). As John Maynard Keynes wrote in 1936, “The power of vested interests is vastly exaggerated compared with the gradual encroachment of ideas…. Soon or late, it is ideas, not vested interests, which are dangerous for good or evil” (1). In our case, the ideas in question have served to promote a higher good. The Rev. Dr. George W. Truett set forth a challenging idea in 1903, at the founding of a new, small, community hospital, the Texas Baptist Memorial Sanitarium, which during the following century grew and developed into Baylor University Medical Center (BUMC) and Baylor Health Care System (BHCS). Dr. Truett’s prophetic challenge was to establish “a great humanitarian hospital, one to which men of all creeds and those of none may come with equal confidence.” The idea of creating a humanitarian institution for the sake of patients first, as well as ethical positions articulated by the institution’s trustees, physician leadership, and senior administrators, set the standards that guided physician practice and institutional care for 6 decades.