Responding to Fiester's Critique of a Bioethical Consensus Project.

We respond to Autumn Fiester's critique that our proposed bioethical consensus project amounts to "ethical hegemony," and evaluate her claim that ethicists should restrict themselves to "mere process" recommendations. We argue that content recommendations are an inescapable aspect of clinical ethics consultation, and our primary concern is that, without standardization of bioethical consensus, our field will vacillate among appeals to the disparate claims in the 22 "Core References," unsustainable efforts to defend value-neutral process recommendations, or become a practice of Lone Ranger clinical ethicists. We contend that a consensus document that captures the basic moral commitments of patients and careproviders is the next step in the professional evolution of our field.