Health care is an increasingly complex space to navigate and particularly so for decision makers. The recent COVID19 pandemic further exacerbated the challenges in health care by bringing to the fore additional ethical dilemmas. 

When leaders are called to take decisions on complex ethical issues  they are faced with various challenges from identifying what the ethical issues exactly are to publicly communicating the social-political implications of their decisions. The ‘ethical’ thing to do is not always straightforward when taking decisions around access, inclusion and equity, digital transformation, public health measures or resource allocation with limited health budgets.  Seeking support from others on these matters is not always an easy feat.  Open discussions on  the ethical ambiguity of certain issues among like-minded colleagues and employees might not lead to actual disclosure and understanding  of critical and ethically salient aspects.  And, once a decision is made, the ethical course of action might also not be widely agreed upon by leaders and other stakeholders.