Suppose a “blue sky” meeting had been called among chief medical officers, chief administrative officers, and other leaders from a range of health-related institutions in this country. The question posed for this meeting was simple but unusual: Are the structures of our organizations, systems, and institutions ethical? Though it was a question reminiscent for a few of the focus some time before on whether the conduct of individuals in their organization was ethical, this question seemed more demanding. Is it reasonable to consider structures or arrangements as ethical or not; or in other words, is ethics an applicable attribute of organizations? And if it is reasonable to speak of an ethics of organizations, by what method might one discern any kind of an answer? And what of the informal connections that link different organizations … how can they be evaluated?