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In this commentary, we agree that veterinarians often face troubling ethical decisions involving potential over- or undertreatment of their animal patients, the financial constraints of their clients, and, sometimes, the goals of the institutions that employ them. While we accept that a CEC may, in some contexts, be an appropriate structure in which to deal with such difficult decisions, we argue that this is not the only, or necessarily the best, approach. We suggest that the ethical problems facing veterinarians differ significantly in different countries; that many acute ethical issues typically arise before animals even arrive at the veterinary specialty hospital; and that even within such hospitals, approaches other than CECs might be more effective, especially at gaining acceptance by the veterinarians themselves.