Hospital Ethics Committees (HECs), a well-established component of institutional healthcare in the United States (US), are beginning to take root in Asia. A major function of HECs is to provide ethics consultation in the clinical setting. Whereas the modus operandi for ethics consultation is reasonably uniform in the US, one should anticipate significant structural and functional deviations in Asia. For HECs to be effective in Asia, substantive and procedural modifications are necessary to accommodate fundamental cultural and attitudinal differences including differences within Asia itself.