There is no doubt that modern clinical medicine in the West is practiced in a pluralistic and multicultural context. Yet nowadays, there is frequently a divide between the moral values of clinicians and those of their patients. Whereas many clinicians, whatever their own personal beliefs, ascribe to a basically secular morality that emphasizes such values as individual autonomy and social utility, many of their patients ascribe to cultural and religious traditions that emphasize such values as obedience to God and the responsibility of families and communities to care for their own. In addition, whereas it is usually quite easy to negotiate respect for the strictly ritual requirements of such patients in such areas as prayer and diet, it is more difficult to negotiate great differences in moral perspectives between clinicians and their patients when it comes to practical questions involved in medical treatment in general and the treatment of the patient at hand in particular. Sometimes these differences need to be more generally negotiated in the public policy discussions that take place in hospital ethics committees or even in legislative and judicial settings. Other times, these differences need to be more particularly negotiated on a case-by-case basis between clinicians and their patients and the patients' immediate families, plus those from their traditional communities authorized by patients and their families, such as priests, rabbis, pastors, or imams, to provide them with moral guidance or even moral governance.