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Although there is wide agreement that ethics consults are at risk for conflicts of interest (COIs), ethics consultants (ECs) have limited guidance with regard to how to identify and approach COIs. We aim to address these concerns and provide practical guidance. We will define and consider four categories of COIs consult type, team composition, dual clinical roles and other concerns. We will define and consider six actions available for ECs to take in response to COIs no action, disclosure only, obtaining a second opinion, referring to another EC, re