This chapter opens with the challenge Nightingale and her close colleagues faced in establishing nursing as a profession when the ethical standards of the existing (secular) nurses were (generally) so low. The ethical issues she had to deal with in her own school, soon after it opened, are discussed three thorny problems with appointments. Anyone reading Nightingale’s writing on nursing will be struck by how often and how forcefully she insisted on high ethical standards. The reason for the emphasis on ethical standards is obvious enough in the task Nightingale faced in raising the new profession from its disreputable past. The International Council on Nursing (ICN) established its Code of Ethics in 1953, again based on Nightingale principles. It identified four responsibilities: to promote health, to prevent illness, to restore health, and to alleviate suffering. The code asks nurses not only to act ethically themselves, but to challenge unethical practices.