Method: We describe how different clinical ethics support services developed in Switzerland, and outline the diversity of structures, languages and cultural sources that these services are based on. Results: Despite differences in models and processes, common elements emerge: reliance on principlism,citizen involvement, interdisciplinarity, as well as the – implicit or explicit – reluctance to rely too strictly on rigid rules or processes for ethics consultation. The multi-lingual and multi-cultural structure of Switzerland results in unique difficulties in setting up a national network. Working in three different languages gives rise to logistical obstacles not present in most other countries. With each language also comes a literature corpus relevant to medical ethics, which is used alongside the English language bioethics literature with different degrees of salience in different regions.