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The fourth step involves loyalties, an area that Christians et al. (1987) suggest deserves the greatest attention because it's easy to deceive ourselves about the loyalties that are most important to us. Assume that you are a Georgia health policymaker. You may have loyalty to your own ethical beliefs, to the people of Georgia, and to your department. You may also be loyal to your own self‐interest, to be and to be seen as effective at your job and worthy of recognition and possibly promotions. Other likely loyalties may be to your family's well‐being, to your coworkers in the department, and so on. If you're committed to the duty of “non‐injury,” then you may be weighing the potential harm that campaign images might do against the possibility that such messaging might be effective. Again, having your campaign shown to be effective could also be a strong benefit to you.Last, you come to some conclusions about the proper course of action in this particular case. Reject the campaign because it unfairly targets vulnerable children and may cause them to feel hurt and ashamed? Go forward with the campaign because it is the most likely to result in better long‐term health for these same children? Ethical decision‐making is a real‐world activity with genuine consequences for real people. What is the right decision in the case of the Georgia obesity campaign? Reasonable people can disagree, but at the very least, the choices made would be based on a systematic and thoughtful process.