This chapter examines the barriers that can prevent professionals from acting on their principles and values, the concepts related to moral distress and moral courage, and some strategies for ethical action in challenging times. Moral distress occurs when a worker has decided on a course of action, guided by clinical, moral, and ethical considerations, but cannot pursue it due to external influences. Moral courage also requires the will to act and it is built and sustained through self-awareness about the personal barriers to action. The associations that represent the social work profession play important roles in preventing moral distress and promoting ethical action, particularly through education, advocacy, and resources. Virtue and integrity, internalization of social work values and ethics, and the skills to create change and speak truth to power are necessary but insufficient ingredients for ethical action. Organizations’ leaders have a particular responsibility for establishing the culture, policies, and structures that foster integrity and ethical action.