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In a context of reforms in institutional governance and personnel management, health supervisors are faced with more and more ethical dilemmas. As intermediaries between caregivers and institutions, they have to simultaneously promote clinical and organizational ethics. The aim of this article is to clarify the links between these two concepts through a qualitative study conducted among thirty-five health supervisors and to propose avenues for improvement. This research identifies twenty ethical dilemmas related to the institution, associated with management, or resulting from the relationship with the patient or the doctor, all of which show the complexity of ethical decision-making. Several managerial implications are highlighted: the training of health supervisors in ethical decision-making and the training of caregivers in narrative ethics; better communication between supervisors; and the establishment of a benevolent ethical climate.