The purpose of this booklet is to provide a method for understanding and reflecting on ethical and clinical competence issues in the practice of Christian holistic healthcare, and particularly for evaluating clinical cases involving healing prayer and spiritual assessment. Four brief case examples present the reader with several ethical considerations involving the integration of Christian spirituality and healing prayer in healthcare practice. Elements in these cases are relatively common in healthcare practice today. However, these cases also reflect some of the unique professional challenges that Christian physicians, nurses, psychotherapists, and chaplains face on a regular basis. Increasingly, ethically and clinically competent practice is coming to mean professional-clinical competence as well as contextual-cultural, relational-ethical, and theological-spiritual competence. Accordingly, Christian healthcare professionals need to consider the implications of all four domains of clinical and ethical competence in their work. Len Sperry, MD, PhD, DMin is Professor of Mental Health Counseling at Florida Atlantic University and Clinical Professor of Psychiatry and Behavioral Medicine at the Medical College of Wisconsin. He has been an ACT member since 1977.