Our methodology is a version of the method of reflective equilibrium that is widely used in philosophy and bioethics. This methodology gives a prominent place to our considered judgments about ethics and to the demands of maintaining a coherent overall set of beliefs. We describe some methodologies for normative theorizing in bioethics that are often advanced as alternatives to reflective equilibrium. Some, such as casuistry, we think are better understood as versions of the method of reflective equilibrium, at least as they are typically practiced. Others, such as particularism and foundationalism, we reject. We defend the method of reflective equilibrium against some prominent criticisms, including skeptical reactions about the use of intuitions motivated by recent work in experimental philosophy. Finally, we turn to metaethics and clarify what we are, and are not, assuming about the nature and foundation of ethics. Although we make no specific assumptions about the foundations of ethics, we assume that people’s beliefs about ethical matters, especially upon reflection and when informed about relevant facts, provide the appropriate starting point for ethical inquiry.