Publisher Summary The chapter reviews how Sciona Ltd., a 10-person British biotech start-up, managed ethical dilemmas and concerns, and the powerful public campaigns aimed against it for pursuing genetic testing. This chapter also examines how the company moved from responding to criticism and opposition, to building a proactive ethical decision-making framework, both internally and externally. From the early formation of its business strategy, Sciona management had recognized the need to address ethical issues associated with the new field of nutrigenomics and, more specifically, their direct-to-the-public business strategy, which had been their original business model. Company executives continued to seek the advice of an ethics expert to help them navigate through the ethical dilemmas surrounding them. The founder and Chief Executive Officer (CEO) of Sciona, Chris Martin, wanted to capitalize on the new advances in genetics research by offering customized dietary advice based on an individual's genetic make-up. Sciona faced the challenge of commercializing the concept of personalized medicine and translating the new science of nutritional genomics into a viable business strategy. Sciona's strategy was to first commercialize the concept of nutritional genomics, with plans to expand to other areas in genetic diagnostics such as heart disease, skin care, drug metabolism, weight management, and sports.