Emergency psychiatric practice requires management of both high psychiatric acuity and high ethical complexity. Ethical dilemmas are embedded in the context and practice of agitation management, medical evaluation of uncooperative patients, and involuntary psychiatric hospitalization. Tensions between patient confidentiality and societal interests arise when obtaining collateral information, reporting abuse and neglect, and managing patients who pose a risk of harm toward others. Ultimately, attention to virtue ethics can guide emergency psychiatrists on how to carry out humane and therapeutic care while navigating the ethical principles and legal rules of the emergency psychiatric context.