Primary health care is an essential health strategy and represents the basis of the Chilean health system. The comprehensive health care model transitions from an entrenched paternalistic clinical relationship to respect for autonomy and a rights-based approach. This transition entails ethical conflicts in any provider network; however, these have been little addressed at the first level of care. This study investigated the case of a Health Care Ethics Committee in the O’Higgins region of Chile. For this purpose, reports and opinions from a seven-year period were analyzed. The main results show the use of Diego Gracia’s deliberative method and the approach to conflicts related to autonomy and confidentiality. The institutionalization of health care ethics committees is considered relevant since they intersect with quality and person-centered care. © 2024, Conselho Federal de Medicina. All rights reserved.