“Cultural Competence” and Informed Consent in International Health Research

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The notion of “cultural competency” in healthcare has gained currency in recent years. Health professionals are expected to be sensitive to the cultural backgrounds and language of their patients. Courses on cultural competency are now routinely offered to physicians, nurses, and others working in health fields. Although the rhetoric of cultural competency has been applied to clinical contexts, little attention has been given to its applicability in health research generally or, more specifically, in international health research. In this paper, I briefly explore the relevance and limitations of cultural competency for informed consent to international health research, particularly in the context of low-resource settings.This paper is based upon material included in Ethical Issues in Research Design and Informed Consent to Biomedical and Social Research in Resource Poor Settings, a monograph by Patricia Marshall (2007) commissioned by the World Health Organization, Ethics, Trade, Human Rights, and Health Law, and Special Topics in Social, Economic, and Behavioral Research Series of Programme for Research and Training in Tropical Diseases. Work on this manuscript was supported by funding from the NIH/National Human Genome Research Institute (PI: Patricia Marshall, 2 R01 HG002207-04), the Center for Genetic Research Ethics and Law, Case Western Reserve University (PI: Eric Jeungst, NIH/National Human Genome Research Institute, P50-HG-03390), and the Case/UHC Center for AIDS Research (CFAR), (PI: Michael Lederman, NIH AI36219). I am grateful to John Stone and Erika Blacksher for their helpful remarks on an earlier version of this manuscript.