Connecting the Dots in Cultural Competency: Institutional Strategies and Conceptual Caveats

Hideo Kimura, a 46-year-old Japanese male patient in a Boston hospital, needs to undergo surgery to remove part of his lower intestine but resists signing the consent form and has little understanding of English. Discussing this with an interpreter, Hideo is puzzled, because he has already authorized his wife Sachiko to decide on his behalf. The interpreter points out to him that he has a right, a moral right, to give his informed consent to the surgery and that Hideo is quite competent to decide for himself. Nonetheless, Hideo cannot grasp the meanings of “informed consent” and “moral right.” Hideo agrees to sign the consent form only after he is told that this is official hospital policy.My thanks for insightful comments and critique by reviewers.