Cultural competence and ethical decision making are two separate, yet intrinsically related concepts

which are central to services rendered by all health care professionals. For the purposes of this article
cultural competence is described as a dynamic, complex and continual evolving process of skill
development by health care professionals to respond appropriately to their clients’/patients’ unique
combination of cultural variables (which may include e.g. ability, age, beliefs, customs, ethnicity,
language, gender and gender identity, sexual orientation, religion etc.) to ensure efficacy in working
within the cultural context of their clients/patients. Ethical decision making can be defined as a complex
process used by health care professionals to resolve ethical dilemmas. It is dependent on and involves
many different factors such as ethical principles, morals, values, beliefs, regulations, legal issues and
personal and professional experiences. Ethical decision making involves ethical sensitivity, ethical
judgement and ethical choice. The decision making process should follow a sequence of logical steps to
guide and support health care professionals.

The importance of cultural competence for health care professionals has been formalized by the
inclusion thereof in professional codes of ethics, such as stated in e.g. the American Speech-Language
Hearing Association Code of Ethics, Cf. the Ref [1]. These codes require competent services be provided
to all populations and recognition of the cultural/linguistic and life experiences. Recent developments
such as changes in health care systems, evidence based practice, new technology used in the delivery of
health care and international migration have accentuated the significance of cultural competence. In
addition, political correctness and diversified health professional workforces are important factors which
necessitate cultural competence, Cf. e.g. the Ref. [2]. Research findings in different health care
professions have led to the recognition that culture may influence clients’/patients’ communication
styles, beliefs about health, and their attitudes towards health care which can include help seeking
behavior and treatment compliance, Cf. e.g. the Refs. [3] and [4]. Culturally competent health care
requires respectful responses to individual clients'/patients’ values, preferences and languages. Health
care professionals need to develop