Cultural Competence Scenario

A newcomer to Canada speaks English as a second language. A private practice RD speaks with the client over the phone to arrange the appointment for dietetic services. From the phone conversation, the RD suggests that if the client found it helpful, she could bring someone along as an interpreter.

What else can the RD do to ensure informed consent and culturally-appropriate services going forward?

Dietitians are responsible for developing the cultural awareness necessary to help clients understand the nutrition treatment proposed for an informed consent. Culturally competent RDs practice the three components of cultural competence:

1. Managing one’s own prejudices;
2. Communicating respectfully across cultures and speaking in a way that does not presume that the other person shares one’s own values or experiences; and
3. Understanding a client’s culture by asking open questions.

Standards for Consent

Standard 6 of the College’s Standards for Consent (revised 2019) states,

“RDs apply a culturally-appropriate process for obtaining informed consent for nutrition assessment/treatment and for the collection, use and disclosure of personal health information.

Performance Indicators:

I. RDs strive to understand the client’s cultural beliefs and values in relation to health and nutrition intervention to facilitate an unbiased approach for obtaining informed consent;

II. RDs clarify with clients/substitute decision-makers whether their cultural practices involve other people in making consent decisions (e.g. spouse, parent, child, friend, spiritual leader, other);

III. RDs use language interpreters, as necessary, to assist in the informed consent process;

IV. RDs use relevant audio-visual materials to assist in the informed consent process, as appropriate; and

V. RDs exercise sensitivity, respect and understanding of the varying age and cross-cultural communication needs and practices among clients/substitute decision-makers.”