Abstract
"Cultural competence" has gained a certain cachet in health care, so much so that an Internet search of the phrase brings up more than 40,000 results. Yet racial and cultural disparities in health and health care persist, perhaps no more heartrendingly so than in end-of-life care. A recent study of the experience of dying in nursing homes noted that "lack of attention to cultural needs," when it occurred, was a "predominant factor" in a person's experience of dying.1 How can this be when there's so much talk of cultural competence in health care?