Cross-Cultural Adaptations of the MacArthur Competence Assessment Tool for Treatment in Iran


1 Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, IR Iran

2 Department of Psychiatry, Kashan University of Medical Sciences, Kashan, IR Iran

3 Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran

4 Department of Psychology, Kashan University of Medical Sciences, Kashan, IR Iran



According to general ethical and legal principles, valid consent must be obtained before starting any procedure.

Due to the lack of a standard tool for assessing patients’ capacity to consent to medical treatment in Iran, the present study was carried out aiming to devise a Persian version of a cross-cultural adaptation of the MacArthur competence assessment tool.

Patients and Methods
By reviewing different methods of cultural translation and adaptation for assessment tools, and due to the lack of consensus on its processes, we selected Wild’s model as one of the most comprehensive methods in this regard. Wild’s (2005) 10-stage model includes preparation, forward translation, reconciliation of the forward translation, back translation of reconciliation, back translation review, cognitive debriefing and cognitive review, and finalization, proofreading and final reporting. Using this model, we translated the MacArthur assessment tool and made it adaptable to Iranian patients.

The MacArthur assessment tool is not dependent on any specific culture and language. As a result, if translation and its scientific adaptation are done based on an integrated and detailed model, the tool can be used for every culture and language. In other words, this tool is not culture-specific; so, it is applicable in cases where a translation is needed, and it can be culturally adapted to suit different societies.

In the present study, we are able to focus on and prove the efficacy and benefits of this measurement tool.