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This paper provides a critical examination of cultural competence approaches, using the findings of a development project in the black voluntary sector that aimed to increase awareness of palliative care amongst older people and carers from groups most commonly referred to in the UK as being ‘minority ethnic’. The project involved narrative interviews with a convenience sample of 33 older people and carers and 11 focus groups with a convenience sample of 56 health and social care professionals. The findings from the interviews suggest that assumptions about culture and about care as competence that inform cultural competence models can have significant drawbacks for both service users and health and social care professionals. The paper further argues that cultural competence fails to fully recognise illness and care as occasions marked by profound moral and ethical demands.