Physicians in Canada are often required to practise cross-cultural medicine. This often leads to difficult ethical situations. Many of our medical decisions are based on values and beliefs about health that are uniquely tied to our culture. Although the temptation to assume they are universal is powerful, even our most basic ethical principles can be challenged. Female circumcision provides an interesting example of a conflict between our sense of beneficence and the desire to respect patient autonomy. Further problems arise with different interpretations of concepts such as individual human rights, informed consent and the value of human life. Physicians must recognize the potential for such conflict and work to achieve a better understanding of the issues relevant to each cultural group.