Efforts to improve informed-consent forms for clinical trials should not overlook difficulties faced by patients in non-Western settings (Nature 482, 16; 2012).

Institutions in developed countries are expanding clinical trials in Africa and Asia, and most focus on the signing of the consent form rather than on the exchange of information between researchers and potential participants.

Information should be culturally adjusted, taking local factors into account. These might include degrees of illiteracy, native dialects of ethnic minorities, a lack of suitable vocabulary, a preference for communal decision-making, and stigmatization by local authorities if people do not sign.

Alternative ways of obtaining consent could be used more often, including witnessing oral consent, verifying the quality of information for participants, or using videos to present the study and record consent.

Revising consent forms could help to reassess the concept of globalized bioethics, preventing controversial practices such as those used in researching the genetics of the Havasupai tribe (J. Couzin-Frankel Science 328, 558; 2010).