A discussion of theoretical issues provides a background for the ethical consideration of specific design and procedure aspects of international nursing research. In any discussion of ethics with an international scope, an inherent tension exists between conceptions of ethics as a set of universal principles and ethics as contingent norms relative to culture. The position adopted by researchers and reviewers along the continuum between relativistic and universal ethics has practical implications. The degree of credence, acceptance and personal endorsement accorded to codes of ethics and guidelines intended to apply across national boundaries depends on an individual’ s beliefs regarding the balance between universalism and relativism or , from a more relativistic perspective, how well the ‘ universal’ code of ethics fits with local custom. Suggestions for approaches to the relativism issue in the international regulation of medical research have ranged from the emphasis on uniform international standardsto stressing ethical procedure to negotiate the specific content of protocols.