Peace and Conflict Studies - Spring 2014

Peace and Conflict Studies Volume 21, Number 1 49 Moving ‘Beyond Neutrality’ and Cross-cultural Training: Using World Café Dialogue to Address End-of-life Care Inequalities Jacqueline N. Font-Guzmán* Abstract In this article I discuss how World Café Dialogues can be used to unveil structural and cultural violence that drive the behaviors that maintain end-of-life care inequalities, especially among minorities, in acute healthcare hospitals. Conflict practitioners are rarely included in conversations of end-of-life care inequalities and when included it is to “solve a problem” through bioethics mediation or provide training in cross-cultural competence. I argue that conflict practitioners need to broaden their approach to conflict and use their skills to surface unequal power structures and implicit beliefs that maintain the unjust status quo in end-of-life care disparities. Introduction “You ache with the need to convince yourself that you do exist in the real world, that you’re part of all sound and anguish, and you strike out with your fists, you curse and you swear to make them recognize you. And, alas, it’s seldom successful!” (Ellison, 1995, p. 4) In May 2006, I co-facilitated with two colleagues (Debra Gerardi and Rob Robson) a World Café Dialogue in San Francisco, USA (hereinafter, Patient Safety World Café). We welcomed approximately fifty people from North, Central, and South America to share their experiences, wisdom, and knowledge on how to improve patient safety and raise awareness about the devastating impact of medical errors. The participants of the Patient Safety World Café fell in one of the following categories: victims of a medical error as a patient or family member, clinicians who had partaken in a chain of events that led to a medical error, and/or patient advocates. The result of many of the medical errors discussed in the Patient Safety World Café had resulted in someone’s death. This event was sponsored by the World Health Organization (WHO) and the Pan American Health Organization (PAHO). * I thank my colleagues Dr. Bernie Mayer and Noam Ebner, The Werner Institute, Creighton University School of Law, for their constructive feedback and Dr. John Stone, Center for Health Policy and Ethics, Creighton University, for our many conversations about health disparities and for sharing valuable references with me on the topic. I am also indebted to my colleague and friend Debra Gerardi, Emerging HealthCare Communities, for inviting me to co-facilitate the World Café Dialogue that I am discussing in this article. I am also thankful to Ajla Aljic, joint degree student at Creighton University Werner Institute and School of Law, for her assistance with citations and references. Peace and Conflict Studies PCS (Spring 2014) 21(1), pp. 49-68 PCS Webpage: http://shss.nova.edu.pcs