Peace and Conflict Studies - Spring 2014

Peace and Conflict Studies Volume 21, Number 1 56 Abby’s situation. No clinician had the courage to give us a “what ifs?”[…] the approach impedes the notion of thinking about the longer-term consequences in any aspects of planning ‘whether planning is going home or planning is starting to confront that your child might die. (Dokken & Ahmann. 2006, p. 175) Acquiring scientific language, “although unsuited to dealing with internal mental events,” (Sinclair, 1997, p. 321) is seen as a necessary evil that allows physicians to be objective and emotionally detached so that they can make proper clinical judgments (Robichaud, 2003; Sinclair, 1997). Patients that are categorized as “incurable” are not worth taking care of (Becker, Geer, Hughes, & Strauss, 1977, pp. 316-317; Chapple, 2010). Physicians learn to limit their conversations with patients and families to “technical matters” (Anspach & Beeson, 2001, p.122; Lamus & Rosenbaum, 2012). Recent studies have shown that in spite of incorporating end-of-life care into the medical school “formal curriculum,” the “hidden curriculum” (including the trainee’s observations and what they are taught in their medical rounds) is to be emotionally detached and depersonalize the patient during their end- of-life care (Billings, Engelberg, Curtis, Block, & Sullivan, 2010). Structural and cultural violence are enabled and sustained by erasing and distorting the historical memory thereby allowing hegemonic accounts of “what happened and why” (Farmer, 2010, pp. 354-357). Therefore, it is not possible to have an honest dialogue about drug addiction among blacks without having a conversation about slavery, segregation, and discrimination in the United States (Farmer et al., 2006). As I will discuss later on, World Café is an appropriate process to facilitate authentic conversations about end-of-life that stimulate new ways of thinking and explore possibilities without ignoring the broader historic and current context in which healthcare disparities take place. Cross-cultural Competency Training (CCT) Culture has been extensively discussed in the academic literature across different disciplines and an in-depth discussion is beyond the scope of this article. However, since cultural differences are constantly (mis)used as “causes” of health disparity, I will provide a brief contextual discussion. When it comes to culture most scholars in the health care and conflict studies disciplines would agree that it is a set of behaviors, values, and customs that are common to a group of people and that they use to make meaning of the world they live in (e.g., Gregg & Saha, 2006; Mayer, 2012). Culture is about sense making. In his seminal work, Geertz (1973) describes culture as “webs of significance” that man has spun himself