Peace and Conflict Studies - Spring 2014

Peace and Conflict Studies Volume 21, Number 1 59 Even more worrisome is the fact that most of the approaches to teach cultural competency ignore the relationship between cultural differences and inequities; by focusing on individual attitudes they ignore the source of inequality by keeping the “focus off structures, institutions, and governmental policies” (Wear, 2003, p. 551). In short, power differentials are ignored. As Kritek (2002) has pointed out “if you take the time to evaluate an uneven table, you can usually find what is missing—what dimensions of the conflict are being treated as if they simply did not exist” (p. 274). I posit that dialogue processes, such as World Café, are better equipped to unveil these unequal power structures. These invisible power structures become visible in World Cafés through deep listening and conversations about dying that take place among a diverse group of people (diversity in professional backgrounds and cultures). Once participants’ “blindfolds” are lifted they can name the injustices and address them. The structural inequities that lead to unequal treatment are so complex that they must be addressed through “deliberative and collaborative actions” from diverse sectors (Beadle, 2011, p. S17). The World Café is an excellent process for these deliberative and collaborative actions to take place. Beyond Bioethics Mediation: World Café When it comes to end-of-life conflict, conflict practitioners have limited their interventions, for the most part, to bioethics mediation. Bioethics mediation addresses conflicts that arise in a clinical healthcare context regarding the “proper” or “appropriate” plan regarding future goals of care (Bergman, 2013; Dubler, 2011). The main exponents and pioneers of bioethics mediation are Nancy N. Dubler and Carol B. Liebman (2004, 2011). Their model, which started in the 1990’s at Montefiore Medical Center in the Bronx, is based on a problem-solving mediation style and is framed within a principle-based approach or principlism. A principled-based-approach to mediation visualizes principles as the essence of moral reasoning and has been the dominant discourse in Western bioethics for the last forty years (Beauchamp & Childress, 2001; McCarthy, 2003). In the context of bioethics mediation, “a principled resolution is a consensus that identifies a plan that falls within clearly accepted ethical principles, legal stipulations, and moral rules defined by ethical discourse, legislatures, and courts, and that facilitates a clear plan for future intervention” (Dubler & Liebman, 2004, p, 14). Within the bioethics mediation model as applied by Dubler and Liebman (2004) the four ethical principles are patient autonomy, beneficence, nonmaleficence, and distributive justice. Patient autonomy is the center of the decision