Essay on "Conflict Resolution in Healthcare"

Essay 5 pages (1763 words) Sources: 4 Style: APA

[EXCERPT] . . . .

Healthcare Conflict Resolution Case Scenario

Introduction:

Conflict cannot be avoided. It is a part of being human.

Disagreements or divergences of interest may emerge in a place of business,

amongst family members or even between two complete strangers on a subway

car. Though the possible contexts in which individuals or groups may find

themselves in conflict are infinitely ranging, we may nonetheless look to

the same path for resolution of nearly any scenario. Namely, just as

conflict in inherent, so too is the proclivity toward interpersonal

communication, an airing of divergent perspectives and a balanced

achievement of compromise. These are distinctive qualities of our species

which endows each of us with the tools to properly navigate through

conflict together. Conflict, speaking in a very general sense and in

specificity to only individuals or small groups (as opposed to conflict

which may develop between nations and whole ethnicities) arises when there

is a difference in desire, expectation or need between two parties, and

where this difference may result in a dichotomy of favorable and

unfavorable conditions for those involved. (Webne-Behrman, 1)

Bringing some semblance of balance in this difference is the purpose

of conflict resolution, though this process must first encounter some

distinctly human obstacles. To this end, such obstacles revolve around

intellectual, emotional and biological needs such as demonstrated by the

healthcare field. Complex and fraught with philosophical and practical

disagreement, the healthcare context induces the case scenario here

discussed, in which a patient in danger of death by pulmonary embolism has

declined an exploratory procedure which could reveal an avenue for

treatment. The scenario brings myriad ethical and practical considerations

to this account, which attempts to weigh the patient's desires and those

for the physician which must treat him.

C- Content- What Do We Want? What does each person want? What

does each party in your conflict want? Examine what each party's

wants are, and state them clearly.

There is a clear conflict of interest which pits the responsibilities

of the physician against the desire of the patient. The patient who

desires not to be treated has expressed a hopelessness and intent to allow

his illness to overtake him through neglect. By contrast, the physician

recognizes the prospects for treatment and has an incontrovertible

responsibility to do all within his power to treat the patient, to remove

the patient from suffering and to prolong his natural life.

In an important sense, this points to a fundamental debate in

healthcare concerning the so-called 'right to die.' The 'right to death'

movement, which has gained greater notoriety in recent decades than ever

before, is informed by the premise that it is within the Constitutional

body of rights for an individual to decide to terminate one's own life.

The purpose of this initiative has been to proliferate entitlement and

access, to those suffering from intractable pain or illness, to those that

might help them achieve death with comfort and dignity. Its supporters are

typically those aligned with civil liberties organizations such as the

ACLU. Likewise, many in the medical community view this is as a natural

right which should be accorded to all patients, fundamentally reflecting

one of the most basic freedoms regarding one's own life. (Young, 1)

Thus, in the current scenario, the conflict for the physician must

also consider this philosophical perspective, which appears to achieve some

consonance with the patient's desires. To what extent the physician's want

to provide observation and treatment may be said to trump the patient's

desire to forego the same is not ethically clear.

R-Relational- Who Are We to Each Other? What is our relationship? The

relationship you have is important, and determines how you might

decide to deal with the conflict. How interdependent are you? How

much influence do you have over one another? How do you want to be

treated versus how you are treated now?

According to the text by Marcus et al (1995), the decision in this

situation is not so simple even as a conflict to be resolved between the

desire of the patient and the priorities of the physician. There are far

more parties and interests to be considered. As Marcus et al delineate,

"health care work is accomplished via an intricately structured set of

relationships. Formal and informal rules determine who speaks to whom, who

makes what decisions, and who has what information. People are organized

and decisions are aligned in a cautiously defined order. The most

important or momentous information, person, or decision gets the uppermost

attention first, and the rest trails behind. This sequence is intended to

yield systematic decision making." (Marucs et al, 3)

This alludes to the idea that the relationship between attending

physician and patient is also a conduit for a host of other relationships.

These include the relationships associated with both the patient and the

physician, meaning that for the former, family members, friends and a

general support system will play into the decisions being made by the

healthcare facility and that for the latter, there is a connection to a

team of nurses and other attending specialists, to the healthcare facility

and to a broader healthcare system and medical community. Thus, in the

context of conflict over interests, these relationships form a network of

interested parties.

Ultimately, it can be said that the influence of the physician over

the patient can be a dominant force. In this case, the interdependence of

parties extends to the fact that the physician requires the patient's

consent in order to meet his professional and ethical responsibilities and

that the patient requires the physician's attention in order to be treated.

I- Identity- Who Am I In This Interaction? What are your identity needs?

Are you saving face in order to appear a certain way to others? Are

you acting out of self-interest or self-preservation? Who is the other

person or people in this interaction?

As for the physician's role in the interaction, it is not simply a

matter of the fulfillment of his ethical responsibilities but a desire to

protect his own interests which must realistically enter into the

discussion. Such is to say that the professional responsibility to attend

in all regards to a patient's condition with a push toward treatment and

cure runs directly contrary to the patient's desires. In this respect, the

patient has asked the doctor to make certain sacrifices in order to allow

him to go without treatment.

Even as the patient attends with an apparent certainty to the task of

avoiding treatment, the onus will fall upon the physician upon the

patient's death to answer to the healthcare system, the healthcare facility

and the family of the deceased. All of these constitute matters of

importance with respect to self-preservation.

P- Process- What Communication Process Will Be Used? How do you

handle this situation? What type of communication would be the best

way of dealing with this conflict? What creative solutions might there

be?

Marcus et al provide the discussion with some avenues for the

exploration of resolution, suggesting that "similarities in priorities can

be used to craft a settlement." (Marcus et al, 104) This should be a point

upon which the parties in question might move in the direction of a

decision here. The physician must take a lead in establishing his shared

priorities with the patient. Most particularly, it might be intuitive to

focus on the mutual desire of physician and patient to see that the patient

is removed from the state of sustained pain and suffering which he is

already undergoing or which he fears undergoing in the immediate future.

Marcus et al assert that "each party brings to the negotiation process

different purposes and priorities. Balancing the relative importance of

the issues what the negotiation process is all about. The frame is a

constructive negotiation tool when it guides the parties to understanding,

using, and adapting their differences and similarities." (Marcus et al,

104)

This is, of course, a deeply complex undertaking in the current

scenario, especially given the degree to which 'the relative importance of

the issues' might cause the dismissal of some of the physicians rationales

for his position. Namely, through such a frame, it becomes increasingly

less likely that the physician's responsibility to the healthcare facility

and to his Hippocratic Oath will register as having greater importance to

the patient than the patient's own degree of suffering and diminished

quality of life. Therefore, as the physician attempts to jockey the

important issues into a resolution, there becomes significantly less to be

gained in considering these priorities. Thought they serve as part of the

impetus for the position of the physician, they are categorically

irrelevant in the area of conflict resolution.

Instead, the greatest opportunity available to the physician is to be

found in an appeal to the relationships surrounding both he and the patient

and the establishment of common priorities through effective and empathetic

communication. As our studies have shown, the way people speak is equally

as important as what people say. To this… READ MORE

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