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Conflict Resolution in the Clinical Setting: A Story Beyond Bioethics Mediation

Published online by Cambridge University Press:  01 January 2021

Haavi Morreim
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Extract

Rarely do ethics consults focus on genuine moral puzzlement in which people collectively wonder what is the right thing to do. Far more often, consults are about conflict. Each side knows quite well what is “right.” The problem is that the other side is too blind or stubborn to recognize it. And so the ethics consultant is called, perhaps in the hope that s/he will throw the weight of ethics toward one side and end the controversy so everyone can get on with other business.

Perhaps the greater problem in these scenarios is that even if one side “wins” by gaining the power to dictate what happens next, the toxicity permeating the relationships often markedly worsens and other conflicts erupt, major and minor.

Type
Independent
Information
Journal of Law, Medicine & Ethics , Volume 43 , Issue 4 , Winter 2015 , pp. 843 - 856
Copyright
Copyright © American Society of Law, Medicine and Ethics 2015

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References

In many scenarios requesting a consult, although some options may be clearly ruled out, the contest appears to be between options that cannot be decisively defended or defeated on rational or empirical grounds. One side, e.g., says the tiniest chance for survival must be pursued at all costs, while the other insists that some qualities of life are worse than death. See Morreim, E. H., “Moral Distress and Prospects for Closure,” American Journal of Bioethics 15, no. 1 (2015): 38–40. Engelhardt described such situations long ago: No single viewpoint can definitively command the moral high ground, and so our challenge is to resolve the conflict procedurally or, as he put it, without resort to force. Engelhardt, T., The Foundations of Bioethics, 2nd ed. (New York: Oxford University Press, 1996). See also Bergman, E., “Surmounting Elusive Barriers: The Case for Bioethics Mediation,” Journal of Clinical Ethics 24, no. 1 (2013): 11–24; Fiester, A., “Ill-Placed Democracy: Ethics Consultations and the Moral Status of Voting,” Journal of Clinical Ethics 22, no. 4 (2011): 363–72.Google Scholar
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As a “Rule-31 listed mediator” in the state of Tennessee I have the opportunity to provide mediations on a regular basis for local courts, and have particularly focused on civil cases in which family have sued family over real estate, unpaid debt, return of property and the like. The emotional intensity of these cases is often comparable to that found in healthcare, and thus provides the kinds of opportunities described.Google Scholar
Advanced training in healthcare mediation is offered, e.g., by the Center for Conflict Resolution in Healthcare LLC (www.healthcare-mediation.net; last visited December 8, 2015), American Health Lawyers Association (healthlawyers.org), and the Penn Department of Medical Ethics (http://medicalethics.med.upenn.edu; last visited December 8, 2015).Google Scholar