Healthcare Conflict Resolution Case Scenario

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.