Physicians often assume that conflict is undesirable and destructive,
yet conflict handled well can be productive, and the clarity that results
can lead to clearer decision making and greater family, patient, and clinician
satisfaction. We review the course of Mrs B, an 84-year-old woman with advanced
dementia and an advance directive stating no artificial hydration or nutrition.
Over the course of her illness, her family and physicians had conflicting
opinions about the use of short-term tube feeding and intravenous hydration
in her care. We describe the conflicts that arose between her physicians and
family and a typology of conflicts common in care of patients who are seriously
ill (family vs team, team member vs team member). Drawing from the business,
psychology, and mediation literature, we describe useful communication tools
and common pitfalls. We outline a step-wise approach that physicians can use
to deal with conflicts and the use of treatment trials as a strategy to address
conflicts about the use of life-sustaining medical interventions.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 44
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.