The Perspective Puzzle: Utilizing Narrative for Conflict Navigation with Surrogate Decision-Makers

Abstract: Ethics consultations are frequently requested when conflicts arising between patients’ surrogate decision-makers and their medical teams increase in complexity. Sometimes puzzling and always stressful, such conflicts often result from divergent opinions about what medical choices would be in the patient’s best interest. These disagreements often develop from the differing perspectives surrogates and providers bring to their roles in a patient’s unique story. Focusing on the importance of the context surrounding a patient’s narrative and their personal identity can enable more effective application of conflict resolution skills to this type of patient care situation. A communicative framework with narrative elements that transforms conflict through perspective-taking is worthy of receiving broader discussion and application in the field.

This interdisciplinary panel will delineate the role that narrative and perspective play in these conflicts. Drawing on case examples, this session will help attendees put the pieces of this approach together to create customized, actionable strategies for conflict management using non-traditional approaches. The methods discussed will promote shared decision-making while affirming the validity of divergent perspectives. Techniques for successful conflict management using empathetic and emotionally-literate communication methods will be explicated.

The panel is comprised of professional Clinical Ethicists from a variety of backgrounds with experience addressing ethical issues across urban, suburban and rural hospitals in multiple states. They will specifically explain how to implement these techniques in cases involving vulnerable populations: patients with developmental disabilities, geriatric patients, patients with mental health issues, and patients under legal conservatorship.

Keywords: Conflict Resolution, Surrogate Decision-Making, Vulnerable Patients