title: Contentious Conversations: Using Mediation Techniques in Difficult Clinical Ethics Consultations.
abstract: Mediators utilize a wide range of skills in the process of facilitating dialogue and resolving conflicts. Among the most useful techniques for clinical ethics consultants (CECs)-and surely the least discussed-are those employed in acrimonious, hostile conversations between stakeholders. In the context of clinical ethics disputes or other bedside conflicts, good mediation skills can reverse the negative interactions that have prevented the creation of workable treatment plans or ethical consensus. This essay lays out the central framework mediators use in distinguishing positions from interests and describes a set of strategies for managing contentious ethics consultations or working with "difficult" patients, families, or patient-careprovider interactions.
authors.affiliation: 3401 Market St., Suite 320, Philadelphia, Pennsylvania 19104 USA. fiester@upenn.edu.
authors.forename: Autumn
authors.initials: A
authors.lastname: Fiester
mesh_terms: D000368:Aged; D000786:Anger; D002755:Choice Behavior / Q000941:ethics*; D000066491:Clinical Decision-Making / Q000941:ethics; D003142:Communication; D016265:Conflict of Interest; D003657:Decision Making / Q000941:ethics; D034462:Dissent and Disputes; D004644:Emotions; D033061:Ethics Consultation / Q000941:ethics / Q000592:standards / Q000639:trends; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications; D008297:Male; D018447:Medical Futility / Q000941:ethics*; D017008:Negotiating / Q000379:methods*; D009679:Nuclear Family; D018802:Patient-Centered Care / Q000941:ethics* / Q000379:methods; D019727:Proxy; D006435:Renal Dialysis / Q000941:ethics*; D051437:Renal Insufficiency / Q000628:therapy; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000628:therapy; D018454:Spouses; D035502:Trust