title: Intensive Care, Intense Conflict: A Balanced Approach.
abstract: Caring for a child in a pediatric intensive care unit is emotionally and physically challenging and often leads to conflict. Skilled mediators may not always be available to aid in conflict resolution. Careproviders at all levels of training are responsible for managing difficult conversations with families and can often prevent escalation of conflict. Bioethics mediators have acknowledged the important contribution of mediation training in improving clinicians' skills in conflict management. Familiarizing careproviders with basic mediation techniques is an important step towards preventing escalation of conflict. While training in effective communication is crucial, a sense of fairness and justice that may only come with the introduction of a skilled, neutral third party is equally important. For intense conflict, we advocate for early recognition, comfort, and preparedness through training of clinicians in de-escalation and optimal communication, along with the use of more formally trained third-party mediators, as required.
authors.affiliation: Northwestern University, Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 73, Chicago, Illinois 60611 USA. Erin.talati@northwestern.edu.
authors.forename: Erin Talati
authors.initials: ET
authors.lastname: Paquette
authors.affiliation: Northwestern University, Feinberg School of Medicine, Department of Pediatrics, Division of Hospital Based Medicine, 225 East Chicago Avenue, Box 73, Chicago, Illinois 60611 USA. ikolaitis@luriechildrens.org.
authors.forename: Irini N
authors.initials: IN
authors.lastname: Kolaitis
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D001926:Brain Death / Q000175:diagnosis*; D002543:Cerebral Hemorrhage / Q000601:surgery; D002675:Child, Preschool; D000066491:Clinical Decision-Making / Q000941:ethics*; D003142:Communication; D003220:Conflict, Psychological; D003422:Critical Care / Q000941:ethics*; D034462:Dissent and Disputes; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D017008:Negotiating; D014474:Unconsciousness