Conflict management by physicians: A heavy hand in preference-sensitive decisions

Conflict implies opposing forces. In the healthcare setting, patients, their family members, and physicians are ideally aligned in promoting patients’ well-being. Therefore, conflicts that arise between physicians and patients or family members regarding patients’ goals of care constitute failures of therapeutic alliance, communication, or the shared decision-making model. In the intensive care unit (ICU), these conflicts may be due, in large part, to lack of agreement on information underlying preference-sensitive decision-making, such as whether family members accept the prognostic estimates provided by physicians, inadequate understanding of the patient’s medical condition or the risks and benefits of therapies, or physicians’ ability to communicate this information effectively.