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The Samurai physician. Negotiation styles for informed consent and conflict mediation
  • Virginia Recchia,
  • Antonio Dodaro
Virginia Recchia
CNR-IFC National Research Council-Institute of Clinical Physiology

Corresponding Author:recchia@ifc.cnr.it

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Antonio Dodaro
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Abstract

Nowadays, patient-centred practice represents the key for quality and successful outcomes in healthcare. At the same time, shared decision-making is acknowledged as the highlight of patient-centred care. Informed consent, whenever derives appropriately from a two-way communication between doctor and patient, follows a negotiation process that leads to appropriate and shared decisions. This article aims to show how the typical negotiating styles can lead or not to effective informed consent and conflict mediation processes. To this end, the three negotiating styles currently theorized (sharks, saints, and samurai) are integrated into the three clinical models of doctor-patient interaction (paternalistic, interpretative and autonomist). Currently, being any paternalistic attitude disapproved both ethically and legally, the model of autonomy is the only suitable one to communicate effectively. A concrete case from cardiology is reported to show the different negotiation styles within a doctor-patient conversation. Upstream, drawing inspiration from the samurai negotiating style, the doctor could find a new approach to effective informed consent. Downstream, during mediation, he/she could recompose all those conflicts that stem from an unsatisfying relationship with the patient. These results suggest, finally, that the physicians should be aware of their own prevalent negotiating style and of how to improve it if necessary.