The Samurai physician. Negotiation styles for informed consent and
conflict mediation
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.