{"title":"作为冲突管理工具的 \"推论阶梯\":在医疗伦理咨询中与 \"难缠 \"的病人或家属合作。","authors":"Autumn Fiester","doi":"10.1007/s10730-022-09476-w","DOIUrl":null,"url":null,"abstract":"<p><p>Conflict resolution is a core component of healthcare ethics consultation (HEC) and proficiency in this skill set is recognized by the national bioethics organization and its HEC certification process. Difficult interpersonal interactions between the clinical team and patients or their families are often inexorably connected to the normative disputes that are the catalyst for the consult. Ethics consultants are often required to navigate challenging dynamics that have become entrenched and work with patient-provider or family-provider relationships that have already broken down. The first step in conflict resolution is diagnosing the source of the conflict. Because so many interpersonal and normative conflicts rest on misunderstanding and mischaracterization, the diagnosis of the problem requires untangling the actual positions and perspectives of the conflicting parties from the fallacious assumptions made about the parties' respective positions and views. Developed in management science, the Ladder of Inference (LOI) is a diagnostic tool for assisting stakeholders in re-examining the process they used to form beliefs about others involved in the conflict. The LOI is a device that detects errors in reasoning, including implicit racial bias, that lead to false judgments and counterproductive responses to those judgments. The LOI is an instrument that can be used by ethics consultants to help resolve contentious bedside conflicts, but the LOI can also be employed as a teaching tool used by healthcare ethics consultants in training the clinical staff in how to avoid such conflicts in the first place.</p>","PeriodicalId":19614,"journal":{"name":"Origins of Life and Evolution of Biospheres","volume":"19 1","pages":"31-44"},"PeriodicalIF":1.9000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The \\\"Ladder of Inference\\\" as a Conflict Management Tool: Working with the \\\"Difficult\\\" Patient or Family in Healthcare Ethics Consultations.\",\"authors\":\"Autumn Fiester\",\"doi\":\"10.1007/s10730-022-09476-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Conflict resolution is a core component of healthcare ethics consultation (HEC) and proficiency in this skill set is recognized by the national bioethics organization and its HEC certification process. Difficult interpersonal interactions between the clinical team and patients or their families are often inexorably connected to the normative disputes that are the catalyst for the consult. Ethics consultants are often required to navigate challenging dynamics that have become entrenched and work with patient-provider or family-provider relationships that have already broken down. The first step in conflict resolution is diagnosing the source of the conflict. Because so many interpersonal and normative conflicts rest on misunderstanding and mischaracterization, the diagnosis of the problem requires untangling the actual positions and perspectives of the conflicting parties from the fallacious assumptions made about the parties' respective positions and views. Developed in management science, the Ladder of Inference (LOI) is a diagnostic tool for assisting stakeholders in re-examining the process they used to form beliefs about others involved in the conflict. The LOI is a device that detects errors in reasoning, including implicit racial bias, that lead to false judgments and counterproductive responses to those judgments. The LOI is an instrument that can be used by ethics consultants to help resolve contentious bedside conflicts, but the LOI can also be employed as a teaching tool used by healthcare ethics consultants in training the clinical staff in how to avoid such conflicts in the first place.</p>\",\"PeriodicalId\":19614,\"journal\":{\"name\":\"Origins of Life and Evolution of Biospheres\",\"volume\":\"19 1\",\"pages\":\"31-44\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Origins of Life and Evolution of Biospheres\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10730-022-09476-w\",\"RegionNum\":4,\"RegionCategory\":\"物理与天体物理\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/4/18 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"BIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Origins of Life and Evolution of Biospheres","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10730-022-09476-w","RegionNum":4,"RegionCategory":"物理与天体物理","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/4/18 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"BIOLOGY","Score":null,"Total":0}
The "Ladder of Inference" as a Conflict Management Tool: Working with the "Difficult" Patient or Family in Healthcare Ethics Consultations.
Conflict resolution is a core component of healthcare ethics consultation (HEC) and proficiency in this skill set is recognized by the national bioethics organization and its HEC certification process. Difficult interpersonal interactions between the clinical team and patients or their families are often inexorably connected to the normative disputes that are the catalyst for the consult. Ethics consultants are often required to navigate challenging dynamics that have become entrenched and work with patient-provider or family-provider relationships that have already broken down. The first step in conflict resolution is diagnosing the source of the conflict. Because so many interpersonal and normative conflicts rest on misunderstanding and mischaracterization, the diagnosis of the problem requires untangling the actual positions and perspectives of the conflicting parties from the fallacious assumptions made about the parties' respective positions and views. Developed in management science, the Ladder of Inference (LOI) is a diagnostic tool for assisting stakeholders in re-examining the process they used to form beliefs about others involved in the conflict. The LOI is a device that detects errors in reasoning, including implicit racial bias, that lead to false judgments and counterproductive responses to those judgments. The LOI is an instrument that can be used by ethics consultants to help resolve contentious bedside conflicts, but the LOI can also be employed as a teaching tool used by healthcare ethics consultants in training the clinical staff in how to avoid such conflicts in the first place.
期刊介绍:
The subject of the origin and early evolution of life is an inseparable part of the general discipline of Astrobiology. The journal Origins of Life and Evolution of Biospheres places special importance on the interconnection as well as the interdisciplinary nature of these fields, as is reflected in its subject coverage. While any scientific study which contributes to our understanding of the origins, evolution and distribution of life in the Universe is suitable for inclusion in the journal, some examples of important areas of interest are: prebiotic chemistry and the nature of Earth''s early environment, self-replicating and self-organizing systems, the theory of the RNA world and of other possible precursor systems, and the problem of the origin of the genetic code. Early evolution of life - as revealed by such techniques as the elucidation of biochemical pathways, molecular phylogeny, the study of Precambrian sediments and fossils and of major innovations in microbial evolution - forms a second focus. As a larger and more general context for these areas, Astrobiology refers to the origin and evolution of life in a cosmic setting, and includes interstellar chemistry, planetary atmospheres and habitable zones, the organic chemistry of comets, meteorites, asteroids and other small bodies, biological adaptation to extreme environments, life detection and related areas. Experimental papers, theoretical articles and authorative literature reviews are all appropriate forms for submission to the journal. In the coming years, Astrobiology will play an even greater role in defining the journal''s coverage and keeping Origins of Life and Evolution of Biospheres well-placed in this growing interdisciplinary field.