Procedures Unique to Bioethics Mediation
As bioethics mediation is a unique form of family mediation, Waldman (2014) has outlined tasks
that bioethics mediators must perform prior to mediation. First, the mediator must review the
patient's medical chart and meet with the healthcare team to gather relevant medical facts and
learn about the treatment recommendations. At this time, the mediator should determine if there
are any disagreements among the healthcare team regarding the recommendations. The
mediator can also bring in additional medical experts and other outside support to help support
them and the family.
The healthcare team can also help the mediator understand any psychological or capacity
concerns regarding the patient. In addition, Waldman (2014) suggest the mediator must review
the case history and ask the following questions:
• Has this patient been in and out of healthcare institutions for the past several years?
• Who has been the primary family contact throughout this period?
• Is there a clinician who has a long-term relationship with this patient and could shed
light on her social and clinical history?
•Have there been any seminal events that have shaped the parties' expectations and
may be contributing to the current conflict?
The mediator should also learn which family members have actively participated in the patient's
care and who plans to participate in the mediation. They should also seek to gain insight into the
family dynamics. Lastly, the mediator should meet with the patient and family to determine their
level of understanding about the patient's medical condition and prognosis (Waldman, 2014).
At the start of mediation, Waldman (2014) further suggests that the mediator must clarify the
medical information and establish legal and ethical norms of bioethics mediation. The
healthcare team plays an essential role by providing detailed information about the benefits,
limitations, and drawbacks of the advanced medical treatment available during the patient's
end-of-life care. Family members and the patient often have an incomplete understanding of the
medical condition and treatment options. A review of medical facts in language understandable
to the patient and family is necessary. In addition, it must be emphasized that a medical
prognosis is a matter of probabilities. There is no guarantee that treatment will extend the
patient's life. Any effort to predict how treatment will work, what capacities the patient will gain or
retain, and how much physical suffering lies in wait are all speculative. Some medical concepts
are more difficult to comprehend by families. For example, in end-of-life cases, one issue that
may arise is the concept of brain death.
Thank you for your continued interest in this series of blog postings on Bioethical Mediation. The next blog will discuss further the difficulty of family interaction in the case of diagnosed brain death.
Michele M. Davda has a B.S in Psychology and an M.S. in Neuroscience. She taught Biomedical Science
at the STEM secondary level for a decade. She is a member and committee member of the Montana Mediation Association (MTMA) and the Academy of Professional Family Mediators (APFM).
This blog is meant to promote and increase awareness of Mediation, as well as to discuss the role that Mediation plays in conflict resolution. This blog series does not provide legal, medical, or psychological advice, and it should not be taken as a substitute for professional advice or treatment.
Waldman, E. A. (2014, June 11). Bioethics mediation at the end of Life: Opportunities and limitations. SSRN. Retrieved October5, 2021, from https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2446758.