Decision-making models for multidisciplinary health care teams:from informed concent to conflict resolution

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  • チーム医療における意思決定モデルーインフォームド・コンセントからコンフリクト・レゾリューションへ－
  • チーム イリョウ ニ オケル イシ ケッテイ モデル : インフォームド ・ コンセント カラ コンフリクト ・ レゾリューション エ

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"Informed consent" has been introduced to respect the autonomy and rights of patients in order to overcome paternalism. However, when some patients are indecisive and cannot make any decisions, we cannot help returning to, and depending upon, paternalism. On the other hand, a health care professional must work in collaboration with others in the multidisciplinary care team. However, it is sometimes difficult to build consensus among different professionals. The aim of this paper is to present a decision-making model that is able to resolve our two problems raised above by examining the two main decision-making models in the curriculum of nursing ethics education not only in Japan, but also worldwide (i.e., Fry and Johnstone's four-step model, and Thompson and Thompson's ten-step model), and to provide a new model, Moore's conflict resolution model. In order to compare and examine the three models, we formulate our problems as follows: Problem A: What if health care team members cannot reach an agreement? Problem B: What if some members (especially patients) are so indecisive that they cannot reach any decision? The third model focuses on the original needs or "interests" of the people involved, and resolves the two problems above (Interest-based approach). Therefore, we can prove the superiority of the third model by answering the two problems.

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