Defending Dubler’s Legacy: Relocating the Role of Conflict Management from the Ethics Consultation Service to Patient and Guest Relations

AbstractNancy Dubler pioneered "bioethics mediation" as a method of clinical ethics consultation (CEC), arguing that "bioethics consultation is largely, although not entirely, a matter of conflict resolution." By the time she published the second edition of Bioethics Mediation in 2011, she had garnered significant support for the idea that mediation had an important role to play in CEC. But in the intervening decade and a half, a new generation of CEC thought leaders have emerged, and there is clear evidence that, for them, conflict management has very little to do with the practice of CEC. Today, there are not only just a small proportion of ethics consultants (ECs) trained in mediation skills but also only a small proportion of ECs who view such skills as essential to the practice of CEC. Yet conflict among patients, families, and healthcare providers remains a significant problem in U.S. healthcare institutions. The new trends in CEC make it unlikely that ethics will be the locus for the conflict management services hospitals need; therefore, I will argue that it is time to transfer the mediator role from ethics to the newly emerging Patient and Guest Relations departments. I believe that this offers the best prospects for defending Dubler's legacy.