What is the best way to handle conflicts between your values and those of a patient?

In my experience, once I have given them all the information I have for my preferences and advise about their care, I have to let go of what I think is best for them because actually I don’t know that. I can just listen to what they want to do and how they want to move forward and do my best to assist them if I can.

Start by actively listening to the patient's values, beliefs, and preferences. Understand their perspective and what matters most to them. Encourage open communication to gain insight into their concerns. Approach the patient with an open and non-judgmental attitude. Create a safe space for them to express their thoughts and concerns without fear of criticism. Practice empathy by trying to understand the emotional and cultural context of the patient's values. Put yourself in their shoes to appreciate their feelings and experiences.

Determine first whether there is in fact a conflict. Often we are speaking about the same thing/s but we define or interpret them in different ways.

Elwyn G, Price A, Franco JVA, Gulbrandsen P. The limits of shared decision making. BMJ Evid Based Med. 2022 Dec 15 10.1136/bmjebm-2022-112089

When dealing with conflicts between your values and those of a patient, it's important to respect their beliefs and communicate openly. Strive to understand their perspective and work collaboratively to find a solution that respects both your values and the patient's autonomy. If needed, seek guidance from a supervisor or ethics committee.

Patients have the right to make choices about their health within legal and ethical boundaries. Respecting autonomy is at the core of patient-centred care, prioritising the patient's values, preferences, and choices. Healthcare providers should involve patients in decision-making processes and offer choices whenever possible. While respecting autonomy, also consider the principles of beneficence (doing good) and non-maleficence (doing no harm). Please make sure that the patient's choices align with their best interests and safety. Maintain an ongoing and collaborative relationship with the patient.

Human diversity remains a constant. Furthermore, nowadays, the widespread availability of medical information via digital platforms significantly shapes and easily sparks conflicts during the healthcare delivery process. Drawing from my experience, a successful and engaging patient-pharmacist interaction involves prioritizing active listening and effective communication. This approach can alleviate tension arising from conflicts, enhance rapport, identify the most appropriate decisions/options, promote adherence, and ultimately enhance the overall patient experience.

Here are some common questions I'd pose while supervising new therapists Why is the difference in value or belief important to you? Is this conflict relevant to the problem or situation that brought them to you? How can the value or belief inform the treatment plan? Does this conflict prevent you from providing care to this individual? What came forward for you... a specific situation, a person? What was your internal response... feelings, judgements, assumptions? As professionals, we come in contact with all sorts of folks. It's important to check yourself regularly so that you know yourself when faced with these types of situations and don't hesitate to seek supervision. You can learn so much from people that are different than you.

All the above feels a little academic and unrealistic. Many of us find ourselves in work environments where there is little time for such discussion either externally or internally. For many clinicians the conflict isn’t with the patient/parent and their wishes, it is with the job they want to do and the job their employers pay them to do. The reality with long waiting lists, poor staffing and limited resources we are at such a basic level of Maslow s Law.