Management in Health, Vol 15, No 1 (2011)

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In recent years, conflicts between patients (or their family) and healthcare professionals and monetary compensations requested for an effective or presumed adverse event are continuously increasing. Conflicts are destructive, as both disputants are suffering: the doctor for the accusations he/she perceives as “unjust”, the patient (or their relatives) for the “harm” he/she attributes to low performance of the healthcare organization. Besides, they stop any communication with each other. The transformative mediation approach allows parties to meet and express those values, points of view and feelings which nourish their conflict, without any involvement of the judicial authority. This paper aims to describe the transformative mediation approach and to illustrate its potential in healthcare organizations, through selected case studies.


Transformative mediation is based on empowerment (parties are enabled to define their own issues and to seek solutions on their own) and mutual recognition (each party listens to and understands the other party’s point of view). The steps for the mediation process are: the individual meetings with the parties, the mediation meeting, and the follow-up post-mediation. During the individual and mediation meetings, mediators act as a “mirror” for the parties’ feelings (affective dimension of the conflict) and do not assess medical or technical details of the conflict (rational dimension of the conflict).

Case studies

Three conflicting situations between patient’s family and professionals from different healthcare organizations in northern Italy, in which a transformative mediation approach was proposed, are illustrated and analysed.


Successful mediation allows healthcare organizations build-up citizens’ trust and to preserve their good reputation and may reduce costs, when a damage request is expressed. Neutrality is a big challenge for mediators. Besides, there is always a lot of uncertainty in transformative mediation, as mediators have to cope with human subjectivity. Unfortunately, a number of disputants do not accept mediation, because they fear or dislike confrontation.


Keywords: healthcare organizations, conflict, empowerment, mutual recognition, transformative mediation

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Journal published by SNSPMS