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ARTICLE:
David M. Studdert, Jeffrey P. Burns, Michelle M. Mello, Ann Louise Puopolo, Robert D. Truog, and Troyen A. Brennan
Nature of Conflict in the Care of Pediatric Intensive Care Patients With Prolonged Stay
Pediatrics 2003; 112: 553-558 [Abstract] [Full text] [PDF]
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[Read eLetters] One-sided View of Conflict
Avrum L Katcher   (11 October 2003)

One-sided View of Conflict 11 October 2003
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Avrum L Katcher,
Pediatrician`
Robert Wood Johnson Medical School

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Re: One-sided View of Conflict

estelleavrumk{at}blast.net Avrum L Katcher

Studdert et al have surveyed how professionals at Boston Children's Hospitals recognize and describe perceived conflicts, both among professionals, between families and professionals, and within families, with reference to patients in the ICU. This group does not report similar information about conflicts recognized and perceived by families. Thus, they report a very one-sided point of view. Residents of the Boston area (I am not one) will be familiar with a series of articles in the Boston Globe providing strong evidence that families see their relationship with staff at the hospital in question, and the care given to their children, very differently from staff. It is surprising that Studdert's group has not included information from families in their report. Perhaps examination of the conceptual structures within which they coded their data indicates a certain bias. For example, they include under the heading of poor communication such items as language related barriers and family problems comprehending prognosis, but have no heading for staff inability to understand family point of view, to mention just one of the several difficulties reported in the Boston Globe. I could go on, but it is sufficient to conclude that Studdert et al could have prepared a distinguished report on the nature of conflict in the ICU had they opened both their mental horizons and their data gathering methods. They failed to do both.