• 作者：B. Herreros^a ; ^&diams ; ; ^{benjaminherreros@gmail.com} ; G. Garcí ; a Casasola^b ; ^&diams ; ; E. Pintor^c ; M.Á ; . Sá ; nchez^d
• 关键词：Conflicto ; Bioé ; tica ; Urgencias
• 刊名：Revista Cl铆nica Espa帽ola
• 出版年：2010
• 期刊代码：pca307_00142565
• 类别：med
• 出版时间：September 2010
• 卷：210
• 期：8
• 页码：404-409
• 文件大小：167 K

A conflictive patient is one who provokes a problem (a conflict) by their attitude or behavior for the physician. Ethical conflicts in emergency care are common and many of them occur with these patients. Among the most common types of patients who generate personal conflicts with health professionals are overly demanding patients, those who refuse medical interventions, those who are aggressive, litigators, excessively-recurrent users of the heath system and those who go to the emergency room without an urgent condition. A patient may include several of these profiles (鈥渕ixed鈥?patient). When they appear, the approach should be, if possible, by a team, establishing a deliberative process. If there is doubt and when possible, the ethics committee of the institution should be consulted, seeking the protocols, this best being institutional, on the subject. After that, if the decision is difficult, support must be sought from the emergency staff and even management. The whole process should be reflected in the clinical history. Specific education in bioethics and communication skills can be of great help to minimize and cope better with long-term conflicts.