The Role of Mediation in Healthcare: A Path to Conflict Resolution and Improved Outcomes

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Healthcare Organizations, Systems, and Providers".

Deadline for manuscript submissions: 27 September 2026 | Viewed by 2827

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Guest Editor
Department of Social Medicine and Public Health, Faculty of Public Health, Medical University of Plovdiv, 4002 Plovdiv, Bulgaria
Interests: mediation; bioethics; epidemiological registries

Special Issue Information

Dear Colleagues,

It is well known that healthcare professionals are currently facing significant challenges in communicating with patients due to advancing technologies and increasing patient expectations. Inadequately managed conflicts can have a negative impact on all stakeholders, including healthcare facilities (through legal costs, staff turnover, and reduced productivity), staff (due to burnout, the deterioration of team relationships, and lower productivity), and patients (through medical errors, the deterioration of doctor–patient relationships, worse health outcomes, and a loss of trust in healthcare systems).

Mediation is one of the most important and successful methods of alternative resolution in such conflicts. It is a voluntary, flexible, and confidential process in which a third party (the mediator) aids the parties involved in the dispute in reaching a consensus without intervention by the court. The main role of the mediator is to help the parties clarify their positions, build their trust to enable them to discuss their problems, and lead the conversation toward resolving the conflict and reaching a consensus.

There are numerous reasons for using mediation in the healthcare sector: it is emotionally gentle and less expensive; it takes significantly less time to resolve disputes; it allows more open communication between the parties involved; and its flexibility makes it suitable for the dynamic, complex, and emotional nature of medical disputes. The most important requirements for patients during a conflict—an explanation of what happened, an apology from the doctor, information on how such situations will be avoided in the future, compensation that satisfies the affected patient, etc.—can be achieved through mediation, thus restoring patients’ trust and guaranteeing the best treatment results based on respectful physician–patient collaboration.

We are pleased to invite you to submit your articles exploring the benefits of mediation.

This Special Issue will focus on applications of mediation in the field of healthcare. Original research articles and reviews are welcome, and research areas may include (but are not limited to) the following:

  • Cases where mediation is applied to achieve out-of-court settlements;
  • Studies on the practical benefits of applying mediation in the healthcare sector;
  • Studies revealing stakeholder options regarding the application of mediation;
  • Studies on the factors leading to the need for mediation;
  • Review articles related to good practice in applying mediation.

I look forward to receiving your contributions.

Dr. Tsonka Miteva-Katrandzhieva
Guest Editor

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Keywords

  • mediation
  • alternative conflict resolution
  • physician–patient agreement
  • patient care improvement

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Published Papers (2 papers)

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Research

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14 pages, 2327 KB  
Article
Attitudinal Profiles Toward Medical Mediation Among Healthcare Professionals: Evidence from a Scenario-Based Survey and Latent Class Analysis
by Olympia Lioupi, Polychronis Kostoulas, Konstadina Griva, Charalambos Billinis and Costas Tsiamis
Healthcare 2026, 14(6), 710; https://doi.org/10.3390/healthcare14060710 - 11 Mar 2026
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Abstract
Medical mediation (MM) is a collaborative tool for resolving ethically complex disputes in healthcare. Background/Objectives: Though widely recognized in international clinical ethics, it has only been recently introduced in Greece. The objective of this study was (i) to quantify agreement with MM [...] Read more.
Medical mediation (MM) is a collaborative tool for resolving ethically complex disputes in healthcare. Background/Objectives: Though widely recognized in international clinical ethics, it has only been recently introduced in Greece. The objective of this study was (i) to quantify agreement with MM across three clinical scenarios, (ii) to estimate the proportion of professionals that support mediation and institutional training, and (iii) to identify distinct attitudinal profiles using latent class analysis (LCA). Methods: A structured, cross-sectional online questionnaire was completed by 431 healthcare professionals across Greece. The survey included three clinical vignettes (on (1) end-of-life care, (2) religious refusal of treatment, and (3) medical error disclosure), Likert-scale items on attitudes toward mediation, and demographic information. LCA was used to identify patterns of response across the scenarios and differentiate between strongly supportive, moderately supportive, and cautiously positive professional profiles. Results: Participants expressed strong support for mediation across all scenarios (median scores ≥ 9), with the highest support for medical error disclosure (mean 8.67 ± 2.10 and a median of 10). Most participants (97.2%, n = 419) considered mediation at least sometimes effective, and 80.7% (n = 348) endorsed institutional training. However, only 3.0% (n = 13) reported formal training and 1.9% (n = 8) reported being very familiar with MM. LCA revealed three distinct respondent profiles: strongly supportive (73.3%, n = 316), moderately supportive (14.6%, n = 63), and cautiously positive (12.1%, n = 52). Significant trends were observed across profiles for the perceived effectiveness of mediation and support for institutional training (p < 0.01). However, formal training and familiarity with mediation among the participants were low (<5%). Conclusions: Despite limited training and formal implementation, Greek healthcare professionals show high support for MM. The demand and need for structured mediation training and integration into the Greek healthcare system is strong. The identification of distinct attitudinal profiles provides insight into potential variation in organizational readiness for implementing structured mediation training Full article
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16 pages, 1066 KB  
Systematic Review
Applications of Medical Mediation: A Systematic Review of Its Role in Healthcare Dispute Resolution and Bioethical Decision-Making
by Olympia Lioupi, Polychronis Kostoulas, Konstadina Griva, Charalambos Billinis and Costas Tsiamis
Healthcare 2025, 13(24), 3235; https://doi.org/10.3390/healthcare13243235 - 10 Dec 2025
Cited by 3 | Viewed by 1580
Abstract
Background: Medical mediation offers a patient-centered, collaborative alternative to traditional resolution methods for healthcare conflicts that is gaining international traction in an increasingly complex environment of advancing technology and diverse patient populations. This systematic review aims to synthesize the literature on medical [...] Read more.
Background: Medical mediation offers a patient-centered, collaborative alternative to traditional resolution methods for healthcare conflicts that is gaining international traction in an increasingly complex environment of advancing technology and diverse patient populations. This systematic review aims to synthesize the literature on medical mediation and analyze its clinical applications, conflict typologies, involved actors, mediation methodologies, legal frameworks, and theoretical underpinnings. Methods: A systematic search was conducted in PubMed and Scopus for English-language articles published between 1984 and 2025. Results: Of 656 initial records, 152 studies met the inclusion criteria and were categorized across six domains: clinical context, actors involved, conflict type, mediation framework, legal/policy structure, and theoretical foundations. Most studies originated from high-income countries, particularly the U.S. and U.K., with notable expansion after 2010. Medical mediation was most frequently applied in bedside care, end-of-life decision-making, and managed-care disputes. While ethics consultants were the primary mediators, increasing involvement of trained clinicians and institutional actors was also observed. Most studies emphasized generic bioethical mediation frameworks, with some focused on formalized models and training. Legal frameworks varied, and an increasing number of countries have been adopting institutional or national programs to support mediation. Conclusions: Medical mediation is an efficient tool for resolving complex clinical conflicts, enhancing communication, and preserving therapeutic relationships. Its institutionalization, through law and training, is key to the promotion of justice, transparency, and ethical integrity in modern healthcare systems. Full article
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