Background Conflicts, particularly between health care providers and families regarding end of life care are common.

Aim To provide a structured way to think about what causes these conflicts and the communication skills one might use to negotiate conflicts over treatment for seriously ill patients.

Results/Discussion To help structure, health providers’ thinking about these cases, a question, “Why is this loving and caring family making a decision that you think is unreasonable?” will be discussed. The talk with focus on the psychology and business literature on conflicts to posit three reasons for why conflicts occur: misunderstandings over what is happening; inattention to the feelings associated with these conflicts and rigid beliefs about one’s identity. A variety of communication skills – ranging from ASK-TELL-ASK, to “rolling with resistance” to responding empathically to emotions will be discussed to help negotiate these conflicts.

Conclusion A specific framework can help health care providers negotiate conflict with families over care at the end of life.