Some of the most stressful times of our lives are spent dealing with our own and our loved ones’ medical emergencies or episodes of ill-health. Whether receiving bad news, spending prolonged periods in hospital, or having to make critical choices about care, our fear and upset can make it extremely difficult to contribute positively to healthcare decisions.

And, at this time, there is also a clear risk that families and healthcare professionals can come into conflict. And, when this happens, communication can break down, barriers are built up, and disputes can quickly develop and worsen.

The key to minimising this risk is the quality and regularity of communication between all parties involved. And, despite everyone’s best intentions, conversations can and do go wrong for many reasons, including:

• High expectations
Based on good feedback they’ve heard, what they’ve seen on social media, or what they’ve found on Google, people may have high, and sometimes unrealistic, expectations of what can be achieved. For example, if they see that someone with a similar diagnosis has been completely cured, they may expect the same for themselves or their loved one.

• Technological advances
With the kinds of technologies involved in medical diagnosis, there is a lot of pressure on clinicians to explain and interpret highly complex ideas to people who aren’t trained in these matters. This can lead to misinterpretations and miscommunications, not to mention potential mistrust towards the professional.

• Uncertain future
Decisions regarding the benefits and burdens of ongoing intensive care, especially in the context of scarce resources, are almost impossible to make, even without the necessity of asking parents and relatives agree to them. Often the ‘more treatment’ option will be chosen because of this difficulty.

• Ethical questions
Care decisions can also be strongly influenced by people’s religious and cultural backgrounds. And, in cases of very sick children, the decisions made in the child’s best interests may go against the deeply-held wishes of the parents.